May has been designated “Pelvic Pain Awareness Month” by the International Pelvic Pain Society. Chronic pelvic pain is internal pain in the area below the belly button that lasts 6 months or longer. It often involves the sex organs, and includes pelvic infections, fibroids, endometriosis, adenomyosis, adhesions, prolapse, malignancy, or ovarian cysts.
Sometimes the pain is tied to problems with the intestines, such as diverticulosis, irritable bowel, food sensitivities, or bowel inflammatory syndromes. Other times, the bladder may cause pelvic pain with diagnoses like interstitial cystitis, chronic infection, stones, or malignancy. In some patients, pelvic pain may be due to musculoskeletal abnormalities, or pain syndromes like fibromyalgia, or history of abuse.
At Michigan Women’s Care, our providers have decades of experience in diagnosing, evaluating, and partnering with our patients to help minimize this difficult condition. We ask our patients to educate us about their pain onset, the circumstances that provoke or improve the pain, the quality, severity and radiation of the pain, and the effect on their quality of life. We then start an evaluation, including physical examination, imaging studies, blood and urine tests, and cultures. Based on the suspected cause of the pain, we offer the patient multiple options to help alleviate her symptoms and follow up appropriately to assure improvement.
In the past few years, many new options for chronic pelvic pain management have emerged. Those include newly FDA approved medications like Orilissa, which is specifically formulated for relief of endometriosis related menstrual pain or sexual pain. For fibroid related pain, our providers offer many options to excise the fibroids surgically, and this is done minimally invasively when appropriate. A new procedure called Acessa, done in an outpatient session, can soften the fibroids to a marshmallow texture, and thus minimize pain and bleeding and pressure symptoms. We also offer a new medication called Oriahnn which relieves heavy menstruation due to fibroids in premenopausal women, and this may decrease their pain. When acceptable, we provide judicious pain medication options.
In many women, physical therapy, counseling, relaxation techniques, biofeedback, and nerve blocks may provide supportive relief of pelvic pain.
If you are suffering from chronic pelvic pain, we promise to keep you informed and involved in your plan of care. Our team stays informed about the most advanced treatment options, and our doctors have years of expertise with minimally invasive hysteroscopic and robotic assisted surgery to help with your quality of life.