Chronic pelvic pain is a problem that negatively impacts the quality of life of women who are affected, and it is far more widespread than most people think. There are several causes of chronic pelvic pain, the most common being endometriosis.
Endometriosis is a condition in which cells from the uterine lining take root and grow outside the uterus. Most often this occurs in the pelvis and around the ovaries, but it can occur in other parts of the body, even the lungs and brain. Endometriosis can lead to pain during menstruation, but can also cause pain during sex, constant chronic pain and more. In contrast, some women with endometriosis will not suffer any pain or have infertility issues. The disease is frequently diagnosed late, which leads to lower quality of life for the women it affects. It is estimated than 5% to 10% of all women of childbearing potential will suffer from symptoms attributed to endometriosis, and 15% to 45% of all women experiencing infertility or chronic pelvic pain will be diagnosed with endometriosis.
The symptoms of endometriosis vary from woman to woman, and their severity does not necessarily reflect the severity of their disease. Furthermore, the symptoms are dependent on the extent and location of the lesions. Some women will have no symptoms at all, while others will suffer serious pain every month around menstruation or even constant pain over the years.
Additional symptoms include:
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Menstrual pain
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Pain during sex
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Regular pelvic or abdominal pain
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Abnormal bleeding - heavy/prolonged/irregular/blood clots
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Fertility issues (difficulty becoming pregnant)
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Pain when urinating and with bowel movements
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Premenstrual symptoms
This situation can lead to anxiety, stress and depression due to the fear of pain around the monthly period.
Treatment
Treatment for endometriosis is dependent on several factors: severity of the symptoms, number of endometriosis lesions, the woman's age, fertility issues and desired outcomes (for example, alleviation of pain, improved quality of life, improved fertility). Note that there is currently no treatment that completely prevents recurrence and regrowth of the lesions. However, comprehensive treatment that includes organized medical follow-up, medication therapy / surgery or a combination of the two - can control the symptoms.
Medication therapy is critical to suppress endometriosis. The medications used include birth control pills, anti-inflammatory drugs, hormonal IUDs and hormone suppression therapy.
The Endometriosis and Chronic Pelvic Pain Center also offers surgical treatments:
Laparoscopic surgeries - designed to reduce pain and improve fertility. During surgery a diagnosis of the character of the disease is done, and the lesions are removed.
Hysterectomy - surgery offered to women who have completed family planning and for whom it is believed will benefit from improved quality of life.
Additional treatments - there are alternative therapies that can provide relief for the symptoms such as acupuncture, physical therapy and special diet. All treatment is tailored to the patient based on the severity of symptoms, the extent of the endometriosis, location of lesions and treatment goals.
Other less common causes of chronic pelvic pain include pelvic congestion, pelvic inflammatory disease and adhesions. Some of the symptoms in such cases are the same as for endometriosis, and the investigation is surgical. Treatment is designed according to the diagnosis.
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