Pelvic pain is a very common complaint when a patient has a gynecological visit. It has been reported that 15-40% of women of childbearing age had or currently have pelvic pain. There are many different causes of pelvic pain, including:
For the purpose of this discussion, we will focus on the gynecological causes for pelvic pain. These can include pelvic inflammatory disease (PID), endometriosis, fibroids, ovarian cysts, dysmenorrhea (painful menstrual cycles) or ectopic pregnancy.
The evaluation of pelvic pain will significantly be guided by a patient’s history and physical examination.
A detailed history will be obtained and a thorough physical examination will be performed at the visit.
Important questions included in the history will include:
These questions help us to personalize your plan of care as far as diagnostic testing and treatment.Sometimes, it can be very difficult to diagnose the cause of pelvic pain. The process usually involves evaluating individual systems in your body and eliminating some of the possible causes listed above until we have narrowed it down. The evaluation can include laboratory studies, ultrasound, CT scan, sexually transmitted disease screening and pelvic examination.
There are many modalities of treatment for pelvic pain. In our practice, all our physicians are well versed in the various forms of surgical, hormonal and pain management.
Each patient will receive individualized care and hopefully relief from pain. The etiology of your pain will dictate YOUR plan of care.
Uterine fibroids, also known as leiomyomas, are benign, non-cancerous muscular tumors that can grow anywhere on a woman’s uterus. They are the most common type of growth found in a woman’s pelvis. Uterine fibroids are made up of the cells that make up the muscle of the uterus, and can grow outside, against, or even inside the uterine lining. The size, shape, number, and location of uterine fibroids vary greatly depending on the woman and her specific case. They can be as small as a pea, or as large as a grapefruit, causing the uterine wall to distort and change. They can even grow large enough to completely fill the pelvis or the abdomen, making the woman appear pregnant. Their growth is unpredictable.
Although fibroids are extremely common, there is not much known about what causes them. However, it is known that the female hormone estrogen can increase their growth. Uterine fibroids are most common among women around the ages of 40 and early 50's, and more common in African-American women. Although they can occur at any age, about 20 to 80 percent of women may develop fibroids by age 50. Fibroids can be linked to family history, obesity and consuming a diet high in red meat.
Many uterine fibroids can be asymptomatic (cause no symptoms), or they can cause many severe symptoms in a woman. Most common symptoms are:
These symptoms are also very general and could be indicative of other problems. If you have any of these symptoms, you should still see your doctor to determine the cause.
The first signs of uterine fibroids may be found during pelvic exams performed by your gynecologist. If he or she finds signs of fibroids, your doctor may perform one or more of these tests:
If you have been diagnosed in the past with uterine fibroids, you will need to have regular check-ups with your doctor to monitor their growth and to make sure that you are healthy.
If the uterine fibroids are small and asymptomatic, many do not need to be treated. However, those that develop severe symptoms, as described above, often require treatment. Rapid increase in growth of a fibroid requires medical attention and proper treatment.