What are the common causes of pelvic pain in women. How is pelvic pain diagnosed. What symptoms are associated with pelvic pain. When should you seek medical attention for pelvic pain.

Understanding Pelvic Pain: A Common Issue for Women

Pelvic pain is a widespread concern among women, characterized by discomfort in the lower abdominal region. Its nature can be complex, with varying intensity and often elusive causes. In some instances, no underlying disease is apparent, making diagnosis challenging.

Pelvic pain is typically categorized into two main types:

• Acute pelvic pain: Sudden and severe
• Chronic pelvic pain: Persistent or recurring for six months or longer

Chronic pelvic pain that shows no improvement with treatment is particularly concerning and requires thorough medical evaluation.

The Origins of Pelvic Pain: Multifaceted Causes

Pelvic pain can stem from various sources, including physical and psychological factors. Understanding these potential causes is crucial for effective diagnosis and treatment.

Physical Causes of Pelvic Pain

Physical causes of pelvic pain may include:

• Inflammation or irritation of nerves due to injury, fibrosis, or pressure
• Contractions or cramps of smooth and skeletal muscles
• Intraperitoneal inflammation

Psychological Factors

Psychological factors can exacerbate pelvic pain or even cause pain sensations in the absence of physical issues. This mind-body connection highlights the complexity of pelvic pain and the importance of a holistic approach to treatment.

Acute Pelvic Pain: Sudden and Severe Symptoms

Acute pelvic pain demands immediate attention due to its sudden onset and intensity. Common causes of acute pelvic pain include:

• Ectopic pregnancy
• Pelvic inflammatory disease (PID)
• Twisted or ruptured ovarian cyst
• Miscarriage or threatened miscarriage
• Urinary tract infection
• Appendicitis
• Ruptured fallopian tube

Are there any warning signs that indicate an acute pelvic pain emergency? Severe, sudden pain accompanied by fever, nausea, or bleeding requires immediate medical attention, as it may indicate a life-threatening condition such as an ectopic pregnancy or appendicitis.

Chronic Pelvic Pain: Persistent and Recurring Discomfort

Chronic pelvic pain persists for an extended period, often six months or longer. Conditions that may lead to chronic pelvic pain include:

• Menstrual cramps
• Endometriosis
• Uterine fibroids
• Pelvic adhesions (scar tissue)
• Endometrial polyps
• Cancers of the reproductive tract

How does endometriosis contribute to chronic pelvic pain? Endometriosis causes tissue similar to the uterine lining to grow outside the uterus, leading to inflammation, scarring, and pain during menstruation and sexual intercourse.

Beyond Reproductive Organs: Other Systems Involved in Pelvic Pain

Pelvic pain is not always related to the reproductive system. Other bodily systems that can contribute to pelvic pain include:

• Digestive system
• Urinary system
• Nervous system

This interconnectedness of various systems within the pelvic region underscores the importance of a comprehensive diagnostic approach.

Decoding Pelvic Pain: Types and Their Potential Causes

Understanding the characteristics of pelvic pain can provide valuable insights into its underlying causes. Here are some common types of pelvic pain and their potential origins:

• Localized pain: May indicate inflammation
• Cramping: Possibly caused by spasms in soft organs like the intestine, ureter, or appendix
• Sudden onset pain: May result from temporary blood supply deficiency due to circulatory obstruction
• Slowly-developing pain: Potentially due to appendix inflammation or intestinal obstruction
• Pain involving the entire abdomen: May suggest accumulation of blood, pus, or intestinal contents
• Pain aggravated by movement or during examination: Possibly due to irritation in the abdominal cavity lining

Can the location of pelvic pain help determine its cause? While the location of pain can provide clues, it’s not always a definitive indicator. For example, lower right quadrant pain could suggest appendicitis, but it might also be related to ovarian issues or other conditions.

Diagnosing Pelvic Pain: A Comprehensive Approach

Accurate diagnosis of pelvic pain requires a thorough evaluation. Healthcare providers typically employ a combination of methods to determine the underlying cause:

Patient History and Symptom Analysis

Healthcare providers often ask detailed questions about the pain, such as:

• When and where does the pain occur?
• How long does the pain last?
• Is the pain related to menstrual cycle, urination, or sexual activity?
• What does the pain feel like (e.g., sharp, dull, cramping)?
• Under what circumstances did the pain begin?
• How suddenly did the pain onset?

Why is a detailed patient history crucial in diagnosing pelvic pain? A comprehensive patient history helps healthcare providers identify patterns, potential triggers, and associated symptoms that can guide further diagnostic testing and treatment planning.

Physical and Pelvic Examination

A thorough physical examination, including a pelvic exam, can reveal valuable information about the source of pain and any visible abnormalities.

Diagnostic Tests

Depending on the suspected cause, healthcare providers may order various diagnostic tests, including:

• Blood tests
• Pregnancy test
• Urinalysis
• Cervical cell culture
• Imaging studies (ultrasound, CT scan, MRI)
• Laparoscopy

How does laparoscopy aid in diagnosing pelvic pain? Laparoscopy allows healthcare providers to directly visualize the pelvic organs, identify abnormalities such as endometriosis or adhesions, and even perform certain treatments during the same procedure.

Navigating Pelvic Pain: When to Seek Medical Attention

While occasional mild pelvic discomfort may be normal, certain symptoms warrant prompt medical evaluation:

• Severe, sudden pain
• Pain accompanied by fever
• Unusual vaginal bleeding
• Pain that interferes with daily activities
• Pain during sexual intercourse
• Pain associated with nausea or vomiting
• Pain that doesn’t respond to over-the-counter pain relievers

Should you wait for pelvic pain to resolve on its own? While mild, temporary pelvic pain may resolve without intervention, persistent or severe pain should be evaluated by a healthcare provider to rule out serious conditions and prevent potential complications.

Pelvic Pain Management: A Multidisciplinary Approach

Effective management of pelvic pain often requires a multidisciplinary approach, involving various healthcare specialists:

• Gynecologists
• Urologists
• Gastroenterologists
• Pain management specialists
• Physical therapists
• Mental health professionals

Treatment strategies may include:

• Medications (pain relievers, hormonal treatments)
• Surgical interventions
• Physical therapy
• Relaxation techniques
• Cognitive-behavioral therapy
• Lifestyle modifications

How can physical therapy help manage chronic pelvic pain? Physical therapy can address muscular tension, improve pelvic floor function, and teach pain management techniques, potentially reducing pain and improving quality of life for women with chronic pelvic pain.

Pelvic Pain Prevention: Proactive Measures for Women’s Health

While not all causes of pelvic pain are preventable, certain measures may reduce the risk or severity of some conditions:

• Maintaining good hygiene to prevent infections
• Practicing safe sex to reduce the risk of sexually transmitted infections
• Regular exercise to strengthen pelvic floor muscles
• Managing stress through relaxation techniques
• Maintaining a healthy weight
• Avoiding constipation through diet and hydration
• Regular gynecological check-ups

Can dietary changes help prevent or manage pelvic pain? Some women find that certain dietary modifications, such as reducing caffeine and alcohol intake or following an anti-inflammatory diet, may help alleviate pelvic pain symptoms, particularly those related to endometriosis or interstitial cystitis.

The Future of Pelvic Pain Research and Treatment

Ongoing research in the field of pelvic pain aims to improve understanding, diagnosis, and treatment options. Some areas of focus include:

• Advanced imaging techniques for more accurate diagnosis
• Genetic studies to identify predisposing factors
• Novel pain management therapies
• Minimally invasive surgical techniques
• Investigation of the gut-brain axis in chronic pelvic pain
• Development of targeted medications with fewer side effects

What role does personalized medicine play in the future of pelvic pain treatment? Personalized medicine approaches, which take into account an individual’s genetic makeup, lifestyle factors, and specific symptoms, may lead to more effective and tailored treatment strategies for women with pelvic pain.

Empowering Women: Education and Support for Pelvic Pain

Education and support play crucial roles in helping women navigate the challenges of pelvic pain. Key aspects include:

• Promoting awareness of pelvic pain causes and symptoms
• Encouraging open communication with healthcare providers
• Providing access to support groups and counseling services
• Educating women about self-care strategies
• Addressing the psychological impact of chronic pelvic pain
• Promoting research participation to advance understanding and treatment

How can support groups benefit women with chronic pelvic pain? Support groups offer a safe space for women to share experiences, coping strategies, and emotional support, reducing feelings of isolation and providing valuable peer-to-peer resources for managing pelvic pain.

Navigating the Healthcare System: Advocating for Effective Pelvic Pain Care

Effectively navigating the healthcare system is crucial for women seeking diagnosis and treatment for pelvic pain. Key strategies include:

• Keeping detailed records of symptoms and triggers
• Seeking second opinions when necessary
• Researching specialists with expertise in pelvic pain
• Understanding insurance coverage and treatment options
• Communicating clearly and assertively with healthcare providers
• Exploring integrative medicine approaches when appropriate

How can women ensure they receive comprehensive care for pelvic pain? Building a strong partnership with healthcare providers, staying informed about treatment options, and actively participating in decision-making can help ensure comprehensive and personalized care for pelvic pain.

The Impact of Pelvic Pain on Quality of Life: Addressing the Whole Person

Pelvic pain can significantly impact various aspects of a woman’s life, including:

• Physical well-being and daily activities
• Emotional and mental health
• Sexual relationships and intimacy
• Work productivity and career advancement
• Social interactions and recreational activities
• Family dynamics and caregiving responsibilities

Addressing these wide-ranging effects requires a holistic approach to care that considers the whole person, not just the physical symptoms.

How can healthcare providers better address the emotional impact of chronic pelvic pain? Integrating mental health screenings, offering psychosocial support, and providing resources for stress management can help address the emotional toll of chronic pelvic pain and improve overall treatment outcomes.

Pelvic Pain Across the Lifespan: Age-Specific Considerations

Pelvic pain can affect women at various stages of life, with different considerations for each age group:

Adolescents and Young Adults

• Menstrual disorders
• Ovarian cysts
• Sexually transmitted infections

Women of Reproductive Age

• Endometriosis
• Fibroids
• Pregnancy-related conditions

Perimenopausal and Postmenopausal Women

• Pelvic organ prolapse
• Vulvovaginal atrophy
• Pelvic floor disorders

How do treatment approaches differ for pelvic pain in various age groups? Treatment strategies may vary based on factors such as reproductive goals, hormonal status, and co-existing health conditions, necessitating age-specific approaches to pelvic pain management.

Integrative Approaches to Pelvic Pain Management

Integrative medicine approaches can complement conventional treatments for pelvic pain, offering additional options for symptom management and overall well-being. Some integrative approaches include:

• Acupuncture
• Mindfulness meditation
• Yoga and tai chi
• Herbal remedies
• Nutritional counseling
• Biofeedback

What evidence supports the use of acupuncture for pelvic pain? Some studies suggest that acupuncture may help alleviate pelvic pain, particularly in cases of endometriosis and chronic pelvic pain syndrome, by modulating pain perception and reducing inflammation.

The Role of Technology in Pelvic Pain Management

Advancements in technology are shaping the future of pelvic pain diagnosis and management. Innovative approaches include:

Pelvic Pain | Johns Hopkins Medicine

What is pelvic pain?

Pelvic pain is a common problem among women. Its nature and intensity may fluctuate, and its cause is often unclear. In some cases, no disease is evident. Pelvic pain can be categorized as either acute, meaning the pain is sudden and severe, or chronic, meaning the pain either comes and goes or is constant, lasting for a period of months or longer. Pelvic pain that lasts longer than 6 months and shows no improvement with treatment is known as chronic pelvic pain. Pelvic pain may originate in genital or other organs in and around the pelvis, or it may be psychological. This can make pain feel worse or actually cause a sensation of pain, when no physical problem is present.

What causes pelvic pain?

Pelvic pain may have multiple causes, including:

• Inflammation or direct irritation of nerves caused by injury, fibrosis, pressure, or intraperitoneal inflammation

• Contractions or cramps of both smooth and skeletal muscles

• Some of the more common sources of acute pelvic pain, or pain that happens very suddenly, may include:

  • Ectopic pregnancy (a pregnancy that happens outside the uterus)

  • Pelvic inflammatory disease (also called PID, an infection of the reproductive organs)

  • Twisted or ruptured ovarian cyst

  • Miscarriage or threatened miscarriage

  • Urinary tract infection

  • Appendicitis

  • Ruptured fallopian tube

Some of the conditions that can lead to chronic pelvic pain may include:

• Menstrual cramps

• Endometriosis

• Uterine fibroids (abnormal growths on or in the uterine wall)

• Scar tissue between the internal organs in the pelvic cavity

• Endometrial polyps

• Cancers of the reproductive tract

Other causes may be related to problems in the digestive, urinary, or nervous systems.

What are the symptoms of pelvic pain?

The following are examples of the different types of pelvic pain most commonly described by women, and their possible cause or origin. Always talk with your healthcare provider for a diagnosis.

How is pelvic pain diagnosed?

Tests will be done to determine the cause of the pelvic pain. In addition, your healthcare provider may ask you questions regarding the pain such as:

• When and where does the pain happen?

• How long does the pain last?

• Is the pain related to your menstrual cycle, urination, and/or sexual activity?

• What does the pain feel like (for example, sharp or dull)?

• Under what circumstances did the pain begin?

• How suddenly did the pain begin?

Additional information about the timing of the pain and the presence of other symptoms related to activities such as eating, sleeping, sexual activity, and movement can also help your healthcare provider in determining a diagnosis.

In addition to a complete medical history and physical and pelvic exam, you may have other tests including:

• Blood tests

• Pregnancy test

• Urinalysis

• Culture of cells from the cervix

• Ultrasound. A diagnostic imaging technique that uses high-frequency sound waves to create an image of the internal organs.

• Computed tomography (CT or CT scan). This is an imaging test that uses X-rays and a computer to make detailed images of the body. A CT scan shows details of the bones, muscles, fat, and organs, and any abnormalities that may not show up on an ordinary X-ray.

• Magnetic resonance imaging (MRI). A noninvasive procedure that produces a two-dimensional view of an internal organ or structure.

• Laparoscopy. A minor surgical procedure in which a laparoscope, a thin tube with a lens and a light, is inserted into an incision in the abdominal wall. Using the laparoscope to see into the pelvic area, the healthcare provider can determine the locations, extent, and size of any endometrial growths.

• X-ray. Electromagnetic energy used to produce images of bones and internal organs onto film.

• Colonoscopy. In this test, the healthcare provider can view the entire length of the large intestine, and can often help identify abnormal growths, inflamed tissue, ulcers, and bleeding. It involves inserting a colonoscope, a long, flexible, lighted tube, in through the rectum up into the colon. The colonoscope allows the healthcare provider to see the lining of the colon, remove tissue for further exam, and possibly treat some problems that are discovered.

• Sigmoidoscopy. A diagnostic procedure that allows the healthcare provider to examine the inside of a portion of the large intestine. It is helpful in identifying the causes of diarrhea, abdominal pain, constipation, abnormal growths, and bleeding. A short, flexible, lighted tube, called a sigmoidoscope, is inserted into the intestine through the rectum. The scope blows air into the intestine to inflate it and make viewing the inside easier.

How is pelvic pain treated?

Specific treatment for pelvic pain will depend on the cause of the pain and will be discussed with you by your healthcare provider based on:

• Your overall health and medical history

• Extent of condition

• Cause of the condition

• Your tolerance for specific medicines, procedures or therapies

• Expectations for the course of the condition

• Your opinion or preference

Treatment may include:

• Antibiotic medicines

• Anti-inflammatory and/or pain medicines

• Relaxation exercises

• Oral contraceptives

• Surgery

• Physical therapy

If a physical cause can’t be found, your healthcare provider may refer you for counseling to help you better cope with chronic pain. In other cases, healthcare providers may recommend a multidisciplinary treatment using a number of different approaches, including nutritional modifications, environmental changes, physical therapy, and pain management.

Key points about pelvic pain

• Pelvic pain is a common problem among women. Its nature and intensity may fluctuate, and its cause is often unclear.

• Pain can be acute or chronic.

• Specific treatment will depend on the cause as determined by the physical exam and tests.

• Treatment may include medicines, surgery, physical therapy and pain management techniques.

18 Possible Causes of Pelvic Pain in Women

If you have pain below your belly button and above your legs, it counts as pelvic pain. It can be caused by a lot of things. It may be a harmless sign that you’re fertile, a digestive disorder, or a red flag that you need to go to the hospital.

If you have a sharp pain in the lower right part of your belly, are vomiting, and have a fever, it could be appendicitis. If you have these symptoms, go to the ER. An infected appendix may need surgery. If it bursts, it can spread the infection inside your body. This can cause serious complications.

Do you have belly pain, cramps, bloating, and diarrhea or constipation that keeps coming back? Talk to your doctor to figure out the problem. It could be IBS, sometimes called spastic colon. Doctors aren’t sure what causes it. Diet changes, stress management, and medications may help.

Ever feel a painful twinge between periods? You may be feeling your body ovulate. When you do, the ovary releases an egg along with some fluid and blood. It can cause irritation. This feeling is called mittelschmerz — German for “middle” and “pain.” That’s because it happens midway through your monthly cycle. The pain may switch sides from month to month. It isn’t harmful and usually goes away in a few hours.

You can usually feel these cramps in your lower belly or back. They typically last 1 to 3 days. Why the pain? Every month, your uterus builds up a lining of tissue. That’s where an embryo can implant and grow. If you don’t get pregnant, the lining breaks down and is shed during your period. When the uterus tightens to push it out, you get a cramp. Try a heating pad and over-the-counter pain relievers to ease pain. Exercise and de-stressing can help, too. You can also talk to your doctor about PMS pain. Certain birth control pills or antidepressants may help.

This happens when an embryo implants somewhere outside of the uterus and begins to grow. This usually happens in the fallopian tubes. Sharp pelvic pain or cramps (particularly on one side), vaginal bleeding, nausea, and dizziness are symptoms. Get medical help right away. This is a life-threatening emergency. 

Pelvic pain is a warning sign of some STDs. Two of the most common are chlamydia and gonorrhea (shown here through a microscope). You often get both at the same time. They don’t always cause symptoms. But when they do, you may have pain when you pee, bleeding between periods, and abnormal vaginal discharge. See your doctor. It’s also important to get partners checked and treated, too, so you don’t pass the infection back and forth.

This is a complication of sexually transmitted diseases. It’s the No. 1 preventable cause of infertility in women. It can cause permanent damage to the uterus, ovaries, and fallopian tubes. Belly pain, fever, abnormal vaginal discharge, and pain during sex or urination can be symptoms. Get it treated right away to avoid damage. It is treated with antibiotics. In severe cases, you may need to be hospitalized. Get your partner treated, too.

Ovaries release eggs when you ovulate. Sometimes a follicle doesn’t open to release the egg. Or it recloses after it does and swells with fluid. This causes an ovarian cyst. They’re usually harmless and go away on their own. But they may cause pelvic pain, pressure, swelling, and bloating. And if a cyst bursts or twists, it can cause sudden, severe pain, sending you to the emergency room. Doctors can spot them during a pelvic exam or ultrasound.

These grow on or in the wall of the uterus. While they’re sometimes called fibroid tumors, they are not cancerous. Fibroids are common in women in their 30s and 40s. They usually don’t cause problems. But some women may have pressure in the belly, low back pain, heavy periods, painful sex, or trouble getting pregnant. Talk with your doctor if you need treatments to shrink or remove them.

In some women, there is tissue growing outside the uterus that is similar to tissue that lines the uterus. It can happen on the ovaries, fallopian tubes, bladder, intestines, and other parts of the body. When it’s time for your period, these clumps of tissue break down. But the tissue has no way to leave the body. While this is rarely dangerous, it can cause pain and form scar tissue that may make it tough to get pregnant. There are several treatment options. Pain medications, birth control pills, hormones to stop periods, surgery with small incisions, and even a hysterectomy (taking out your uterus) are options.

Do you have to pee often, or does it hurt when you do? Or do you feel like your bladder is full? It could be a UTI. This happens when germs get into your urinary tract. Treating it quickly can keep it from it getting serious. But if it spreads to the kidneys, it can cause serious damage. Signs of a kidney infection include fever, nausea, vomiting, and pain in one side of the lower back.

These are globs of salt and minerals that your body tries to get rid of in urine. They can be as tiny as a grain of sand or as large as a golf ball. And boy can they hurt! Your urine may turn pink or red from blood. See your doctor if you think you have a kidney stone. Most will pass out of your system on their own, but some need treatment. Even if they can pass on their own, your doctor can help with pain medication and will tell you to drink lots of water.

This condition causes ongoing pain and is related to inflammation of the bladder (illustrated here). It’s most common in women in their 30s and 40s. Doctors aren’t sure why it happens. People with severe IC may need to pee several times an hour. You might also feel pressure above the pubic area, pain when you urinate, and pain during sex. Although this can be a long-term condition, there are ways to ease the symptoms and avoid flares.

As you get older, this may happen. Your bladder or uterus drops into a lower position. It usually isn’t a serious health problem, but it can be uncomfortable. You may feel pressure against the vaginal wall, or your lower belly may feel full. It may also give you an uncomfortable feeling in the groin or lower back and make sex hurt. Special exercises like Kegel’s or surgery may help.

We’ve all seen varicose veins in legs. (This is a picture of one in the upper thigh.) They can sometimes happen in the pelvis, too. When blood backs up in veins, they become swollen and painful. This is known as pelvic congestion syndrome. This is a condition that’s difficult to diagnose and treat. It tends to hurt worse when you sit or stand. Lying down may feel better. But because the best treatment is still unclear, you need to work with your doctor to learn what the options are and to find what works well for you.

If you’ve had surgery or an infection, you could have ongoing pain from this. Adhesions are a type of scar tissue inside your body. They form between organs or structures that aren’t meant to be connected. Adhesions in your belly can cause pain and other problems, depending on where they are. In some cases, you may need a procedure or surgery to get rid of them.

Does it hurt when you ride a bike or have sex? If it burns, stings, or throbs around the opening of your vagina, it could be this. The feelings can be ongoing or come and go. Before you’re diagnosed with this, your doctor will rule out other causes. This isn’t caused by an infection. Treatment options range from medication to physical therapy.

This can be caused by many things. Most are treatable. It could be a vaginal infection, or you just may need more lubrication. The medical name is dyspareunia. Sometimes the pain gets better after sexual therapy. This type of talk therapy can focus on inner conflicts about sex or past abuse.

If you have pain that lasts at least 6 months, it’s considered chronic. It may be so bad it messes with your sleep, career, or relationships. See your doctor. Most of the conditions we’ve covered get better with treatment. Sometimes, even after a lot of testing, the cause of pelvic pain remains a mystery. But your doctor can still help you find ways to feel better.

Article “Chronic pelvic pain in women”

The problem of chronic pelvic pain in women of reproductive age occupies a special place in gynecology. Almost half of the patients who turn to the specialists of the EMC Department of Gynecology and Oncogynecology have complaints of chronic pelvic pain – discomfort for a long time in the lower abdomen, in the area below the navel. Long-term, despite the fact that conventional painkillers are ineffective, pelvic pain changes the psyche, the behavior of women, reduces the ability to work and quality of life.

Pain may be constant or intermittent, even paroxysmal, may be cyclical or not at all related to the menstrual cycle. Pain impulses arising in the genitals and surrounding tissues as a result of irritation of nerve endings are transmitted to the central nervous system, which in most women is accompanied by general weakness, irritability, anxiety, excitability, emotional lability, attention disorders, memory loss, sleep disturbances.

Chronic pelvic pain is characterized by:

• persistent pain in the lower abdomen and lower back of varying intensity and character (pulling, dull, burning, etc.), prone to irradiation, lasting more than 6 months;

• periodic exacerbations – pain crises arising in connection with cooling, overwork, stress, etc. ;

• psycho-emotional disorders, manifested by insomnia, irritability, disability, anxiety and depression, decreased sexual function up to a complete lack of interest and sexual response;

• no or little effect of conventional pain and antispasmodic therapy.

In some cases, it is not possible to identify its causes even with in-depth examination – this is the so-called “inexplicable” pain. For such patients, the “triangle” route – gynecologist-urologist-neurologist – becomes familiar, and pain and fear force them to turn to an oncologist. Often, for years, these patients have been treated for “inflammation of the uterus and appendages” with large doses of antibacterial drugs, and such irrational treatment aggravates the situation even more.

Pain is one of the most common symptoms in many gynecological diseases. External genital endometriosis, adhesions in the pelvic cavity, chronic inflammatory diseases of the internal genital organs, internal endometriosis of the uterine body, Allen-Masters syndrome, genital tuberculosis, uterine fibroids, benign and malignant ovarian tumors, malignant neoplasms of the body and cervix, developmental anomalies genital organs with a violation of the outflow of menstrual blood – this is not a complete list of diseases and conditions that may be accompanied by chronic pelvic pain.

The most common misconceptions about chronic pelvic pain

Chronic pelvic pain in women can only be caused by gynecological diseases

syndromes, arthrosis of the sacro- coccygeal articulation, primary tumors of the pelvic bones, metastases to the pelvic bones and spine, bone forms of tuberculosis, pathology of the symphysis), retroperitoneal neoplasms, diseases of the peripheral nervous system (plexitis), diseases of the gastrointestinal tract (chronic colitis, irritable bowel syndrome, nonspecific ulcerative colitis, proctitis, adhesive disease), diseases of the urinary system (chronic cystitis, urolithiasis, pelvic location of the kidney, prolapse of the kidney), vascular disease (varicose veins of the small pelvis). The causes of chronic pain syndrome can also be mental illness (abdominal epileptic seizures, depressive syndrome, schizophrenia).

Pain is usually caused by one factor, eliminating which, you can get rid of pain

In fact, in most gynecological diseases, the origin of pain is caused by several irritants at once, and it is often impossible to single out the leading factor. With uterine fibroids, pain can be caused by an increase in this organ, a violation of its blood supply and contractility of the uterine muscle, deformation of the uterine cavity by nodes, compression of the enlarged uterus or individual nodes of neighboring organs – the intestines, urinary tract, nerve plexuses, blood vessels.

With tumors and ovarian cysts are exposed to the tissue and bunch of ovaries (up to twist), the maturation of follicles is disturbed, microwaves with inflammation and formation of adhesions are possible, and squeezing of neighboring organs

Pancous pains are characteristic of the development of genitals (normal or repented a functioning uterus with aplasia of the cervix or vagina, a rudimentary uterine horn, a closed cavity of a bicornuate or doubled uterus) and other conditions accompanied by a violation of the outflow of menstrual blood (intrauterine synechia, stenosis of the cervical canal or cicatricial changes in the vagina). In these cases, the onset of pain is due to the expansion of closed cavities with blood and irritation of the peritoneum with almost constant hemoperitoneum, inflammation, and adhesions. Incorrect positions of the internal genital organs (bends of the uterus, prolapse, prolapse) also cause pelvic pain.

As a rule, most patients have a combined gynecological pathology, and each of the diseases can cause pain. External endometriosis often accompanies any other gynecological disease, and uterine fibroids are combined with internal endometriosis of the uterine body. Often there is a prolapse of the uterus, affected by fibroids or adenomyosis. The presence of a combined gynecological and extragenital pathology (hernias, diseases of the gastrointestinal tract, urinary tract, osteochondrosis of the spine) can significantly complicate the determination of the true cause of pain.

Periodic pain in women is normal

This myth has been around since the 19th century. Doctors then explained menstrual pain by the instability and delicacy of the physiology of women and believed that pain during menstruation is the norm, which is very characteristic of the female body. Another “cause” of pain in women during menstruation is, according to some, a low pain threshold.

In fact, many women and girls experience pain during their periods. However, severe pain that disrupts the habitual lifestyle and level of activity cannot be the norm, and usually they are based on some kind of disease, for example, endometriosis, a hormone-dependent disease in which the lining of the uterus (endometrium) grows in other parts of the body. This is the third most common gynecological disease after uterine fibroids and various inflammatory processes in the genitals.

Therefore, every woman with severe pain during menstruation should be fully examined to identify their cause.

Early identification of the causes of pain determines the success of treatment. To establish the possible causes of pelvic pain, we work as a team with doctors of other specialties – general surgeons, oncologists, urologists, neurologists, psychologists.

For the treatment of chronic pelvic pain, EMC gynecologists-surgeons use an approach based on reducing the invasiveness of surgical intervention, avoiding excessive radicalism, and expectant management in certain diseases of the genital area.

Laparoscopy and hysteroscopy provide us with unique diagnostic and therapeutic opportunities, which allow us to identify and eliminate possible causes of pain that are not diagnosed by other examination methods: endometriosis of the pelvic peritoneum, adhesions, anatomical disorders – hernia, peritoneal defects (Allen-Masters syndrome).

From the patient’s point of view, laparoscopic intervention, unlike laparotomy, is not perceived as a “big and difficult” operation, and the absence of intense and prolonged postoperative pain associated with the surgical wound of the anterior abdominal wall eliminates the aggravation of the initial pain due to layering on them operating rooms. And, finally, early activation and return to physical activity, the almost absence of cosmetic defects also contribute to a quick recovery.

The volume of surgical intervention is chosen by EMC gynecologists depending on the age of the patient, her plans for childbearing, the severity of the detected pathology, the severity of pain. In young women, organ-preserving surgeries are performed, warning patients about the likelihood of recurrence of diseases such as endometriosis and uterine fibroids. Patients of older age groups with adenomyosis, multiple uterine fibroids, accompanied by severe pain, bleeding and leading to anemia, tumor growth and its significant size, dysfunction of neighboring organs, are shown radical operations in the volume of removal of the uterus, which we perform by laparoscopy or from a vaginal access .

In case of prolapse and prolapse of the pelvic organs accompanied by pelvic pain, EMC gynecologists use surgical correction technologies that are fundamentally different from each other, depending on the age of the patient, to effectively eliminate gynecological pathology and restore the disturbed pelvic anatomy. For pelvic varicose veins, we perform laparoscopic ovarian vein ligation, which is highly effective for pelvic pain due to congestion in the pelvic veins, without adversely affecting ovarian function.

The efficiency of surgical interventions performed by specialists of the EMC Department of Gynecology and Oncogynecology varies from 60 to 95%, which indicates the effectiveness of the treatment and the high level of training of specialists, whose experience allows them to take on even the most complex cases.

EMC Clinic of Gynecology and Oncogynecology works in accordance with evidence-based medicine protocols practiced in the USA and Western Europe. The EMC clinic is one of the few in Moscow whose level of medical services meets international standards.

The doctors of the Clinic work under the guidance of Vladimir Nosov, an experienced surgeon-gynecologist and obstetrician-gynecologist, certified by the US National Commission (Board Certified) in obstetrics-gynecology and oncogynecology, and also certified in Russia in obstetrics-gynecology and oncology.

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Consulting
Obstetrician-gynecologist extended consultation	8000. 00
Consultation of an obstetrician-gynecologist on the correction of the prescribed treatment (Dr. Astrakhantseva M.M., Ermakova D.M., Mezhlumova N.A., Plakhova T.A., Timofeeva V.V.) 00
Obstetrician-gynecologist consultation (Dr. Astrakhantseva M.M., Ermakova D.M., Mezhlumova N.A., Plakhova T.A., Timofeeva V.V.)	4000.00
Obstetrician-gynecologist primary consultation (Doctor of the highest category Shcherbakova T.I.)	8000.00
Obstetrician-gynecologist repeated consultation (Doctor of the highest category Shcherbakova T.I.)	8000.00
Obstetrician-gynecologist remote consultation	3000.00
Primary gynecologist-reproductologist consultation	5000.00
Repeated consultation with a gynecologist-reproductologist	4500.00
Consultation with a gynecologist-reproductologist and ultrasound to assess the ovarian reserve	6500. 00
Extended consultation with a gynecologist-reproductologist and ultrasound to assess the ovarian reserve	7000.00
Consultation of an obstetrician-gynecologist (Honored Doctor of the Russian Federation kmn Ivanova N.V.)	8000.00
Council of obstetricians-gynecologists (Honored Doctor of the Russian Federation Ivanova N.V. together with the chief physician Khersonskaya E.B.)	4000.00
Council of Obstetricians and Gynecologists (Chief Physician Khersonskaya E.B. together with Honored Doctor of the Russian Federation Ivanova N.V.)	4000.00
Obstetric invasions
Vaginal pH measurement (PH-metry)	500.00
Amniotest (test for amniotic fluid leakage)	800.00
Amnisure Rapid Test	4000.00
Pregnancy test	1000. 00
Insertion of the unloading obstetric pessary	5500.00
Removal of the unloading obstetric pessary	2500.00
Obstetric pessary Arabin	9500.00
Gynecological procedures
Gynecological smear collection (WB contract)	500.00
Collection of gynecological smear 1 category	800.00
Gynecological smear collection 2 category	1900.00
Procedure in the gynecological room 1st category	1500.00
Procedure in the gynecological room 2 category	2700.00
Colposcopy (video colposcopy)	3500.00
Colposcopy (video colposcopy) extended	5000.00
Insertion of intrauterine contraceptives (excluding the cost of the spiral)	2700. 00
Introduction of intrauterine contraceptives II degree of complexity (excluding the cost of the spiral)	4500.00
Removal of intrauterine devices (coils)	1200.00
Removal of intrauterine contraceptives (spirals) II degree of difficulty	1700.00
Placement/removal of the contraceptive ring (excluding the cost of the ring)	800.00
Placement/removal of the contraceptive ring (without the cost of the ring) II degree of complexity	1100.00
Removal of a foreign body from the vagina	1000.00
Removal of a foreign body from the vagina II degree of complexity	1500.00
Radio wave removal of single (up to 3 units) genital warts or papillomas	2000.00
Radio wave removal of multiple (more than 3 units) genital warts or papillomas	4000. 00
Treatment of cervical pathology by radio wave method (Surgitron device) I degree of complexity	7000.00
Treatment of cervical pathology by radio wave method (Surgitron apparatus) II degree of complexity	12000.00
Treatment of cervical pathology by radio wave method (Surgitron device) III degree of complexity	19000.00
Cryogenic removal of single genital warts or papillomas (up to 5 units) (nitrogen included)	2000.00
Cryogenic removal of multiple warts or papillomas of the female genital organs (up to 10 units) (nitrogen price included)	3000.00
Chemical removal of single warts or papillomas of the female genital organs (up to 5 units)	1000.00
Chemical removal of multiple warts or papillomas of the female genital organs (up to 10 units)	2000.00
Chemical destruction of cervical pathology (treatment of cervical diseases with Solkovagin)	2500. 00
Opening of cysts of the cervix	2000.00
Opening of cervical cysts II degree of complexity	3000.00
Hysterosonography	10000.00
Hysterosonography II degree of complexity	13000.00
Uterine aspiration	3200.00
Uterine aspiration II degree of difficulty	4700.00
Arabin obstetric pessary	7500.00
Endometrial aspiration biopsy (Pipel biopsy)	3500.00
Endometrial aspiration biopsy (Pipel biopsy) II degree of complexity	4900.00
Loop biopsy of the cervix (1 position) using the Surgitron apparatus	2700.00
Loop biopsy of the cervix (1 position) II degree of complexity using the apparatus Surgitron	3300.00
Curettage of the cervical canal	2200. 00
Curettage of the cervical canal II degree of complexity	3200.00
Curettage of the cervical canal + loop biopsy of the cervix using the Surgitron apparatus	7000.00
Curettage of the cervical canal + loop biopsy of the cervix using the Surgitron device II degree of complexity	10000.00
Curettage of the cervical canal + loop biopsy of the cervix using the Surgitron device III degree of complexity	15000.00
Hysteroscopy, separate diagnostic curettage	16000.00
Hysteroscopy, separate diagnostic curettage II degree of complexity	19500.00
Hysteroscopy, separate diagnostic curettage, IUD removal	18000.00
Hysteroscopy, separate diagnostic curettage, removal of the IUD II degree of complexity	25500.00
Hysteroscopy, separate diagnostic curettage, loop biopsy of the cervix	18000. 00
Hysteroscopy, separate diagnostic curettage, loop biopsy of the cervix II degree of complexity	27000.00
Hysteroscopy, separate diagnostic curettage, polypectomy	20000.00
Hysteroscopy, separate diagnostic curettage, polypectomy II degree of complexity	27500.00
Hysteroscopy, dissection of intrauterine synechiae	25000.00
Hysteroscopy, dissection of intrauterine synechia II degree of complexity	37500.00
Curettage of the cervical canal, removal of the polyp of the cervical canal	10000.00
Curettage of the cervical canal, removal of the polyp of the cervical canal II degree of complexity	15000.00
Instrumental IUD removal	6000.00
Instrumental removal of the IUD II degree of difficulty	9000.00
Cervical conization	22000. 00
Conization of the cervix II degree of complexity	25000.00
Operations on the Bartholin’s gland (marsupialization, removal of the Bartholin’s gland)	15000.00
Operations on Bartholin’s gland (marsupialization, removal of Bartholin’s gland) II degree of complexity	22500.00
Removal of stitches from the cervix	3000.00
Removal of stitches from the cervix II degree of complexity	4500.00
Removal of staples after caesarean section I category of complexity	2500.00
Removal of staples after caesarean section II category of complexity	3500.00
Removal of sutures of I category of complexity	3000.00
Removal of sutures II category of complexity	4500.00
Cervicoscopy II degree of complexity	12000. 00
Cervicoscopy+cervical curettage	18000.00
Cervicoscopy + curettage of the cervical canal II degree of complexity	15000.00
Polypectomy II degree of complexity	9000.00
Removal of a vaginal growth	15000.00
Removal of a neoplasm of the labia minora	15000.00
Removal of a neoplasm of the labia minora II category of complexity	25000.00
Contouring with hyaluronic acid fillers 3 ml	40000.00
Sling installation (without cost of the sling)	55000
Colporrhaphy, perineolevathoroplasty II level
Colporrhaphy, perineolevathoroplasty level I	70000
Colporrhaphy II level	70000
Colporrhaphy level I	50000
Hysteroresectoscopy + dissection of the uterine septum (Honored Doctor of Russia kmn Ivanova N. Leave a Reply Cancel reply Your email address will not be published. Required fields are marked * Comment * Name * Email * Website