Pelvic pain / Endometriosis
Pelvic Pain is usually multi-factorial. The most common causes of chronic pelvic pain are:
Female reproductive system
Pelvic pain arising from the female reproductive system may be caused by conditions such as:
•. Adenomyosis
•. Endometriosis
•. Menstrual cramps (dysmenorrhea)
•. Mittelschmerz (ovulation pain)
•. Ovarian cysts
•. Chronic Pelvic inflammatory disease (PID)
•. Uterine fibroids
•. Vulvodynia
Other causes
Examples of other possible causes of chronic pelvic pain include:
1. Bowel related problems:
2. Urinary related problem:
3. Past physical or sexual abuse
4. Pelvic floor muscle spasms / dysfunction
5. Pelvic congestion syndrome
6. Fibromyalgia
Understanding Endometriosis
Introduction
Endometriosis is common condition that affects at least 1 in 10 women approximately 179 million women and girls worldwide (usually in the reproductive years) of all ethnicities and social backgrounds. More than 120,000 Kiwi women suffer from this condition. It is one of the common but not the only cause of long-term pelvic pain as pelvic pain is usually multifactorial. 25-35% of women diagnosed with endometriosis have fertility delay. Family history of endometriosis can increase the chance to develop endometriosis 6 times.
What causes endometriosis?
The exact cause of endometriosis is unclear. Unfortunately, due to a widespread lack of awareness, women and girls go an average of nearly a decade before their symptoms are accurately diagnosed and appropriately treated. This obviously will have impact on their social and sexual live. In addition 25-35% will have their fertility reduced. Therefore an endometriosis specialist referral is recommended.
What are the symptoms of endometriosis?
The most common symptoms are pelvic pain, painful periods, pain during or after sex and impaired fertility or pregnancy loss. Some women have pain when they open their bowels or pass urine and some women have no pain or symptoms at all. Others only discover they have endometriosis when they are investigated for subfertility.
Some other symptoms associated with endometriosis are low mood, fatigue, poor sleep, headaches and anxiety or even significant depression.
How is it diagnosed?
It can be difficult to diagnose endometriosis through syptoms only as often the symptoms mimic other conditions such as irritable bowel syndrome, pelvic inflammatory disease, normal period pain or bladder inflammation. The only way to make a definite diagnosis is by laparoscopy (keyhole surgery).
Adenomyosis, in which endometriotic tissue is formed within the muscle wall of the uterus, is usually difficult but it not impossible to diagnose and treat.
Referral to our pelvic pain / endometriosis specialist:
If initial measures failed by your local doctor, referral to see endometriosis specialist is recommended. You will then need a full assessment by specialist to cover all related areas as well as set of investigation will be offered to initiate the best treatment plan for best outcome.
Female reproductive system
Pelvic pain arising from the female reproductive system may be caused by conditions such as:
•. Adenomyosis
•. Endometriosis
•. Menstrual cramps (dysmenorrhea)
•. Mittelschmerz (ovulation pain)
•. Ovarian cysts
•. Chronic Pelvic inflammatory disease (PID)
•. Uterine fibroids
•. Vulvodynia
Other causes
Examples of other possible causes of chronic pelvic pain include:
1. Bowel related problems:
- Irritable bowel syndrome
- Chronic constipation
- Crohn's disease
- Diverticulitis
- Ulcerative colitis
2. Urinary related problem:
- Interstitial cystitis (also called painful bladder syndrome)
- Recurrent urinary tract infection
- Kidney stones
3. Past physical or sexual abuse
4. Pelvic floor muscle spasms / dysfunction
5. Pelvic congestion syndrome
6. Fibromyalgia
Understanding Endometriosis
Introduction
Endometriosis is common condition that affects at least 1 in 10 women approximately 179 million women and girls worldwide (usually in the reproductive years) of all ethnicities and social backgrounds. More than 120,000 Kiwi women suffer from this condition. It is one of the common but not the only cause of long-term pelvic pain as pelvic pain is usually multifactorial. 25-35% of women diagnosed with endometriosis have fertility delay. Family history of endometriosis can increase the chance to develop endometriosis 6 times.
What causes endometriosis?
The exact cause of endometriosis is unclear. Unfortunately, due to a widespread lack of awareness, women and girls go an average of nearly a decade before their symptoms are accurately diagnosed and appropriately treated. This obviously will have impact on their social and sexual live. In addition 25-35% will have their fertility reduced. Therefore an endometriosis specialist referral is recommended.
What are the symptoms of endometriosis?
The most common symptoms are pelvic pain, painful periods, pain during or after sex and impaired fertility or pregnancy loss. Some women have pain when they open their bowels or pass urine and some women have no pain or symptoms at all. Others only discover they have endometriosis when they are investigated for subfertility.
Some other symptoms associated with endometriosis are low mood, fatigue, poor sleep, headaches and anxiety or even significant depression.
How is it diagnosed?
It can be difficult to diagnose endometriosis through syptoms only as often the symptoms mimic other conditions such as irritable bowel syndrome, pelvic inflammatory disease, normal period pain or bladder inflammation. The only way to make a definite diagnosis is by laparoscopy (keyhole surgery).
Adenomyosis, in which endometriotic tissue is formed within the muscle wall of the uterus, is usually difficult but it not impossible to diagnose and treat.
Referral to our pelvic pain / endometriosis specialist:
If initial measures failed by your local doctor, referral to see endometriosis specialist is recommended. You will then need a full assessment by specialist to cover all related areas as well as set of investigation will be offered to initiate the best treatment plan for best outcome.
Management
The exact cause of endometriosis is unclear. Therefore, unfortunately, due to a widespread lack of awareness, women and girls go an average of nearly a decade before their symptoms are accurately diagnosed and appropriately treated. Therefore an endometriosis specialist referral is recommended.
Treatment plan for Endometriosis will include:
1. Complete Initial assessment and examination
It is usually long consultation for 45-60 min by expert endometriosis / pelvic pain gynaecologist.
2. Arranging appropriate investigation
These investigations are based on presenting problem and any associated symptoms
3. Treatment plan for each symptom
4. Medical options:
There is a wide range of effective treatment available. The commonly used options are through special drug (s) +/- surgery (Keyhole surgery) by highly specialist gynaecologists. Each woman need to have treatment plan based on her condition and severity of endometriosis. In addition; complementary medicine, dietary advice and life style modification may be considered through our team.
How to make a decision about treatment
Each woman will be given specific information about the different options available to her and benefits involved.
Several factors may influence her decision including:
Living with endometriosis
Pelvic pain is often multi-factorial. It is important to over review other possible causes rather than focus only on endometriosis. Psychological issues as well as the urinary tract or bowel will need to be address.
Complementary therapies have been used by some women to relieve endometriosis symptoms e.g Yoga, Naturopath, dietary modification, gentle exercise and life style modification. We can help you with this. Also, joining support group found to be very helpful for many women.
For some women there is no long term treatment that helps. In these cases the woman will be helped to manage her symptoms rather than focus on more treatments. It is recommended to involve your partner during your treatment process for support and more understanding of your pain and associated problems. A specialist counsellor appointment can be arranged to see you and your partner.
The exact cause of endometriosis is unclear. Therefore, unfortunately, due to a widespread lack of awareness, women and girls go an average of nearly a decade before their symptoms are accurately diagnosed and appropriately treated. Therefore an endometriosis specialist referral is recommended.
Treatment plan for Endometriosis will include:
1. Complete Initial assessment and examination
It is usually long consultation for 45-60 min by expert endometriosis / pelvic pain gynaecologist.
2. Arranging appropriate investigation
These investigations are based on presenting problem and any associated symptoms
3. Treatment plan for each symptom
- Fatigue, low mood, poor sleep, anxiety, chronic pain condition
- Painful period.
- Pelvic pain muscles and painful intercourse.
- Bladder and Bowel symptoms.
4. Medical options:
There is a wide range of effective treatment available. The commonly used options are through special drug (s) +/- surgery (Keyhole surgery) by highly specialist gynaecologists. Each woman need to have treatment plan based on her condition and severity of endometriosis. In addition; complementary medicine, dietary advice and life style modification may be considered through our team.
How to make a decision about treatment
Each woman will be given specific information about the different options available to her and benefits involved.
Several factors may influence her decision including:
- Age
- Symptoms
- Wish to have children
- Previous treatments and effectiveness
- Feelings about surgery
- Other medical problems
Living with endometriosis
Pelvic pain is often multi-factorial. It is important to over review other possible causes rather than focus only on endometriosis. Psychological issues as well as the urinary tract or bowel will need to be address.
Complementary therapies have been used by some women to relieve endometriosis symptoms e.g Yoga, Naturopath, dietary modification, gentle exercise and life style modification. We can help you with this. Also, joining support group found to be very helpful for many women.
For some women there is no long term treatment that helps. In these cases the woman will be helped to manage her symptoms rather than focus on more treatments. It is recommended to involve your partner during your treatment process for support and more understanding of your pain and associated problems. A specialist counsellor appointment can be arranged to see you and your partner.