Pelvic Pain Specialist

What causes pelvic pain?

Pelvic pain may originate from the peritoneum, the membrane that lines the abdomen and covers all of your abdominal organs. Your pain may also arise from conditions affecting the pelvic organs and supporting muscles.

Gynecologic conditions often cause pelvic pain, with the most common including:

• Endometriosis
• Uterine fibroids
• Adenomyosis
• Ovarian cysts
• Pelvic inflammatory disease
• Pelvic adhesions (scar tissue)

Among all of the conditions in this list, endometriosis is the most common.

What is the connection between endometriosis and pelvic pain?

Endometriosis occurs when tissues normally found in the uterus lining grow on other organs in your pelvic area. The lining of the uterus, called the endometrium, thickens every month. If you don’t get pregnant, the endometrium sheds, and you have your period.

Many experts believe that endometriosis begins when some of your menstrual blood flows backward, through the fallopian tubes, and out into your pelvic region. Endometrial cells in the blood then attach and grow on your fallopian tubes, ovaries, bladder, outer uterus, and other organs.

The patches of endometriosis follow the same monthly cycles as if they were still inside your uterus. When they bleed, the blood causes inflammation and scarring. That’s when you develop pelvic pain.

How is pelvic pain diagnosed?

Dr. Brodman begins by reviewing your medical history, learning about your symptoms, and completing a pelvic exam. 

They may also do diagnostic imaging such as ultrasound or MRI, depending on the results. Ultrasound may provide enough information for an accurate diagnosis, but an MRI does a better job of showing deep infiltrating endometriosis.

How is pelvic pain treated?

Once Dr. Brodman diagnoses the cause of your pelvic pain, she creates a plan to ease your symptoms and treat the underlying condition. 

The first line of treatment for most women is medication to relieve the pain, such as over-the-counter painkillers. You may need hormonal treatment like birth control pills if your pelvic pain is associated with specific times during your menstrual cycle.

Surgery is often the best treatment when your pelvic pain is caused by endometriosis, adenomyosis, or uterine fibroids. Dr. Brodman may recommend one of the following:

Laparoscopic deep excision surgery

This minimally invasive procedure is the best way to remove the patches of endometriosis and all of the scar tissue caused by endometriosis and adenomyosis. Adenomyosis occurs when endometrial tissue lining your uterus grows into the muscular wall.

Myomectomy

You may need a myomectomy when uterine fibroids are responsible for your pelvic pain. Your provider carefully cuts away all fibroids by performing a minimally invasive hysteroscopic myomectomy or laparoscopic myomectomy. 

Hysterectomy

Dr. Brodman only recommends a hysterectomy (removal of your uterus) as a last resort. A hysterectomy is typically only performed when your pelvic pain is caused by severe, diffuse adenomyosis.

If you struggle with pelvic pain, call the office of Karen F. Brodman, MD, or book an appointment online today.