There are a number of reasons women have pelvic pain.  This pain can be constant, or come and go with your cycle.  It can be a lot worse with your period, or possibly get worse with intercourse.  It can be related to ovulation or bowel function.  In this brief space we will limit the options, but it is important to discuss, and we can do that in general terms.  Obviously, your particular situation will be different, so discussing that with your doctor is important.

            Some of the most common causes of pain in the pelvic include Endometriosis (when cells from the lining of the uterus grow on the peritoneal surface), adhesions (from surgery or previous infection), and abnormal ovaries (such as Polycystic Ovarian Syndrome) or from the bowel and bladder.  Obviously there are more causes, but these are the most common.

            Evaluation of these causes starts with an examination.  Acute causes of pain such as ectopic or infection can usually be diagnosed with this.  Ultrasound can be helpful for certain conditions such as large ovarian problems (i.e. cysts) or such things as uterine fibroids.  Unfortunately, ultrasound does not help with conditions such as Endometriosis or adhesions.  At times, your doctor may recommend a surgery called laparoscopy.  This is a belly button surgery where we place a scope into the abdomen through the belly button.  This allows us to see the internal organs and diagnose things such as Endometriosis or adhesions.

            Sometimes the problem is from the bladder.  This requires a simple test in the office called a KCL test.  This will diagnose a condition called Interstitial Cystitis which causes pain in a large number of women.  It is then treated with simple treatments in the office and with medication. 

            There are also a certain number of women that have pain without an obvious cause.  This is very frustrating for both the patient and the doctor.  This is jus a small snapshot of pelvic pain.  We are happy to see you and evaluate further, if needed.