Monday Medical: Women find help for pelvic pain
March 23, 2014
Pelvic pain has various descriptions, a range of causes and a multitude of symptoms. It can be serious enough to interfere with work and recreational activities. Sometimes, it is cyclical, an unwelcome aspect of a woman's menstrual cycle. Or it may develop at a later age.
How widespread is pelvic pain? It is estimated that more than one-third of all women will seek diagnosis and treatment by age 60. Many others choose to live with the pain or discomfort rather than see a health care provider.
"Some women think, ‘It's just what happens,' and don't get help," Steamboat Springs OB-GYN Dr. Mary Bowman said. "They expect their periods to be really awful, or they think that a pregnancy changed their uterus and they just have to live with it.
"Sometimes, pelvic pain is a short-term issue and it's good not to get overly anxious. However, if the problem continues for a couple of weeks without getting better, it's best to schedule an office exam. We can help figure out what is wrong."
Bowman said pelvic pain comes from three sources: infection, anatomic problems and hormonal issues. Infections can be diagnosed easily and treated with medication.
Anatomic examples include fibroids and ovarian cysts that may cause pain or bleeding. Previous surgery or pregnancy also can cause problems with the pelvic floor or prolapse of the uterus.
Endometriosis is a hormonal condition that often is cyclically painful, Bowman said.
"Diagnosis of pelvic pain may require an exam, ultrasound or further imaging. Occasionally, we need to use diagnostic laparoscopy to identify the problem," Bowman said. "Treatment depends on the cause but can include hormonal management, anti-inflammatory medications, pelvic pain therapy or sometimes surgery. Most of the time, there is help."
Kim Miles is a women's health specialist, also called a pelvic specialist. She has been working in this field for almost 15 years and has been providing pelvic pain therapy at Yampa Valley Medical Center's SportsMed clinic since 2006.
"For women who are experiencing urinary urgency and frequency, pain with intercourse or hormonal changes that cause a painful perineal area, therapy can address these issues and decrease the symptoms," Miles said.
"Therapy can include massage, biofeedback, muscular re-education and techniques to reduce spasm, therapeutic exercises and yoga-style stretching," she added. "Our clients will get initial treatment to improve their quality of life, then learn how they can continue self-treatment at home."
Miles likes to empower her clients through education. She may recommend a consultation with a YVMC dietitian or help her patients obtain a biofeedback unit for home use and teach them how to use it.
"Most therapy clients come for six to eight visits and then use the techniques on their own," she said. "A lot of women come to see me once a year for a checkup."
Miles' clients range in age from 18 to 80 and beyond. She said young women in their 20s experience more pelvic pain than people might realize.
"Some of my patients, especially younger women, have done significant online research before seeking therapy," Miles said. "And we know that other women suffer in silence, thinking there may not be help or a cure."
Miles and Bowman would like to change that in the Yampa Valley.
"Yes, it happens, our bodies do change and sometimes we develop problems, but we don't necessarily have to put up with it," Bowman said. "Sometimes, women are so worried or fearful that it can be a relief to find out what is causing the problem and what we can do to help them."
"A lot of women think it's natural to experience the same things their mothers did, or they feel they just have to endure hormonal changes," Miles said. "But we don't want women to live with problems when there are many ways we can help."
Christine McKelvie is a writer/editor for Yampa Valley Medical Center. She can be reached at firstname.lastname@example.org.