Chronic Pelvic Pain: Diagnosis and Treatment

During the conversation with your health care provider, don't be afraid to tell him or her what you think is causing your pain. Did you have pain like this during a previous ectopic (tubal) pregnancy? When you had an ovarian cyst? This gives your health care professional a starting point for diagnosis. It is also important to talk honestly and openly with your health care professional about any abuse or sexual trauma you experienced in the past or that may be occurring now. Such trauma can be a cause of pelvic pain.

The first step in diagnosis is a complete medical history and full medical examination, typically including a pelvic examination. Sometimes your health care professional may be able to begin treating your pain medically, even without a clear diagnosis. This might sound a little disconcerting—how can someone treat your pain if they don't know what's causing it?—but can often work quite well.

Sometimes, however, your health care provider may need more tests, including a vaginal ultrasound, in which a small wand is inserted into the vagina. Sound waves from the wand create a picture identifying any masses that may be contributing to your pain. Sometimes a laparoscopy is needed, where a thin tube is inserted through a tiny incision in your abdomen. A small camera on the end of the tube sends a picture back to a screen, allowing the doctor to see any abnormalities in your pelvic region. This is considered surgery, however, and so is used only when the doctor thinks the findings might change the course of treatment. It is not required to begin treatment.