If you experience chronic pelvic pain, seek medical advice to learn what treatments are available. After an examination, your doctor will order tests to determine the cause of your discomfort. Your physician may order an ultrasound, CT, or MRI scan of your pelvic area in addition to blood, urine, and lab tests.
Diagnosing Pelvic Pain
DiagnosisYour physician will request blood tests to detect blood cell counts and inflammation markers, or use tests to evaluate liver and kidney functions. Your health care provider may also suggest a cystoscopy, a procedure where a small camera (cystoscope) is inserted into the urethra allowing the doctor to view the inside of the bladder.
Laboratory tests and procedures
Pelvic pain can be diagnosed through various laboratory tests and procedures as recommended by your health care physician. Lab tests such as:
- Blood or urine tests – These tests may be conducted to determine if pelvic pain is associated with sexually transmitted diseases, pregnancy, or urinary tract infections
- Cystoscopy - This procedure involves a thin camera inserted into the urethra, allowing the doctor to view the inside of the bladder
- Transvaginal ultrasound - This test uses high-pitched sound waves and converts them into a picture displayed on a video monitor. No X-rays or radiation are used in this procedure.
- Pelvic laparoscopy – A pelvic laparoscopy may be performed as determined by your doctor. This is a minimally invasive surgical procedure in which a small incision is made below the belly button. An instrument called a laparoscope is inserted in order to view the inside of the pelvis.
Treatment for Pelvic Pain
TreatmentYour doctor can suggest pelvic pain treatments to manage and reduce your symptoms, whether or not a specific cause has been determined.
Over-the-counter medication, such as ibuprofen or another nonsteroidal anti-inflammatory, can help alleviate mild pain caused by fibroids, ovarian cysts, or other pelvic inflammatory diseases.
Medications
Medication can be used to manage and treat chronic pelvic pain, depending on the cause. Discuss these options with your physician to determine which is the best pelvic pain treatment for you:
- Over-the-counter pain relief medication, such as ibuprofen or naproxen (NSAID), is part of a nonsteroidal anti-inflammatory drug class taken by mouth to help relieve chronic pelvic pain
- In cases where pelvic inflammatory disease or urinary tract infection is the cause of pelvic pain, antibiotics may be prescribed
- Depending on the diagnosis made by your doctor, hormone treatment may be an option. This course of treatment could include oral contraceptives, gonadotropin-releasing hormone agonists, called GnRH therapy. This treatment suppresses ovulation and puts the body in a temporary, reversible state of menopause, that only lasts if the medication is taken.
- Progestin, a synthetic hormone, may be administered to shrink endometrial implants, thus reducing or eliminating pelvic pain caused by endometriosis
- Antidepressants are sometimes used to manage chronic pain. Tricyclic antidepressants can have pain-relieving qualities and may also help patients who do not suffer from depression.
Therapies
Your doctor may recommend physical therapy to address your pelvic pain. Trigger point injections are sometimes used to treat chronic pelvic pain. Additionally, psychotherapy can help you cope with pelvic pain regardless of its cause.
- Stretching exercises, massage therapy, and relaxation methods are beneficial in helping reduce chronic pain
- A physical therapist can target a specific point of pain using a TENS (transcutaneous electrical nerve stimulation) machine which delivers electrical nerve stimulation
- Physical therapists may also help you with exercises to relax and strengthen your pelvic muscles or ease discomfort
Surgery
Your doctor may recommend surgery to correct an underlying condition causing your chronic pelvic pain. Surgery is sometimes recommended in cases of endometriosis, ovarian cysts, and ectopic pregnancies.
- Laparoscopic surgical removal of endometriosis and ovarian cysts may be performed as determined by your doctor. During this minimally invasive surgical procedure, an instrument called a laparoscope will be inserted, allowing your physician to view the inside of the pelvis.
- A hysterectomy may be recommended in cases when chronic pelvic pain arises from endometriosis that is not treatable through hormone therapy
Find Treatment & Support for Pelvic Pain at NewYork-Presbyterian
At NewYork-Presbyterian, we pride ourselves on our unique approach to personalized care, treatments, and support for patients experiencing pelvic pain