Do you have chronic pelvic pain that has persisted over weeks to months? Do you experience pelvic pain whenever you have sex? If you suffer from acute or chronic pelvic pain issues, you should undergo an evaluation. There are many potential causes for your pelvic pain problem, and only a thorough evaluation can help diagnose and treat the causative condition. Pelvic anatomic conditions, urinary tract, psychological, atrophic and intestinal problems are just some of the issues that can cause pelvic pain.

Anatomic conditions that can cause pelvic pain include endometriosis, adenomyosis, large or ruptured ovarian cysts, pelvic tumors, pelvic adhesions, and many other female anatomic conditions. These problems can be diagnosed through many evaluations including pelvic exam, pelvic ultrasound, pelvic CT or MRI, and/ or Laparoscopy. Treatment can include medical therapy, but may also need an outpatient surgical procedures such as laparoscopy. Here, a scope is inserted into the abdomen and the pelvic area is examined. If a problem is identified, treatment may be also performed at the same time as the laparoscopy procedure through small poke holes in the abdomen.

Painful intercourse on first penetration into the vagina may be caused by an inflammation of the hymenal remnant on the outside of the vagina. Called a vestibulitis, it may be treated adequately by a simple excision of this excess tissue to allow for more comfortable penetration. Called a vestibulectomy, it can be performed as an out patient. The results can improve a woman’s sexual experience remarkably if she suffers from this problem.

Lack of hormones during menopause may cause a thinning of the vaginal mucosa resulting in pain with intercourse. Hormone therapy many times is all that is needed to take care of this problem. Sometimes prior trauma or emotional experiences can result in spasms of the vaginal muscles, called vaginismus. Biofeedback therapy may be necessary to treat this condition.

Pelvic Pain Causes at a Glance
Bladder Infections
Evaluated with a urine culture. Treated with antibiotics.
Bowel condition
Inflammatory conditions of the bowels usually are associated with symptoms of diarrhea or constipation
Endometriosis
Endometrial implants inside the abdomen can be diagnosed and treated with laparoscopy; sometimes hysterectomy.
Pelvic Adhesions
Scar tissue inside abdomen diagnosed and treated with laparoscopy
Ovarian cysts
First seen via ultrasound. Treatment may be through laparoscopy
Uterine adenomyosis
Suspected through patient’s complaints, by uterine palpation and by vaginal ultrasound evaluation. Treatments are multiple, but may include a hysterectomy.
Uterine fibroids
Degenerating fibroids may cause pain. Diagnosed by ultrasound. Treatments are variable, including hysterectomy.
Appendicitis
Suspected from exam and history. Treated with laparoscopy or surgery
Ovarian tumor
Multiple etiologies, including endometriomas. Diagnosed laparoscopically

There are many other causes of pelvic pain that can occur in a woman. If you suffer from this problem, call our office for an appointment. Dr. Robert True has been helped hundreds of women in the Dallas Fort Worth areas solve their pelvic pain problem through multiple modalities. Located in Colleyville, TX, his office is right next to DFW airport. For an appointment, call 817-399-8783.

Options to evaluate and treat pelvic pain:

  • Vaginal Ultrasound
  • Laparoscopy
  • Vestibulectomy
  • Hormonal Therapy
  • Hysterectomy