----Finding Relief from Pelvic Pain

Many women have pelvic pain at some point during their lives, with approximately 14% to 16% of patients reporting significant pelvic pain during the past six months. Many times there is more than one reason for the pain, making it difficult to pinpoint the exact source. Chronic pelvic pain can be intermittent, which often has a distinct cause, or constant, which may be the result of more than one problem.

Common Causes

• Dysmenorrhea—painful cramping in the lower abdomen that occurs just before or during the menstrual cycle.
• Endometriosis—cells that normally line the uterus are found outside of the uterus. Painful menstrual cramps may be a sign, but some women also experience pain at other times during their cycle.
• Adenomyosis—cells that normally line the uterus grow into the uterine wall, causing painful menstruation and heavy or prolonged periods.
• Uterine Fibroids—benign (noncancerous) tumors that grow inside the uterus, on its outer surface, or within the wall of the uterus. Fibroids may cause heavy or more frequent menstrual periods and pain or pressure in the stomach or lower back.
• Pelvic Adhesive Disease—caused by scar tissue in the abdomen or pelvis following surgery, which may form between structures or organs not normally connected.

Non-gynecologic Causes

• Diverticulitus—inflammation of a pouch bulging from the wall of the colon
• Interstitial Cystitis—a common bladder problem
• Irritable Bowel Syndrome—may cause alternating bouts of constipation and diarrhea
• Depression—sometimes can also be the result of chronic pain

A variety of treatments may be used to treat this complex condition. Oral contraceptives may relieve pain from menstrual cramps. Other hormones may shrink the growth of endometriosis or fibroids. In some cases, antidepressants are prescribed for chronic pelvic pain when other treatments have been unsuccessful. Dependent upon diagnosis, certain conditions may be treated with surgery. Minimally invasive techniques can be used in some cases; traditional surgical procedures are necessary in others.

To learn more about the causes of and treatments for chronic pelvic pain, contact the Pelvic Pain Clinic within U-M’s Department of Obstetrics & Gynecology at (734) 763-6295.