Pelvic Pain

Pelvic pain is a common problem among women. The pain can be acute (immediate/short term) or chronic (long term). For most women, it will relate to menstrual cramping pain or painful ovulation pain. Chronic pelvic pain affects approximately 4-16% of women between the age of 18 to 50. This condition can result in a significant burden on the health and emotional status effecting a patients quality of life. Seeking help early from health professional may avoid the pelvic pain becoming a long-term problem.

• Gynaecology related – endometriosis, pelvic mass

• Urogynaecology related – bladder pain syndrome/interstitial cystitis, pelvic mesh related complications

• Bowel related – Irritable bowel syndrome, diverticulitis

• Infection – sexually transmitted infection

• Other – Fibromyalgia, neuropathic pain, chronic fatigue syndrome, pelvic adhesions, referred pain

1. Baseline blood test to rule out possible infective or inflammatory causes

2. Imaging – pelvic ultrasound is the most common imaging modality used. Occasionally may require a CT scan or MRI of the pelvis depending on the clinical situation

3. Diagnostic laparoscopy may be considered if pelvic pain failed to improve with conservative management

The treatment can vary depending on the clinical condition. General pelvic pain management include:

• Oral analgesia – simple or multimodal therapies

• Managing slow bowel transit/constipation with laxatives

• Use of hormonal therapy (oral or intrauterine device) to supress menstruation if cyclical pain

• Women with complex or chronic pelvic pain may require a multidisciplinary team involvement including Urogynaecologist/Gynaecologist, Pain Specialist, Pelvic Floor Physiotherapist, Clinical Psychologist and possible gastroenterologist.

• Surgical management may be considered depending on clinical history and causes

Please contact Dr Yong’s room if you have further queries