Comprehensive Diagnosis and Treatment of Chronic Pelvic Pain
Loyola Medicine’s chronic pelvic pain program takes an integrated, multidisciplinary approach to the diagnosis and treatment of pelvic pain. Far too many women needlessly suffer in silence with this disorder and go years without receiving the correct diagnosis for this common medical problem.
Loyola’s team of highly experienced specialists will evaluate your symptoms, provide you with the correct diagnosis and develop an individualized treatment plan to eliminate or reduce your pain. We will help you to enjoy a more functional life again. Our clinicians have experience caring for women with:
- Abnormal uterine bleeding
- Chronic pelvic inflammatory disease
- Interstitial cystitis
- Irritable bowel syndrome
- Musculoskeletal causes of pelvic pain
- Ovarian cysts
- Painful bladder syndrome (interstitial cystitis)
- Pelvic adhesions
- Pelvic floor muscle tension
- Pelvic organ prolapse
- Psychological factors
Why Choose Loyola for Chronic Pelvic Pain?
Loyola’s chronic pelvic pain program provides truly integrated clinical care for chronic pelvic pain, bringing together specialists in female pelvic medicine and reconstructive surgery, gynecology, urology, psychology, physical therapy, urogynecology and gynecologic surgery to provide women with advanced care in a compassionate environment.
Loyola was one of the first medical centers in the nation to create a chronic pelvic pain program, which was founded by an all-female group of doctors, surgeons and advanced practice nurses, some of whom have been providing women’s healthcare for more than 30 years.
Your Loyola doctor will first explore non-surgical treatments to alleviate your pelvic pain. However, if surgery is deemed the best treatment option, we perform the vast majority of procedures via laparoscopy, surgeon-guided robotic surgery or hysteroscopy. These approaches are known to reduce pain, scarring and recovery time. Loyola was also one of the first medical centers in the Chicago area to offer minimally invasive gynecologic surgery.
As part of an academic medical center, Loyola’s expert clinicians perform and teach the latest surgical techniques and medical treatments in numerous locations across the Chicago area. Our doctors and advanced practice nurses provide preventive care for women of all ages, from young girls to menopausal women. In addition, our nurses have earned Magnet status, which means they have been recognized for delivering the highest level of care.
What It Is
What is Chronic Pelvic Pain?
Women with chronic pelvic pain (CPP) experience constant or periodic pain in the pelvic region that has persisted for more than six months. CPP can be caused by structural and functional problems involving the pelvic muscles, nerves, bladder, bowel and reproductive system. Inflammation can play a role in many forms of CPP.
Psychological factors also can aggravate this condition; many women who experience CPP have a history of depression and sexual or physical abuse, which can physically heighten the sensitivity to pain. Often, anxiety about a long-term condition like CPP that has gone without a definitive diagnosis increases the degree of pain. In addition, CPP can be a sign of another medical condition.
Symptoms of CPP may include:
- Constant, severe pain
- Cramping or sharp pain
- Digestive problems
- Dull, general ache
- Intermittent pain
- Pain after sitting for some time
- Pain during urination or bowel movements
- Painful intercourse
- Pressure within the pelvis
- Urinary urgency
Loyola’s integrated team has experience caring for women with the following conditions:
- Abnormal uterine bleeding — Irregular uterine bleeding that is not prompted by a tumor, infection, normal menstrual cycle or pregnancy may be linked to pelvic pain.
- Chronic pelvic inflammatory disease — Scarring across the pelvic organs may be caused by a long-term infection, such as from a sexually transmitted disease.
- Endometriosis — In women with endometriosis, the lining of the uterus grows in other areas of the pelvis, causing pain, heavy bleeding, bleeding between periods and fertility problems.
- Fibroids — These benign tumors (myomas) can grow in the uterus and cause pain. These tumors are rarely cancerous.
- Interstitial cystitis — This condition, also called painful bladder syndrome, can cause frequent or urgent urination, bladder pain and pressure and pelvic pain. Treatment usually involves medication and other forms of symptom management.
- Irritable bowel syndrome — Irritable bowel syndrome causes abdominal pain and bowel changes. Stress can cause intestinal nerves to become hypersensitive, leading to painful contractions.
- Musculoskeletal causes of pelvic pain — Women may have torn or injured pelvic joints and nerves from childbirth or surgery, which can cause pelvic pain. The pelvic floor muscles may be prone to spasm which can cause localized pain.
- Ovarian cysts — A fluid-filled sac develops on or inside the ovary. These usually cause no pain and go away without treatment.
- Painful bladder syndrome (interstitial cystitis) — This disorder causes burning, pain or pressure in the bladder.
- Pelvic adhesions — For women with previous infections such as appendicitis or pelvic inflammatory disease, scar tissue may have formed which binds organs together. This can cause pelvic pain and discomfort and requires surgical treatment.
- Pelvic floor muscle tension — Recurring pelvic pain can develop from tension or spasms in the pelvic floor muscles.
- Pelvic organ prolapse — Pelvic organ prolapse is a common condition that occurs in women when the vaginal wall starts to bulge outside of the vagina or the rectum starts to protrude outside of the anus. Usually a woman will start to feel a bulge that is soft and can be pushed back in place with her fingers. This condition is caused by a weakening in the pelvic floor muscles and connective tissues that support the uterus and vagina. Learn about pelvic organ prolapse.
- Psychological factors — Stress, depression or a history of physical or sexual abuse can increase the risk for chronic pelvic pain. Anxiety and distress over lack of a proper diagnosis also can heighten the sensation of pain.
- Vulvodynia — A sensation of burning or irritation in the vulvar area.
How is Chronic Pelvic Pain Diagnosed?
Loyola offers a unique, comprehensive approach to the diagnosis of pelvic pain—which can be a life-altering condition. Our specialists will consider all possible causes for your pelvic pain and provide you with a holistic treatment plan.
As a patient in our chronic pelvic pain program, you will receive care from urogynecologists and female pelvic medicine and reconstructive surgeons who will collaborate on the evaluation, diagnosis and plan of care for your pelvic pain over the course of several visits. In addition to taking your medical and family history and providing a pelvic exam, your healthcare team may request testing in order to make an informed diagnosis, which may include:
How is Chronic Pelvic Pain Treated?
The goal of Loyola’s chronic pelvic pain program is to provide an accurate diagnosis for your condition and develop a plan of treatment that will improve your quality of life. Improvement of pelvic pain relies on our patients’ willingness to commit the time and effort required to follow through with treatment. You are the most important member of your healthcare team.
Loyola offers the most advanced treatment options available for chronic pelvic pain, including:
- Medications — Your doctor may prescribe pain relievers, antidepressants, hormone treatments or antibiotics to relieve pelvic pain of various causes, including those caused by infection and those associated with your menstrual cycle.
- Neurostimulation — This treatment may also be called spinal cord stimulation. Your doctor may implant a device that blocks nerve pathways so you don’t feel the pain associated with this condition. It may be helpful, depending on the cause of your pelvic pain.
- Pelvic floor physical therapy — Loyola’s program works in conjunction with our chronic pelvic pain program, which was one of the first such programs in the United States. Our all-female team utilizes advanced techniques to provide relief for many treatment-resistant conditions. Our team is trained in pelvic health and may use hands-on techniques to release trigger points and re-educate muscles affected by pelvic and nerve pain. Loyola’s physical therapists are skilled in evaluating and treating dysfunction in the joints, muscles, nerves and scar tissue. These treatments can help strengthen pelvic muscles, which may reduce pelvic and bladder pain, bladder spasms, leakage and the sudden urge to urinate. Learn more about pelvic floor physical therapy.
- Pelvic trigger point injections — If your doctor finds a specific point where you feel pain, you may benefit from direct injection of a numbing medicine into a painful spot (trigger point). The medicine, usually a long-acting local anesthetic, can block pain and ease discomfort.
- Psychological support — For some women, pain is intertwined with depression, sexual abuse, a personality disorder, a troubled marriage or a family crisis. Your Loyola healthcare team provides help for psychological, social, spiritual and emotional challenges, as well as the physical pain.
- Specialized exercises — Your doctor may recommend exercises to strengthen your pelvic floor muscles, as well as applications of heat and cold to your abdomen, stretching exercises, massage and other relaxation techniques to improve your chronic pelvic pain.
- Surgery — Loyola’s chronic pelvic pain program includes skilled surgeons. The adhesions associated with endometriosis can be removed with laparoscopic surgery. In severe cases in women past childbearing age, your doctor may recommend a hysterectomy and bilateral oophorectomy to remove the uterus and both ovaries.
Exceptional Services to Diagnose and Treat Chronic Pelvic Pain
Loyola’s chronic pelvic pain program provides care for women of all ages in outstanding, conveniently located facilities. We have multidisciplinary facilities at the Loyola University Medical Center campus, in addition to outpatient services at other locations.
We offer the following specialized services to provide you with the most comprehensive care:
- Acupuncture clinic — Modern medical acupuncture combines western biomedical knowledge with eastern approaches to advance healing. This clinic offers patients another tool to help alleviate symptoms without the side effects of medication.
- Clinical health psychology — Treatment options are designed to be comprehensive and multidisciplinary to meet the specific needs of each patient. Our specialists are skilled in therapy for women coping with chronic pain.
- Gastroenterology — Loyola’s GI team is highly experienced in the diagnosis and treatment of gastrointestinal issues that cause chronic pelvic pain. Learn about gastroenterology services.
- Internal medicine or pediatrics (for patients under age 21) — Our chronic pelvic pain program works closely with primary care physicians, including internal medicine doctors or pediatricians, to eliminate systemic conditions that may be causing your pain.
- Minimally invasive gynecologic surgery — Our team of experts uses innovative surgical tools to perform precise surgical treatment through small incisions, in order to treat conditions such as fibroids, endometriosis and ovarian cysts. Learn more about gynecologic surgery.
- Obstetrics/gynecology — Our OB/GYN doctors specialize in a wide range of conditions and diseases including the many causes of pelvic pain.
- Pelvic floor physical therapy — Loyola’s program works in conjunction with our chronic pelvic pain program, which was one of the first such programs in the United States. Our all-female team utilizes advanced techniques to provide relief for many treatment-resistant conditions. Our team is trained in pelvic health and may use hands-on techniques to release trigger points and re-educate muscles affected by pelvic and nerve pain. Loyola’s physical therapists are skilled in evaluating and treating dysfunction in the joints, muscles, nerves and scar tissue. These treatments can help strengthen pelvic muscles, which may reduce pelvic and bladder pain, bladder spasms, leakage and the sudden urge to urinate. Learn about pelvic floor physical therapy.
- Physical medicine and rehabilitation — Our physiatrists have special training in non-surgical treatment of musculoskeletal conditions that are often seen with chronic pelvic pain.
- Urology — Our team is acclaimed for its treatment of numerous conditions, including urinary tract infections, kidney stones and urinary incontinence. Learn about urology.
Advanced Research to Improve Chronic Pelvic Pain Treatments
Loyola’s expert chronic pelvic pain program is actively pursuing new research with a focus on patient-centered outcomes. As an academic medical center, Loyola is dedicated to improving future treatments by conducting research on new diagnostics and treatments. Loyola’s patients benefit from research discoveries made here; read about Loyola’s current clinical trials.