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Diagnosing Chronic Pelvic Pain
Your pelvic pain may not have an obvious cause. It may take some time and effort to figure it out. According to the International Pelvic Pain Society, 61% of women suffering from chronic pelvic pain don't know what is causing it. But with the right diagnosis you can get relief. There are specialists you can turn to and tests that can be done to determine why you have the pain and what can be done about it.
First, make a detailed list of your symptoms, both physical and emotional, to share with the doctor. Also make a note of:
- When you started having each symptom
- If anything you've tried has helped with the pain
- Whether the pain is better or worse at certain times
- If the pain is related to your menstrual cycle
- Any injury, illness, or surgery you have had
Because chronic pelvic pain often has more than one cause, you may need to see more than one specialist. Your gynecologist would be a good person to see first. For many women, pelvic pain is related to a problem with the reproductive system.
Tests for Chronic Pelvic Pain
First you will have a pelvic exam. Then the doctor will:
- look at the way you sit and stand
- press on various points all over your abdomen and pelvic area, asking you to say if anything hurts
- have you tense and relax your pelvic muscles
- feel for anything unusual inside your vagina, uterus, and rectum
In addition, a urine test can help identify if a urinary tract infection might be the cause of your pelvic pain.
A pelvic exam may be enough to diagnose your problem, or at least part of it. But the doctor may want to do an imaging test like a transvaginal ultrasound, a CT scan, or an MRI scan of the abdomen and pelvis for a more complete picture. Unfortunately these test may be negative and there still may be a physical cause to the pain which can only be seen by laparoscopy.
Radiological tests may be useful to diagnose:
- Endometriosis
- Pelvic congestion
- Adhesions
- Fibroids
- Pelvic inflammatory disease
Procedures Used to Diagnose Chronic Pelvic Pain
An operation called laparoscopy can confirm a diagnosis or look for the cause of chronic pelvic pain that can't be found in radiological exams. It involves inserting a camera or scope through a small incision to look at the pelvic organs or take tissue samples. Also, a hysteroscopy, a small camera placed through the vagina into the uterus, may be useful to diagnose abnormalities that may cause pain originating inside the uterus.
"Pain mapping" is a technique some doctors use. While you're sedated but awake, a doctor uses a laparoscope and a probe to stimulate points inside your pelvis. You rate any pain you feel and say whether it is like the pain you typically experience. This creates a "map" of sensitive areas.
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VIVELLE-DOT (estradiol transdermal system) IS AVAILABLE BY PRESCRPTION ONLY.
INDICATION
Vivelle-Dot is used after menopause to: reduce moderate to severe hot flashes; treat moderate to severe dryness, itching and burning in or around the vagina; help reduce your chances of getting osteoporosis (thin weak bones); and treat certain conditions in which a young woman's ovaries do not produce enough estrogens naturally. Vivelle-Dot 0.025 mg/day is only used to prevent osteoporosis from menopause. If you use Vivelle-Dot only to treat your dryness, itching, and burning in and around your vagina or if you use Vivelle-Dot only to prevent osteoporosis from menopause, talk with your healthcare professional about whether a different treatment or medicine without estrogens might be better for you.
IMPORTANT SAFETY INFORMATION
Estrogens increase the chances of getting cancer of the uterus (womb). Report any unusual vaginal bleeding right away while you are taking estrogens. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb).
Do not use estrogens with or without progestins to prevent heart disease, heart attacks, or strokes. Using estrogens with or without progestins may increase your chances of getting heart attacks, strokes, breast cancer, and blood clots. Using estrogens with progestins may increase your risk of dementia (decline in memory and thinking skills).
Vivelle-Dot should not be used if you have unusual vaginal bleeding; currently have or have had certain cancers, including cancer of the breast or uterus; had a stroke or heart attack in the recent past (for example, in the past year); currently have or have had blood clots; currently have or have had liver problems; or think you may be, or know that you are, pregnant.
The most common side effects that may occur with Vivelle-Dot are headache, breast tenderness, and back pain.
You and your healthcare professional should talk regularly about whether you still need treatment with Vivelle-Dot.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Please see Full Prescribing Information for Vivelle-Dot.
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