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The Causes and Complexities of Pelvic Pain

March 1, 2021
Chronic pelvic pain is a common ailment that may be hard to pinpoint in women of reproductive age. Christine M. Helou, M.D., a board-certified gynecologist with GBMC Health Partners, says there are several types of pelvic pain, ranging from acute, sharp spasms to heaviness or fullness that is felt more at the end of the day.

Pelvic pain can be caused by several different ailments or illnesses. Dr. Helou explains, "It's not an easy fix."
The number of women that only have one cause of pelvic pain is minimal, and there's usually more than one diagnosis that goes into treating pelvic pain

Some of the more common causes of pelvic pain include endometriosis, cysts, bowel disease, and pelvic inflammatory disease. Because of the variety of illnesses, Dr. Helou says she performs a thorough health history on every patient.

"We ask them about timing and patterns of the pain and any past trauma to the area, including sports injuries, car accidents, even horseback riding," she says. "We check for abdominal wall tenderness and do a pelvic exam to check for any signs that suggest infection or excess scar tissue from prior surgeries."

She notes that sometimes when pain continues for a long time, your brain starts to perceive the pain differently. Even after the original problem resolves, the pain can remain. When that happens, Dr. Helou explains, "We need to work to turn the pain signal down in the brain. All pain is experienced in the brain, and sometimes treatment efforts need to be directed there."

Pelvic pain can be caused by so many factors, which means treatments can vary greatly, and improvements are often gradual over time.

"Treatments can include medication, surgery, physical therapy, and complementary therapies like acupuncture, counseling, and even Botox injections," Dr. Helou says. "Often the best outcomes are found when we use a variety of treatments."

Similar to the development of chronic pain, it can take time to find and address the underlying problems causing the pain, Dr. Helou says.

Chronic pelvic pain isn't something you have to live with, according to Dr. Helou. She wants women to know that if something feels off, you shouldn't hesitate to reach out to your doctor. Whether it's pain during a period, discomfort when you urinate, or just a feeling of heaviness or tenderness in your pelvic area or lower back, finding the cause quickly will help put you on the road to recovery.

"The multidisciplinary team at GBMC is committed to working with patients to navigate the complexities of chronic pelvic pain," Dr. Helou says. "We're here to provide support and present the best options available for each individual."
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