In the first part of this article, we looked at endometriosis and uterine fibroids as causes of chronic back and pelvic pain. The following two gynecological conditions may also cause such symptoms.
Adenomyosis is similar to endometriosis in that it entails the irregular growth of the tissue that lines the uterus. In adenomyosis, however, the tissue intrudes upon the uterus itself and not other structures. Endometrium is the lining of the uterus that sheds during menstruation, and myometrium is the thick muscle wall that supports the uterus and gives it its shape. Adenomyosis is present when the endometrium intrudes upon the myometrium.
The endometrium that is embedded in the uterine muscle can’t shed normally during menstruation. This can cause the uterus to swell, sometimes doubling or tripling in size.
Some common symptoms of this condition include:
Severe cramping and sharp pains during period
Heavy or prolonged periods
Worsening menstrual pain with age as uterus enlarges
Pain as feces pass through bowels or bladder fills with urine, pressing on uterus
Passing of blood clots during period
Adenomyosis may easily be misdiagnosed as endometriosis or uterine fibroids. It is most common in women over 35 who have had children. Like most other pelvic disorders, its cause is not known for sure. It is thought that pelvic surgery such as fibroid removal or C-section can cause the two tissues to mix, or that genetic abnormalities at birth may cause this to occur. A pelvic exam, ultrasound and/or MRI may be used to diagnose the condition. Treating adenomyosis usually involves treating the symptoms, as the condition is generally not serious beyond the pain it causes. Hormone medications that alleviate painful periods often help. In rare cases, hysterectomy might be in order.
Pelvic Inflammatory Disease (PID)
This gynecological condition stands out from the other three in that it is better understood by the medical community. PID is caused when bacteria from the vagina travels up into other pelvic organs, like the ovaries, uterus and fallopian tubes. Most of the time, the bacteria involved are sexually transmitted, usually in the form of gonorrhea or chlamydia. PID is startlingly common; according to the National Center for Biotechnology Information’s website, about 1 in 8 sexually active females develop PID before age 20.
Bacterial infection causes inflammation. The body’s inflammatory response rushes to infected areas to 1) block off the threat from other body parts and 2) attempt to kill the infection. This leads to chronic inflammation of the affected pelvic organs.
Not all women with PID have symptoms, but for those that do, common symptoms include:
Chronic pelvic and lower back pain
Ectopic pregnancy or infertility
Vaginal discharge with odd consistency, color or smell
As with the other gynecological conditions discussed, PID can cause menstrual abnormalities and pain during intercourse.
A pelvic examination can reveal abnormal cervical conditions like bleeding and pain that indicate pelvic inflammatory disease. Blood work may also be done to detect infection. STI testing, which involves collecting a culture of your vagina or cervix, can detect gonorrhea or chlamydia. An ultrasound or CT scan can rule out other possible causes of your symptoms.
If you have chronic pelvic and back pain accompanied by fever, menstrual irregularities, infertility and painful intercourse, the cause of your pain is likely gynecological. It is a good idea to keep track of your symptoms in a log or pain diary so that your doctor can more easily help you reach a diagnosis. There are many causes of pelvic pain in women; narrowing yours down to a gynecological cause is one step closer to relieving your pain.
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