Navigating Pelvic Pain Dismissals
Hello! I’m a 34-year-old female, weighing 51 kg and standing at 5 feet 7 inches. I don’t smoke and am currently not on any medications, but I’m grappling with the feeling of being dismissed regarding my pelvic pain and am seeking guidance on how to proceed. My medical history includes one irregular Pap smear from seven years ago, after which I underwent laser ablation on my cervix; however, subsequent Pap tests have returned normal results. For the past year, I have been experiencing pelvic discomfort that seems unrelated to my menstrual cycle. Initially, this pain localized to my lower right abdomen, but it has recently generalized, affecting the entire lower abdominal area. The pain isn’t continuous but rather intermittent. Since giving birth in 2022, my periods have become significantly heavier. Additionally, I’ve noticed cramping that occurs between my cycles when I wouldn’t usually expect any pain. Importantly, I also experience discomfort after manual pressure is applied to my abdomen; for instance, when my child playfully crawls over me, I feel pain if he steps on my abdomen. Occasionally, I experience mild discomfort during intercourse and slight cramping the following day. I raised my pelvic pain with my family doctor, who conducted blood tests, revealing normal results except for low iron levels, likely due to my heavy menstruation. An ultrasound focused on the lower right abdomen was performed about six months ago, which yielded no concerning findings. Subsequently, I was referred to a gynecologist. I had my appointment with the gynecologist today, who ordered an HPV test and performed a manual pelvic examination. Following this exam, I experienced cramping and some dull pain in my lower abdomen when pressure was applied. While both medical visits have resulted in discussions about managing my heavy menstrual flow, my primary concern remains the pain occurring between my cycles. I am scheduled for a follow-up with the same gynecologist in a month to go over the HPV test results, which will also provide another opportunity to address my concerns. I would greatly appreciate any recommendations on next steps or potential tests to make sure my concerns are effectively advocated for!
Answers (1)
3/20/2025, 7:20:42 PM
OpenHealth AI
I'm sorry to hear about your ongoing pelvic pain and the frustrations you've faced in addressing it. Your concerns are valid, especially given the discomfort you're experiencing. Let's break down your situation and focus on actionable steps you can take to advocate for your health.
Key Points:
- You have persistent pelvic pain and heavy menstrual flow that is causing concern.
- Previous tests (blood work and ultrasound) were normal, but you're still experiencing symptoms.
- You've already taken proactive steps to consult a gynecologist and discuss your symptoms.
Explanation:
Pelvic pain can arise from various conditions, and while some concerning issues may be ruled out, it’s essential to continue exploring the causes of your pain—especially since it's beyond typical menstrual-related discomfort. The discomfort during and after pressure, as well as the pain between cycles, could suggest a few things like pelvic floor dysfunction, adenomyosis, or endometriosis, though these are only possibilities.
Next Steps:
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Track Your Symptoms: Keep a detailed diary of your pelvic pain. Note when it occurs, its intensity, duration, and any accompanying symptoms (like changes in your menstrual cycle, food intake, stress levels, etc.). This will help you present a clearer picture at your next appointment.
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Discuss Pain Management: At your follow-up with the gynecologist, bring up more specific pain management options. Ask about using non-steroidal anti-inflammatory drugs (NSAIDs) or hormonal treatments that may help regulate your menstrual flow and reduce pelvic pain.
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Explore Imaging Options: If your pain persists, discuss whether further imaging like a pelvic MRI might be useful to explore for conditions like endometriosis, which may not be apparent on ultrasound.
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Consider Consulting a Specialist: Given that your symptoms are persistent and affecting your daily life, you may also want to ask for a referral to a specialist in chronic pelvic pain or a pain management clinic.
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Lifestyle Adjustments: In the meantime, consider gentle exercises such as yoga or pelvic floor physical therapy, which can sometimes help alleviate pain. Also, ensure you maintain a balanced diet rich in iron to support your low iron levels from heavy menstruation.
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Communicate Openly: Don’t hesitate to express your concerns at your next appointment. Being clear about how the pain impacts your quality of life can help your healthcare provider understand the urgency of your situation.
By taking these proactive steps, you can effectively advocate for your health and seek a resolution to the discomfort you're experiencing. Let me know if you need further details or support!
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