County Obstetrics & Gynecology

County Obstetrics & Gynecology

(636)  680-1960

Pelvic Pain

In the case when pelvic pain becomes disruptive to your life at home or work, oraffects your relationship or social life, it should not be simply accepted as a normal part of being a woman.

There are many possible causes of pelvic pain, and at times it may be difficult to figure out the specific cause or causes. In many cases, pelvic pain indicates a problem with one or more of the organs in the pelvic area.

Pelvic pain can arise from your:

Reproductive Organs – uterus, ovaries, fallopian tubes, cervix, vagina, or the vulva.

Urinary Tract – Bladder (Interstitial cystitis/painful bladder syndrome)

Digestive System – Small or Large Intestine (irritable bowel, SIBO, spastic colon, or colitis)

We also have recognized that some pelvic pain, particularly chronic pelvic pain, can also arise from the structures of the pelvic floor:

Muscles and Connective Tissue (ligaments)- Organ prolapse

What type of pain are you experiencing?

The medical term for painful menstrual periods:  Dysmenorrhea

Women can experience painful cramps and lower abdominal discomfort with their monthly menstrual cycles.  

It affects 20% to 90% of women of reproductive age.

While it can be difficult to find the exact cause of painful menstruation, dysmenorrhea can be split into two categories, primary and secondary dysmenorrhea, which each have different possible causes.

Primary dysmenorrhea

This type of dysmenorrhea is most common menstrual disorder affecting over half of menstruating women.

 

Dysmenorrhea typically starts within a year of the first menstrual period and typically affects adolescent women in the first few years after their period begins.

Symptoms associated with dysmenorrhea in adolescents include:

  • nausea, vomiting, diarrhea, headaches, and muscle cramps
  • Primary dysmenorrhea can affect sleep and cause an increase in school absenteeism.
  • PMS increase with the severity of dysmenorrhea.

If you are not sexually active, diagnosis of primary dysmenorrhea does not require a pelvic exam or additional testing.

 

 

Secondary Dysmenorrhea

Although it is normal to experience mild discomfort with your cycle, your symptoms should not prevent you from performing any of your normal daily activities.

These pains may involve bad cramps during your period, or even severe cramping before your period.

Women who experience painful cramps and lower abdominal discomfort with their monthly menstrual cycles who do not respond to medicine, may have an undiagnosed underlying condition causing pain with your periods and may require a more comprehensive evaluation.

Pain during sex, or dyspareunia, is persistent or recurring pain just before, during or after sex.

While you may experience pain during sexual intercourse occasionally, it is not normal to experience frequent or severe pain.

Dyspareunia is reported to affect 20% of American women and can have negative emotional and psychological effects. In addition to the physical pain, couples may suffer from loss of intimacy or experience strain in their relationship.

Painful sex may be felt in the vulva or vagina, during or shortly after sex.  Many women also report pain in the perineum (the small stretch of skin in between your vagina and anus), pelvis, lower back, bladder, and/or uterus.

Superficial dyspareunia

Pain that occurs prior to or during initial penetration. This pain is felt at the entrance to the vagina during initial penetration.

deep dyspareunia

Pain that occurs with deeper penetration that might be worse in certain positions.

Pelvic pain is chronic if it lasts longer than six months.

Chronic pelvic pain is defined as persistent pain in the lower abdomen and pelvic area that lasts for more than six months. The pain may be dull or sharp and can vary in intensity. It can also be accompanied by other symptoms such as bloating, constipation, diarrhea, painful urination, painful intercourse, and menstrual cramps.

There are many possible causes of pelvic pain, and at times it may be difficult to figure out the specific cause or causes. In many cases, pelvic pain indicates a problem with one or more of the organs in the pelvic area.

Diagnosis and treatment of chronic pelvic pain depends on the underlying cause.