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10 Pelvic Conditions

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Updated April 05, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

As women, we face the possibility of a number of pelvic conditions - some that cause pain and some that do not. Let's take a look at some of these pelvic conditions so that you might recognize them if they happen to you.

Asherman's syndrome is the formation of intrauterine adhesions (IUAs) or scar tissue. Because these adhesions are inside the uterus, the front and back walls of the uterus often stick together.

Most patients who have Asherman's syndrome experience very light or no periods. Some women who do not have periods experience pain during the time that menstruation would normally occur. This may be due to adhesions covering the cervical opening, thus not allowing the menstrual flow to escape from the body.

Miscarriages and infertility often occur in women with the syndrome. Intrauterine adhesions often occur because of a dilatation-and-curettage (D&C) for a missed or incomplete miscarriage, or the retention of the placenta following birth. While 90% of cases of Asherman's are pregnancy-related, other causes include surgery for uterine fibroid tumors or polyps, as well as Cesarean section.

Diagnosis usually occurs through hysteroscopy, sonohysteroscopy or hystersalpingogram. While treatments for IUAs remain controversial, the most common treatment requires the skills of a highly trained surgeon who performs hysteroscopy, sometimes assisted by laparoscopy. Unfortunately, if the adhesions are severe, they often reform, requiring additional surgery or treatment. Read more on Asherman's syndrome.

Benign uterine fibroid tumors are solid masses made of fibrous tissue. The good news is that uterine fibroid tumors are almost never cancerous. Benign uterine fibroid tumors frequently occur without causing any pain.

These tumors usually manifest as a number of small tumors; however, they can occur as a single large tumor, sometimes as large as a grapefruit or even bigger. Women with large fibroid tumors may appear pregnant.

There are a number of treatment options, including no treatment since the tumors will frequently shrink on their own once menopause occurs and levels of estrogen in the body naturally decline. Other treatments include myomectomy, endometrial ablation and hysterectomy when other treatments do not produce the desired result and the woman does not desire future pregnancies. For more information, read 10 Things to Know About Uterine Fibroid Tumors.

Dysmenorrhea is the medical term for severe menstrual cramps that keep you from performing your normal daily activities. Pain frequently occurs in the lower abdomen, lower back and sometimes in the inner thighs. Other symptoms may include nausea, vomiting, diarrhea, headaches and dizziness.

During menstruation, prostaglandins are released and the uterus contracts, which can often cause dysmenorrhea. Prostaglandins are hormones that are at a high level when menstruation begins and decline over the following days. The declining level of prostaglandins leads to lessening pain as each menstruating day passes.

Non-steroidal anti-inflammatory drugs (NSAIDS) frequently help reduce the pain and work best when taken at the first sign of pain. Other treatments that can help reduce the severity of dysmenorrhea include hormonal treatments such as birth control pills, patches and vaginal rings.

See Dysmenorrhea - What You Should Know About Menstrual Cramps for more information.

Endometriosis occurs when endometrial tissue that normally lines the inside of the uterus grows in other places in the body. The most common places where it can grow are the ovaries, fallopian tubes, outer surface of the uterus, cul-de-sac (the area behind the uterus, bowel and bladder) and the rectum. While the pelvic area is the most common site for endometriosis, the tissue can spread to other parts of the body, including the lungs.

Hormones cause changes to endometriosis whenever menstruation occurs. The breakdown of these tissues frequently leads to pelvic adhesions or scar tissue, which may cause severe pain and bind organs together.

The main symptom of endometriosis is pain. Pain may occur during sex, bowel movements, urination and menstruation. Treatment of endometriosis depends on the severity of the disease and whether you desire children. They include medications and surgical procedures. Learn more about endometriosis.

Mittelschmerz is a German word that means "midcycle pain." Other terms include ovulation pain, midcycle pain and cramps. Most often, mittelschmerz lasts for six to eight hours. However, some women experience ovulation pain for 24 to 48 hours. The good news is that there are some self-help treatments that can ease discomfort. Read more about mittelschmerz.

Ovarian cancer is often called a "silent killer" because there are few or no symptoms until the disease has reached a late stage. There are three main types of ovarian cancer: epithelial, which is the most common (85% to 90% of cases) and covers the outer surface of the ovaries; germ cell tumors, which form on the cells in the ovary that develop into eggs; and sex cord-stromal tumors, which occur in the connective tissues inside the ovaries.

Warning signs of ovarian cancer may include unexplained bleeding, back pain, increase in abdominal size, difficulty eating, unexplained weight loss, loss of appetite, urinary incontinence, frequent urination, constipation and fatigue. For more information, read Ovarian Cancer - The Silent Killer.

Ovarian cysts are fluid- or tissue-filled sacs that form on the ovary. Most ovarian cysts go away on their own. Symptoms include dull or sharp pain in the abdomen during certain activities. There may not be any symptoms with small cysts. However, larger cysts may twist, causing pain. Some ovarian cysts can rupture or bleed, requiring immediate medical attention. For more information, read about ovarian cysts.

Pelvic inflammatory disease (PID) is an infection of the female reproductive organs that can lead to infertility if untreated. More than 1 million women each year receive a diagnosis of PID.

Symptoms include abnormal vaginal discharge, pain in the lower abdomen, pain in the upper right abdomen, abnormal bleeding, fever, chills, painful sexual intercourse, painful urination, nausea and vomiting. Fortunately, treatments are available, including antibiotics. Learn more about pelvic inflammatory disease.

Polycystic ovary syndrome (PCOS) appears to be caused by a number of factors that work together to trigger this condition, which frequently leads to infertility. These factors are insulin resistance, increased androgens and irregular or absent menstruation.

Signs of PCOS include obesity; hirsutism (increased hair growth on face, chest, abdomen and upper thighs); heavy, irregular or absent menstruation; oily skin; severe acne that occurs after adolescence; patches of thickened, dark, velvety skin; and multiple small cysts on the ovaries.

There are many treatment options that depend largely on whether you desire pregnancy. For more information, read What Is PCOS?

Uterine or endometrial cancer is the most common type of gynecological cancer, affecting two or three out of every 100 women. This type of cancer rarely affects women under 40 and is most common in women 60 and older.

Risk factors include obesity; never having had a baby; irregular periods; infertility; starting menstruation before age 12; experiencing menopause late (51 is the average age for menopause); history of ovarian or colon cancer; cigarette smoking; family history of endometrial cancer; diabetes; gallbladder disease; high blood pressure; long-term use of estrogen without progesterone; long-term use of high-dose oral contraceptives; and the use of tamoxifen for breast cancer.

Symptoms include abnormal bleeding, spotting, new vaginal discharge and bleeding or spotting after menopause. These symptoms can be constant or can come and go.

Any time you experience vaginal bleeding after menopause, you should see your doctor for diagnosis and treatment. See What Is Uterine Cancer?

Sources:

Frequently Asked Questions: Dilation and Curettage (D&C), FAQ 062 Special Procedures. ACOG. http://www.acog.org/publications/faq/faq062.cfm. Accessed 11/29/11.

Frequently Asked Questions: Dysmenorrhea, FAQ 046 Gynecological Problems. ACOG. http://www.acog.org/publications/faq/faq046.cfm. Accessed 11/29/11.

Frequently Asked Questions: Cancer Of The Uterus, FAQ 097 Gynecological Problems. ACOG. http://www.acog.org/publications/faq/faq097.cfm. Accessed 11/29/11.

Frequently Asked Questions: Endometriosis, FAQ 013 Gynecological Problems. ACOG. http://www.acog.org/publications/faq/faq013.cfm. Accessed 11/29/11.

Ovarian Cancer Fact Sheet. ACOG. http://mail.ny.acog.org/website/OvarianCaFactSheet.pdf. Accessed 11/29/11.

Frequently Asked Questions: Ovarian Cysts, FAQ 075 Gynecological Problems. ACOG. http://www.acog.org/publications/faq/faq075.cfm. Accessed 11/29/11.

Frequently Asked Questions: Pelvic Inflammatory Disease, FAQ 077 Gynecological Problems. ACOG. http://www.acog.org/publications/faq/faq077.cfm. Accessed 11/29/11.

Frequently Asked Questions: Polycystic Ovary Syndrome, FAQ 121 Gynecological Problems. ACOG. http://www.acog.org/publications/faq/faq121.cfm. Accessed 11/29/11.

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