Pelvic pain
Women and Pelvic pain
Most women (and some men), sometime in their lives experience pelvic pain (when at least 3 mths, called chronic pelvic pain (CPP)). This is a poorly understood condition that likely represents abnormal neurological function, either in the peripheral nervous system or central nervous system. Mainly different etiologies have been proposed for CPP, but a major problem is that virtually none of them have been validated. Commonly proposed etiologies include:
- endometriosis (very controversial)
- infection or post-infectious neurological hypersensitivity
- exaggerated bladder, bowel, or uterine pain sensitivity (also known as visceral pain)
- ovarian cysts, uterine leiomyoma - often found in asymptomatic patients as well, however
- less common emergencies: ovarian torsion - sudden loss of circulation to the ovary, appendicitis - infection of one part of the intestine, with right lower abdominal pain, ectopic pregnancy - where an early pregnancy grows outside of the uterus, and can cause sudden, heavy intra-abdominal bleeding
Women with symptoms of pain may want to see a gynecologist if problems don't go away after a few days, and workup should begin with a careful history and examination, followed by a pregnancy test. Some women may also need bloodwork or additional imaging studies, and a handful may also benefit from having surgical evaluation using small telescopes. Many women will benefit from a consultation with a physical therapist, a trial of anti-inflammatory medications, hormonal therapy, or even neurological agents.
This is a condition that although common, direly needs to be studied more closely.
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