Pelvic Pain

Most women experience pelvic pain at some point of their life, regardless of age, race, marital status or childbearing history. Pelvic pain may occur due to the normal functioning of the female reproductive or other organs, but sometimes women may have chronic pelvic pain that indicates a problem that may need treatment.

Period pain and endometriosis are the two common pelvic pain conditions that most women go through.

Period pain (Dysmenorrhea)
It is common for women to experience pain during their monthly period. This is also known as dysmenorrhea. Women often describe this pain as a deep, dull ache, or a cramping sensation in the lower abdominal area. Although this pain usually occurs during menstruation, it can start a few days before the menses as well (pre-menstrual syndrome).

Period pain is usually classified into two types:

Primary dysmenorrhea occurs when menstruation begins and lasts for about 2 to 3 days. It is caused by forceful contractions of the uterus brought about by prostaglandins (naturally occurring hormones produced by the body).
Secondary dysmenorrhea is caused by an underlying disorder, such as endometriosis, pelvic inflammatory disease, a growing fibroid tumour or an ovarian cyst. Women who have heavy periods (menorrhagia) have trouble with period pain more often than women who do not. Their pain may be caused by the uterus trying to expel blood clots that have not fully dissolved.
Keep a diary of your symptoms for a few months. This will enable you to look closely at when the pain is at its worst and let you plan ahead. You will also be able to give your doctor accurate information about the nature of your period pain, if required.

Exercise regularly between periods. Some women find that doing gentle stretching exercises or going for a walk helps relieve their pain. Resist the urge to walk hunched over during your period. A warm pack, such as a hot water bottle, applied to the abdomen can also provide some relief.

You may need to take some mild painkillers, such as paracetamol, aspirin or other NSAIDs, to relieve your period pain. These are available from your doctors and pharmacists. You will need to take these painkillers regularly during the first few days of your menses in order to control the pain better. If you have other symptoms associated with your period pain, such as irregular or heavy bleeding, you will need to see your doctor for further evaluation.

Endometriosis
Endometriosis is a disease that affects female reproductive organs and the monthly menstrual cycle. Under the influence of cycling female hormones , the t issue that lines the uterus (endometrium) thickens with blood every month. With endometriosis, tissue from the lining of the uterus grows elsewhere in the pelvic cavity and bleeds every month when you have your period. Instead of flowing harmlessly outside the body, however, the bleeding wreaks havoc in the abdominal cavity. The resulting chronic tissue inflammation leads to the formation of adhesions and scars, which surround and entrap delicate reproductive organs. The result can be severe pain that adversely interferes with your daily living and may affect your health.

Endometriosis commonly affects women of childbearing age. A woman who has endometriosis may experience one or more symptoms – cramps and period pain, fatigue, premenstrual spotting, pelvic pain, pain during sexual intercourse and difficult getting pregnant (infertility).

To confirm this condition, a pelvic examination, laboratory tests and/or laparoscopy may be required.

If you have endometriosis, your doctor may treat you with hormone therapy alone or in combination with surgery. Hormone therapy limits the swelling of the endometrium and endometrial implants by controlling or blocking the actions of the hormones that regulate the menstrual cycle. Medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), are sometimes given to relieve the pain.

For some women, surgery may be required to combat the effects of endometriosis. The type of surgery performed would depend on the woman's age, extent of disease and fertility issues.