Chronic Pelvic Pain & Endometriosis

Dysmenorrhoea is pain occurring during menstruation. It may be primary or secondary dysmenorrhea. Chronic pelvic pain is defined as pelvic pain of at least 6 months duration, not associated with periods or sex and may be continuous or intermittent. ​Causes of pelvic pain could be due to:

• Endometriosis
• Ovarian cysts
• Adenomyosis
• Fibroids
• Muscle spasm​
• Pelvic venous congestion
• Interstitial cystitis/bladder pain syndrome
• Irritable Bowel Syndrome
• Vulvodynia

Diagnosis is through careful and detailed history taking, thorough pelvic examination. And Investigations which may   include pelvic ultrasound and sometimes diagnostic laparoscopy.   

 

Management requires a holistic approach and may sometimes require a multidisciplinary input. Treatment may include NSAIDs, OCPills, and surgical LUNA -Laparoscopic uterine nerve ablation -Cutting or destroying uterine nerves blocks pain signals from reaching tissues and organs. Dietary supplements such as Magnesium and Vitamin B1 may also be helpful.