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Healthy You Archives Healthy You Archives |
Just for Women
Is It More Than Just Cramps?Pay attention to above-normal pelvic pain A little monthly pain is normal for many women. “But if you
have above-normal pain for more than three menstrual cycles—especially
if it keeps you from work or school—see your doctor,” says Joseph
Patruno, M.D., gynecologist at Lehigh Valley Hospital and Health
Network. “Severe and persistent menstrual pain may indicate a problem.”One of the most common causes of pelvic pain is endometriosis, a condition in which cells from the uterine lining (endometrium) are displaced into the abdominal cavity. There, they keep on responding to hormonal cycles, swelling and bleeding and eventually causing scarring on the fallopian tubes, ovaries and other organs. Endometrial pain is usually worse during menstruation, but there may be pain with intercourse, too. Untreated, the condition can lead to infertility. “Because endometriosis is complex, it is hard to diagnose and treat,” Patruno says. Your doctor may use laparoscopy, in which a tiny camera is inserted through a small incision to check for lesions (built-up tissue) on pelvic organs. Tissue samples often are taken for analysis (biopsy) to confirm the condition. Treatment usually begins with hormone therapy to prevent ovulation and sometimes menstruation. Many physicians use other drugs to completely block hormone production, as hormones stimulate the growth of endometrial cells. If drug therapy isn’t successful in controlling pain, or if infertility is the issue, a surgeon can remove the endometrial lesions laparoscopically. This often improves pain and fertility. “If your pelvic pain is sudden and acute, get to the doctor immediately,” Patruno says. “You may have a ruptured or rotated ovarian cyst, cutting off the ovary’s blood supply. Severe, sudden pain also can signal emergencies like appendicitis, bowel obstruction or ectopic pregnancy.” Chronic (ongoing) pelvic pain can result from a sexually transmitted disease. STDs in the cervix and vagina usually aren’t painful, but once the infection moves to the uterus and fallopian tubes, there can be chronic discomfort if it’s left untreated. Most cases of cyclic chronic pelvic pain are menstruation-related. “About 20 percent of women have painful periods,” Patruno says. “This usually results from hormonal fluctuations and the production of irritating chemicals (prostaglandins) in the uterus. Ibuprofen or anaprox can counteract those chemicals.” If the pain persists or periods last more than seven days, birth control pills may help. Conditions like irritable bowel syndrome, interstitial cystitis and fibromyalgia often worsen during menstruation, contributing to the overall pain level. In some cases, Patruno says, no clear cause of chronic pelvic pain is apparent. “That doesn’t mean the pain isn’t real. Many of those patients find relief from a multidisciplinary approach including physical therapy.” This page last updated 2/12/08 04:08 PM
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