What Happens If You Have Endometriosis, a Cause of Chronic Pelvic Pain

stomach-pain-article-2Chronic pelvic pain can be caused by numerous conditions and can sometimes be very difficult to diagnose.  One cause of chronic pelvic pain is endometriosis, which is many times overlooked in women.  Endometriosis has been called “the great masquerader” because it can present many different symptoms.

Endometriosis is when the endometrium, or the tissue and glands that line the uterus, is found outside the uterine cavity.  Endometriosis may cause painful periods, painful intercourse, and infertility.  The pain usually lasts more than 6 months and can be located deep in the pelvis or in the lower abdomen.  It can occur intermittently throughout the menstrual cycle or continuously.

Before attributing pelvic pain to endometriosis, one must rule out bladder, bowel, musculoskeletal, and psychiatric causes.  In order to definitely diagnose endometriosis, a patient must have minimally invasive laparoscopic surgery to visualize the endometrial implants outside the uterus.  During the surgery, the endometrial lesions can be treated in a variety of ways.

The symptoms of endometriosis can be treated medically with pain medications like Motrin, hormonal therapy such as birth control pills, or the Depo-Provera injection.  If you or someone you know is suffering from chronic pelvic pain, please speak to your health care provider to see if endometriosis may be the cause!

-Dr. P

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Gonorrhea – A Condition Which Often Lacks Symptoms

…..teenage depression - teen woman sitting thinkingNext in my series about sexually transmitted infections in adolescents, we will be discussing gonorrhea.

…..Gonorrhea is a common STI in the adolescent and young adult population (15 to 25).  There are about 750,000 cases each year, with women having a slightly higher rate than men.  We should use the same targeted screening that is used for chlamydial infections (with all women under 25 being tested).  The same risk factors are associated with gonorrhea and chlamydia, and with both, more than 50% of women are asymptotic.

…..When there are symptoms, they may include vaginal discharge, pelvic pain, or pain with urination.  Again, if there is a delay in diagnosing and implementing the treatment of an infection, severe pelvic problems can develop.

…..There are specific antibiotic protocols for treatment that are available.  These days, consideration must be made for antibiotic resistance, which has been developing.  Lastly, with all persons found to have gonorrhea, there should be testing for HIV, syphilis, and chlamydia.

-Dr. P

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Urgent Facts About Chlamydia, a Common STI

…..Sexually transmitted infections in adolescents continued…

…..CChlamydia Infohlamydia is one of the most common infectious diseases in the United States, with somewhere between 1 to 3 million cases each year among women ages 15 to 45. The most affected group is between ages 15 and 19, followed by 20 to 25 as the second most affected group.

…..One problem in finding this infection is that less than half of the most affected women are screened for Chlamydia trachomatis. The Center for Disease Control (CDC) guidelines suggest a yearly screening for chlamydia on all sexually active women who are 25 and younger, and testing should be performed for women over 25 if they have a new sexual partner or multiple partners. Women should also seek testing if they experience abdominal or pelvic pain, vaginal discharge, painful intercourse, pain with urination, or irregular bleeding.

…..Testing usually entails a speculum exam with a Q-tip swab of the cervix. If the speculum exam is a problem for the adolescent, then a vaginal swab can be performed. The patient can even collect a vaginal swab test privately if necessary.

…..After a woman is treated, reinfection is common, and having a treated infection does not provide immune protection against future infections. It is therefore advised that a repeat test be performed a few months after a treated infection.

…..If there is a delay in treatment of this infection, then there is an increased chance of developing an infection of the pelvis, called pelvic inflammatory disease (PID), which can lead to infertility. Some studies suggest that PID can develop in up to 30% of women with their first chlamydial infection.

…..There are many antibiotic treatment plans suggested by the CDC, and they all are very successful. The adolescent and her partner should avoid intercourse for 7 days after both partners have been treated.  Ideally, the patient should refer for testing any sexual partner that she encountered within the last 1-2 months.

-Dr. P

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