Pelvic pain is one of the most common symptoms that bring women to see their GP or gynaecologist. The good news is that it's usually possible to reduce the pain, even if you've been affected for years.
At The Medical Chambers Kensington the first important step is to have an accurate diagnosis. You'll be in good hands with our very experienced ultrasound specialists, gynaecologists and general practitioners. Once the cause of pain is more clearly understood, we'll suggest a programme of treatment to suit you.
Pelvic Pain and associated symptoms
Pelvic pain is a broad term and is frequently accompanies other symptoms, including:
- heavy bleeding, or irregular periods
- PMS (premenstrual syndrome)
- painful sex
- back pain and headaches
- irritable bowel syndrome, cramping, bloating
- stress, depression or anxiety
What may cause pelvic pain?
Pelvic pain may be caused by or connected with one or more of the following:
- conditions such as endometriosis (the growth of endometrial lining tissue outside the uterus, which reacts to hormone changes through the month)
- fibroids (masses of muscle tissue growing on or around the uterus)
- irritable bowel
- cystitis or other infection in the pelvis
- hormonal imbalance and dysfunction of the ovaries and uterus (including overactive ovaries, multicystic and polycstic ovaries)
- thyroid dysfunction
- conditions affecting the spine, muscles and pelvic bones, and poor posture
- emotional stress, depression or anxiety (which can have an impact on hormonal balance, lifestyle and posture, among other things)
A detailed examination is vital. As part of this we offer ultrasound scanning that allows us to view the structure and muscle tissues of your uterus, fallopian tubes and ovaries and observe the blood flow in your pelvis and the activity of your ovaries. We'll also take blood and swab tests to screen for infection.
Ultrasound is becoming increasingly accurate and we are proud to have some of the UK's leading specialists in gynaecological diagnosis. But occasionally, perhaps where there are very small patches of endometriosis or infection, it is useful to have a more detailed investigation using MRI scans or a hysteroscopy or laparoscopy, where a tiny 'scope' or camera is introduced into the pelvis. If this is advised in your case, your doctor will talk it through in detail and refer you to a specialist in these procedures.
Finding the right treatment for you
Occasionally there is a single issue that requires treatment, such as the existence of fibroids, but often there is more than one element that requires attention to assist the journey back to hormonal balance, healthy pelvic function, and a pain-free life.
Your gynaecologist or GP will consider your symptoms in the context of your personal medical history and your current lifestyle, and talk through the options with you. Often a combination of medical treatment and lifestyle or nutritional changes can help to reduce symptoms. Occasionally surgery is recommended and wherever possible this will be minimally invasive surgery.
Medication Treatment Options
Medication options for treating pelvic pain include pain relief such as paracetamol; for cramping or more severe pain during a period, NSAID medicines such as ibuprofen may be prescribed. Where heavy bleeding is a problem, medicines to reduce bleeding may be prescribed. Hormonal medication (such as the contraceptive pill) may help to restore balance and reduce menstrual flow, pain and PMS symptoms.
The hormonal coil (Mirena) delivers hormones directly into the uterus and can be very effective, particularly when there are fibroids. Other medication options include medicines targeted to reduce irritable bowel syndrome, GnRH analogues (which quieten the hormonal output from the ovaries) and HRT. Your doctor will talk to you about your options to discover which is most suitable. If an infection is identified, this will be treated with the appropriate medication.
Medications, particularly those affecting hormonal balance, can have side effects. Your doctor will talk through these in detail with you and at follow-up appointments will monitor the effectiveness of any medication that you are prescribed.
Surgical Treatment Options
Surgical treatment is an option in some cases, for instance where large fibroids are present in or around the uterus, or symptoms arise from endometriosis. Hysterectomy was once a fairly common treatment for severe pain, persistent fibroids or endometriosis, but where possible it is preferable to replace this with a procedure such as embolisation or myomectomy. These involve minimally invasive surgery and typically rapid recovery.