Other GYN Concerns
One of the most common causes of frequent pelvic pain is a chronic condition known as endometriosis. Affecting 1 in 10 women in the United States, endometriosis causes tissue that is typically found in the lining of the uterus to grow on the outside of the reproductive organs. This can cause symptoms such as chronic pain in the area, especially before and during menstrual periods, as well as pain during sex, heavy menstrual bleeding, nausea or vomiting, and long menstrual periods. In 30-40% of women with endometriosis, the condition can also create problems with fertility.
The cause of endometriosis is still somewhat of a mystery. While symptoms don’t tend to appear until puberty or years after, there is evidence that the condition is present even during fetal development. There are several theories about potential contributing factors, including genetics, retrograde menstruation (in which menstrual blood and endometrial cells flow backward through the fallopian tubes and into the pelvic cavity), embryonic cell growth, and more.
Fortunately, not all women with endometriosis have difficulty conceiving or carrying out a healthy pregnancy. But in some cases, the endometrial tissue can obstruct the fallopian tube, blocking the sperm and egg from uniting, or the inflammation caused by the condition can damage the sperm and egg. For these women, excision surgery to remove the endometrial tissue may be able to improve their fertility.
Pelvic Organ Prolapse
The organs in the pelvic area are held in place by supportive tissue and muscle, but when this support fails, organs can lose position and drop toward or into the vaginal area. This is called pelvic organ prolapse. The condition can affect the uterus, bladder, rectum, or part of the small intestine. Though pelvic organ prolapse can be alarming for women, it is a treatable condition with both surgical and non-surgical options, depending on each patient’s unique needs.
Pelvic Organ Prolapse FAQs
Many women, especially those with only mild prolapse, do not have any symptoms. However, if symptoms do appear, they typically include a feeling of heaviness or fullness in the pelvic region, a pulling or aching feeling in the pelvis, pain or discomfort during sexual activity, and difficulty urinating to having a bowel movement. In cases of severe prolapse, you may be able to see or feel a bulge either at or past the vaginal opening.
In short, pelvic organ prolapse is caused when there is damage or weakening of the tissue and muscle which secures the pelvic organs in place. This is most commonly caused by pregnancy and childbirth (especially vaginal childbirth), though it can also occur due to a previous pelvic surgery, menopause, and aging.
Polycystic Ovarian Syndrome (PCOS)
PCOS is a hormonal imbalance in which a woman’s body produces too much androgen. This affects menstrual regularity and fertility and causes multiple cysts to form in the ovaries. This same hormonal imbalance can also be associated with insulin resistance and is more prevalent among obese women. While PCOS can have significant implications for fertility and has also been associated with a higher risk of several serious health conditions, it is a highly treatable condition.
Polycystic Ovary Syndrome FAQs
Though symptoms will vary somewhat from one woman to another, the most common symptoms of PCOS include irregular menstrual periods, discomfort/pain from ovarian cysts, hirsutism (excess hair growth on the face, chest, abdomen, or upper thighs), severe and/or stubborn acne and oily skin, and acanthosis nigricans (patches of thickened, velvety, darkened skin). PCOS is also associated with obesity, infertility, and insulin resistance.
The cause of the condition is still unknown. However, researchers believe it to be a combination of several factors, and genetics is thought to play a role as well. Obesity is also likely to be related, because over 80% of women with PCOS are obese and when PCOS is developed at a later age, it often follows a substantial weight gain. In some cases, bariatric surgery to help morbidly obese women lose weight has also been shown to improve or resolve PCOS.