Why pelvic pain may be misdiagnosed — and what you can do

Pelvic pain is common, complex and often misdiagnosed, leaving many women suffering and in continued search of relief.

What makes diagnosis so difficult? And what steps can you take to prevent misdiagnosis from happening (or happening again) to you?

A wide range of causes

Much of the challenge stems from the wide range of potential causes of pelvic pain, including  underlying conditions unrelated to a woman’s reproductive system.

Common causes include:

• Endometriosis
• Severe menstrual pain (dysmenorrhea) 
• Pelvic inflammatory disease (PID)
• Ovarian conditions
• Uterine fibroids
• Gynecologic cancers
• Vaginismus
• Urinary tract conditions, including interstitial cystitis (inflammation of the bladder)
• Digestive system issues, such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD) and diverticulitis
• Muscular and skeletal conditions

The cause of your pelvic pain may be linked to a single health issue — or, as is the case for many women, there may be multiple overlapping conditions and organs involved, making diagnosis that much more challenging.

When is pelvic pain “normal” and when should you seek help from a specialist in pelvic pain or endometriosis?

Seek an expert evaluation if you have:

• Persistent, severe pelvic pain during your period that isn’t controlled by over-the-counter medication.
• Pain during your periods that progresses to non-period related pain.
• Pelvic pain and a family history of underlying causes such as endometriosis.
• Pelvic pain and infertility.
• Deep pelvic pain during intercourse.

The need for specialized care

Choosing the right provider can help prevent years of pain and suffering.

Misdiagnoses — and missed diagnoses — can occur when patients seek help from a practitioner inexperienced in the care and treatment of these complex conditions.  

For example, a woman with severe, persistent pain during her period may assume the pain is a normal part of her menstrual cycle. She turns to her general OB/GYN, who may not recognize that her symptoms could be a sign of endometriosis, a leading cause of chronic pelvic pain, and may not investigate further. Medications may provide temporary relief, but her underlying condition goes untreated.

Timely, accurate diagnosis of pelvic pain requires an expert evaluation by an OB/GYN specialist highly experienced in the care, treatment and complexities of these painful conditions.

Teaming up to provide much-needed relief

In my experience, identifying the cause of pelvic pain takes time, patience, an expert evaluation, a thorough screening and a multispecialty team.

Ideally, your provider will be part of a team of specialists from multiple disciplines who are experienced in working together to diagnose the causes of pelvic pain and to provide comprehensive treatment that brings lasting relief. Depending on the diagnosis and organs involved, additional specialists may include urogynecologists, gastroenterologists, urologists, thoracic surgeons, vulvovaginal health specialists, minimally invasive gynecologic surgeons and pelvic floor physical therapists, as well as reproductive psychiatrists to help with the emotional toll of chronic pain.

What steps should an expert pelvic pain evaluation include?

Find out at our free Pelvic Pain Patient Seminar Thursday, July 21. Our team of experts will share the facts on pelvic pain that all women need to know and will answer your specific questions.

To reserve your spot, call 832-826-7376 or register online at https://bit.ly/PelvicPain7-21.

Dr. Xiaoming Guan is a Professor of Obstetrics and Gynecology Division and Fellowship Director of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, at Baylor College of Medicine and Texas Children’s Pavilion for Women.