Chronic pelvic pain in women


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Tests and diagnosis

By Mayo Clinic staff

Pain Management Advisor

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Figuring out what's at the root of your chronic pelvic pain often involves a process of elimination because many different disorders can cause pelvic pain. In addition to a detailed interview about your pain, your personal health history and your family history, your doctor may ask you to keep a journal of your symptoms.

Possible tests or exams your doctor might suggest include:

  • Pelvic exam. This can reveal signs of infection, abnormal growths or tense pelvic floor muscles. Your doctor checks for areas of tenderness and changes in sensation. Let your doctor know if you feel any pain during this exam, especially if the pain is similar to the discomfort you've been experiencing.
  • Cultures. Lab analysis of cell samples from your cervix or vagina can detect infections, such as chlamydia or gonorrhea.
  • Ultrasound. This test uses high-frequency sound waves to produce precise images of structures within your body.
  • Other imaging tests. Your doctor may recommend abdominal X-rays, computerized tomography (CT) scans or magnetic resonance imaging (MRI) to help detect abnormal structures or growths.
  • Laparoscopy. During laparoscopy, your doctor makes a small incision in your abdomen and inserts a thin tube attached to a small camera (laparoscope). The laparoscope allows your doctor to view your pelvic organs and check for abnormal tissues or signs of infection in your pelvis. This procedure is especially useful in detecting endometriosis and chronic pelvic inflammatory disease.

Finding the underlying cause of chronic pelvic pain can be a long process, and in some cases, a clear explanation may never be found. With patience and open communication, however, you and your doctor can develop a treatment plan that helps you live a full life with minimal discomfort.

References
  1. Howard F. Causes of chronic pelvic pain in women. http://www.uptodate.com/home. Accessed April 7, 2013.
  2. Howard F. Treatment of chronic pelvic pain in women. http://www.uptodate.com/home. Accessed April 7, 2013.
  3. Gallenberg MM (expert opinion). Mayo Clinic, Rochester, Minn. April 19, 2012.
  4. Rakel RE. Textbook of Family Medicine. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.mdconsult.com/das/book/body/191205553-4/0/1481/0.html#. Accessed April 7, 2013.
  5. Chronic pelvic pain. The American Congress of Obstetricians and Gynecologists. http://www.acog.org/~/media/For%20Patients/faq099.pdf?dmc=1&ts=20130418T1809515975. Accessed April 18, 2013.
  6. Howard F. Evaluation of chronic pelvic pain in women. http://www.uptodate.com/home. Accessed April 7, 2013.
  7. Interstitial cystitis/painful bladder syndrome. National Kidney and Urologic Diseases Information Clearinghouse. http://kidney.niddk.nih.gov/kudiseases/pubs/interstitialcystitis/index.htm. Accessed April 7, 2013.
  8. Carinci AJ. Complementary and alternative treatments for chronic pelvic pain. Current Pain and Headache Reports. 2013;17:316.
  9. Stones W, et al. Interventions for treating chronic pelvic pain in women. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000387/abstract. Accessed April 7, 2013.
  10. Relaxation techniques for health: An introduction. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/sites/nccam.nih.gov/files/relaxation_introduction.pdf.Accessed April 14, 2013.
  11. Noncyclic chronic pelvic pain therapies for women: Comparative Effectiveness Review No. 41. AHRQ Publication No. 11(12)-EHC088-EF. https://www.ncbi.nlm.nih.gov/books/NBK84586. Accessed April 28, 2013.
  12. Martinez B. Management of patients with chronic pelvic pain associated with endometriosis refractory to conventional treatment. Pain Practice. 2013;13:53.
  13. George SE, et al. Physical therapy management of female chronic pelvic pain: anatomic considerations. Clinical Anatomy. 2013;26:77.
  14. 14. Kotarinos RK. Pelvic floor physical therapy for management of myofascial pelvic pain syndrome in women. http://www.uptodate.com/home. Accessed April 8, 2013.
  15. Hunter C, et al. Neuromodulation of pelvic visceral pain: Review of the literature and case series of potential novel targets for treatment. Pain Practice. 2013;13:3.
  16. Acupuncture for pain. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/acupuncture/acupuncture-for-pain.htm. Accessed April 14, 2013.
DS00571 May 18, 2013

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