Persistent pelvic pain
A lot of the women we see at Aceso have trouble with pelvic pain. If it has been present for more than 6 months, and especially if it is present more days than not, then it is called persistent (or chronic) pelvic pain. From the outset, it should be recognised that this is often due to several causes, which may be inter-related.
Common issues we will look out for include:
- Painful bladder syndrome/Interstitial cystitis
- Irritable bowel syndrome
- Pelvic muscle pain and dysfunction
- Pudendal nerve pain (neuralgia)
- Chronic vaginal infection or irritation – for example, due to thrush, chlamydia, or after menopause
Sometimes, something such as an ovarian cyst might be found, but in general cysts cause reasonably rapid onset of pain, and often resolve by themselves. In some cases, some of the above issues might have already been diagnosed, and the tendency is to try and fit all the symptoms into one category (“it’s my endo”). In our experience, this is usually a mistake, and might explain why some women have had several surgeries for endometriosis, but never really got a lot better.
What to do
The first step is to take a careful and thorough history.
In some cases, particularly when the problem has been there for a long time, if there have already been several operations done and/or several different practitioners involved, the history and examination might have to be spread across two visits. Please bring any copies of operation notes or letters you have from previous doctors.
How we can help
Frequently when we break the issues down and start thinking about the sources of pain more holistically we can make some real progress.
Be prepared for it to take some time – a complex problem is unlikely to be solved with one simple solution, be that a drug or an operation.
However we will take your symptoms seriously and try our best to help make some progress.