Endometriosis and Chronic Pelvic Pain
What is endometriosis?
Endometriosis is a condition where the tissue that lines the uterus grows or migrates outside of the uterus and implants in the pelvis. This lining is called the endometrium. This tissue responds to hormones just like the endometrium lining the uterus—it thickens, breaks down, and bleeds.
Common symptoms include:
- Pelvic pain
- Painful periods
- Pain with sex
- Infertility or difficulty getting pregnant
- Heavy periods
How to evaluate chronic pelvic pain:
At Gynecology Specialists, we will do a thorough history and physical exam to evaluate chronic pelvic pain. We will order a urine culture to check for a urinary tract infection and STD cultures to check for a sexually transmitted infection. We will order imaging studies like a pelvic ultrasound or MRI to assess the uterus and ovaries. Finally, we will discuss a surgical option called laparoscopy, to go into the pelvic with a camera to look for endometriosis.
What are other causes of chronic pelvic pain?
- Pelvic inflammatory disease
- Ovarian cyst
- Enlarged uterus—possibly due to uterine fibroids
- Pelvic floor dysfunction
- Interstitial Cystitis
What are my options for treatment?
There are many treatment options for pelvic pain depending on the source of the pain. These options include medications, physical therapy, and surgery.
Endometriosis may be managed by hormonal medication options including the birth control pill, Nuvaring®, Depo-Provera® shot, Mirena® IUD, and the Skyla® IUD. Other medications that suppress ovarian function like Lupron® can be considered.
Surgical options include a laparoscopy (as mentioned above) and removal of endometrial implants. Another surgical option includes a hysterectomy to remove the uterus and possible removal of the ovaries. At Gynecology Specialists, a surgical consult appointment can be made with one of our surgeons to discuss these options in more detail.
For other sources of chronic pelvic pain, other treatment options to consider may include pelvic floor physical therapy, antidepressant medications, and multi-disciplinary care with other specialists.
The decision about whether treatment is needed, and what type of treatment to choose, is different for every woman. We will discuss all of your options with you, and come to a decision about treatment based upon your personal situation and preferences.