Chronic Female Pelvic Pain - Exams and Tests
Although your condition may be diagnosed during your first exam, don't be surprised if you need to have a series of
medical appointments and tests. For many women who have pelvic pain, diagnosing the
cause is a process of elimination that takes a while.
Even if tests don't find any problems, it doesn't mean that there's no physical cause for your chronic pain. Tests aren't yet able to detect all causes.
It's a good idea to make a calendar or diary of your symptoms(What is a PDF document?), menstrual cycle,
sexual activity, and physical exertion. And keep track of any other things that you think are
important, such as stressful events or illnesses. Bring it with you when you see your doctor.
To begin narrowing down the
list of possible causes of your pain, your doctor will review your
symptom diary and:
- Ask about
your health history. This includes the history of your menstrual cycle and any pelvic surgery, radiation treatment, sexually transmitted infection,
pregnancy, or childbirth.
- Do a
pelvic exam to look for signs of abnormalities. You may also have a
digital rectal exam. Your doctor may
conduct these exams in a slower, more thorough manner than a routine pelvic exam,
carefully checking for tender areas.
You may also have tests, such as:
Sometimes more tests are needed. Your doctor may recommend one or more of the following:
- Imaging tests (tests that take pictures of the pelvic area), such as:
- Abdominal ultrasound and/or
transvaginal ultrasound of the pelvic area using a small ultrasound device inserted into the vagina.
- Intravenous pyelogram, which uses an injected
dye combined with X-rays to create pictures of the kidneys, bladder, ureters,
- CT scan, which uses X-rays to create pictures of organs
- MRI, which uses a magnetic field and pulses of radio wave energy to create
pictures of organs and bones.
- LaparoscopyLaparoscopy. This surgical procedure uses a thin, lighted viewing instrument inserted through a small
cut in the belly. If needed, scar tissue or a growth can
also be removed during the procedure.
- CystoscopyCystoscopy, which uses a viewing
instrument inserted through the urethra into the bladder.
- Urodynamic studiesUrodynamic studies. In these tests, a catheter is inserted through the urethra into the bladder to check for bladder problems.
- Other evaluations:
- For irritable bowel syndrome.
- For abdominal wall "trigger points." These are specific places on your abdomen that cause pain when pressed.
Your mental health
Chronic pain can have a
wearing effect on the mind and emotions, which can in turn make harder to manage pain.
Your doctor may recommend a
mental health assessment. You'll be asked questions
to find out whether such conditions as
insomnia, or stress are adding to or being
caused by your chronic pain.
For the best chance of recovering from pain, you will need treatment for emotional problems like these, plus treatment for any known physical causes of pain.