Diagnosing Chronic Pelvic Pain

Your pelvic pain may not have an obvious cause. This may require some effort and time. With the right diagnosis you will be able to get some relief . There are many specialists that you can consult and test to help you determine what to do about the pain .

Make a complete list of all your symptoms to be shared with the doctor. You should also take note of:

• When each of these symptoms started to appear
• Whatever you tried helped the pain
• At certain times, the pain may be worse than others
• If your pain is due to your period or sexual activity
• Any injuries, illnesses, or surgeries you've had

You may require multiple specialists because chronic pelvic discomfort can be due to more than one reason. A good place to start is your gynecologist. Sometimes, pelvic discomfort is caused by a problem within the reproductive system. Problems with the abdomen wall muscles, bladder or bowels could also be a possible cause.

Testing for chronic pelvic pain

The doctor will first perform a pelvic exam ination. Next the doctor will do:

Take a look at how you stand and sit. Ask you for feedback on your abdominal and pelvic posture. Also, ask you to tell us if you feel any pain. Tests you may need include a blood test, pregnancy test and examination for infections such as chlamydia or gonorrhea. A urine test may also be performed to determine if you have a problem with your pelvic floor.

Your doctor may only need to do a pelvic exam in order to determine the cause of your problem. For a complete picture, the doctor may order an imaging test such as a transvaginal ultrasound, a CT scan or an MRI scan.

Diagnostic radiological tests could be helpful:

• Endometriosis
• Congestion of the pelvic floor
• Adhesions
• Fibroids
• Inflammatory disease of the pelvic floor
• Methods to relieve chronic pelvic pain

Laparoscopy is a technique that may be used to diagnose the root cause of pelvic pain. The procedure involves inserting either a camera, scope, or camera into a tiny incision. This allows for the examination of pelvic organs as well as tissue samples. A hysteroscopy is a procedure that uses a tiny camera to view the inside of the uterus and diagnose any abnormalities.

Pain mapping is an option that some doctors employ. The doctor stimulates your pelvis with a laparoscope while you remain awake and sedated. Your pain is rated and you can indicate whether or not it's similar to what you normally experience. It creates a "map", which shows the sensitive regions.

Questions for the Doctor

You can ask your doctor about chronic pelvic pain if it has been diagnosed recently.

• My pelvic pain isn't getting better.
• Are there any over-the counter pain relievers I should be using?
• Is there any self-care that could ease my pain?
• My fertility could be affected by my medical condition, or treatments.
• Do I have to visit a specialist?
• What is the best way to get relief quickly?
• Can my pelvic pain return?
• How do I deal with it?
• What are some other signs I should watch out for?
• Is my pelvic pain being caused by emotional distress? Is it possible to receive help for emotional distress?

What is the Role of an Urologist?

You might also see a urologist if your pain is due to problems with the bladder. A urologist may be able to perform tests if you have symptoms or a pelvic examination that suggests interstitial cystitis. IC refers to painful bladder inflammation , which isn’t due to an infection.

Cystoscopy can help diagnose interstitial cystitis. The doctor will examine your bladder with a magnifying glass to check for any bleeding or ulcers. If symptoms are not related to other problems, doctors may be able to diagnose interstitial bladderitis.

Gastroenterologist's Role

A gastroenterologist is a specialist in the treatment of digestive disorders and may be required to visit some women suffering from pelvic pain. IBS (irritable bowel syndrome) is the leading cause of pelvic discomfort. You may not have any other cause.

Doctors usually diagnose IBS by looking at the symptoms that you have described. If the doctor believes that there is another problem, tests may be performed to rule it out.

What is the Role of a Pain Specialist?

A pain specialist is usually anesthesiologists that have received specialized training on pain management. Women suffering from persistent pelvic pain may seek these specialists to augment their treatment by their primary care physician or gynecologist. A pain specialist may be needed to administer nerve blocks or transcutaneous electrical neuro stimulation (TENS) units. They also can manage medications that are used for chronic pain.

A Physical Therapist's Role

For women with chronic pelvic pain, a physical therapist may be able to create an exercise and relaxation program that will strengthen and ease the muscles of the pelvic floor, relieve pain and help manage anxiety.

The Therapist's Role

Even if the source is physical, psychologists and psychiatrists may be able to help. Mind plays an influential role in how we perceive pain. Anxiety, stress and depression can magnify pain.

It doesn't matter how many specialists you visit, choosing a provider with a good knowledge of chronic pelvic pain is important. Different types of doctors may have special interests in treating pain. Request a referral from your general practitioner if you are not well-versed in the causes of pelvic discomfort.