Pain

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Common Problems Women Experience:

Chronic Pelvic Pain:

What Is Chronic Pelvic Pain?

Chronic pelvic pain is pain in your pelvic region (the area below your bellybutton and above your hips), that lasts 6 or more months. The pain may be a steady or it may come and go. It can feel like a dull ache or it can be sharp. The pain may be mild or it may be bad enough to interfere with normal daily activities.

What Are Possible Causes Of Chronic Pelvic Pain?

Endometriosis- Endometriosis is a problem with the lining of the uterus. Tissue from the lining of the uterus moves through the fallopian tubes and gets on your ovaries, in your pelvis, on your bladder or in other areas. When you have your period, this tissue swells and bleeds, just like the lining of your uterus. This is often painful, and scar tissue can form in your pelvic area.
Pelvic inflammatory disease (PID)- Pelvic inflammatory disease is an infection in the female reproductive organs (uterus, fallopian tubes and ovaries). Normally, the cervix (opening to the womb) prevents bacteria in the vagina from spreading up into these organs. However, if the cervix is exposed to a sexually transmitted infection such as gonorrhea or chlamydia, it becomes infected. This can allow bacteria to travel up into the internal organs, making them inflamed and infected. If this occurs, the woman's fallopian tubes may be damaged, making it difficult for her to become pregnant.
Fibroids- Fibroids are benign growths (not cancer) in the muscular wall of the uterus. These growths can be very tiny or as large as a cantaloupe.
Ovarian Remnant- During a complete hysterectomy, the uterus and ovaries are removed. Sometimes a small piece of the ovary gets left behind, and that can develop painful cysts.

How Is Chronic Pelvic Pain Diagnosed?

A gynecologist will ask you questions about your past and present health and about illness or health-related problems in your family. You may be asked to describe the kind of pain you have where it is and how strong it is.

Is the pain related to your menstrual cycle?
Is it related to bowel movements?
Does it hurt during urination or sexual activity?
Have you had an infection?
Have you had surgery in your pelvic area?

Extra tests may needed to be performed to help make the diagnosis.

How Is Chronic Pelvic Pain Treated?

Treatment depends on the individual problem. Your gynecologist will help you determine which form of treatment is right for you. Some treatment options include:

Stopping ovulation (release of eggs from the ovary) with birth control pills or Depo-Provera injections. Use of nonsteroidal anti-inflammatory pain relievers such as Ibuprofen, Motrin and Aleve.
Relaxtion exercises, biofeedback (treatment to control emotional states using electrical devices) and physical therapy.
Abdominal trigger point injections. A trigger point is a tender area in the lower wall of the abdomen. Pressure that is put on this area causes pain. Injecting medicine into the trigger point can block this pain.
Antibiotics.
Psychological counseling.
Surgery is usually only an option if abnormalities in the pelvis are seen.

Dyspareunia (Pain During Intercourse):

What is Dyspareunia?

Painful sexual intercourse, called dyspareunia in medical terminology, is a common complaint among women seeking gynecologic care. Many women report occasional pain with intercourse but some women have pain with every episode of sexual intimacy. Sex should never be painful. When referred to a gynecologist by another health care provider, it may take a few visits to determine the cause of dyspareunia but the cause is usually identified and treated.

What Is The Cause Of Dyspareunia?

Tipped Or Retroverted Uterus - Some women with a tipped uterus experience pain during intercourse. This happens when the penis hits the cervix or uterus during sex. This condition is known as collision dyspareunia.
Endometriosis - The tissue lining the uterus(the endometrium) may grow outside the uterus causing deep pain during sex.
Infection - Bacterial or yeast infections are among the most common causes of pain during intercourse.
Lack Of Estrogen - During menopause, the vaginal walls thin and the amount of vaginal lubrication decreases.
Vulvodynia - In this condition, the vulva is hypersensitive and extremely tender on touch.
Drug Side Effects - Common drugs including those for allergy, high blood pressure or depression may affect the amount of vaginal lubrication, as well as the level of sexual arousal and desire.
Physical Problems - Scar tissue from abdominal surgery or from delivering a baby can distort the anatomy and cause significant pain during intercourse. A cyst on an ovary can also cause pain.
Pelvic Floor Myalgia - Pelvic floor muscle spasms are involuntary muscle spasms and can result in difficult and uncomfortable sex.
Emotional Issues - Sometimes, past issues such as sexual abuse or communication problems in a relationship can translate into sexual difficulties.

How Is It Treated?

Your treatment depends on the cause of the pain.

If you have an infection, your provider will prescribe medicine for it.
If vaginal dryness is the cause, your provider may recommend using a water-based lubricant every day or every time you have sex to decrease pain or discomfort. Lubricants can be purchased at a drugstore.
During or after menopause, an estrogen cream put on the vaginal area may help.
Kegel exercises and dilators of the vagina can help vaginismus.

Depending on the cause, other possible treatments include counseling or surgery.