Endometriosis is a painful disorder in which tissue that normally lines the inside of your uterus, the endometrium grows outside (endometrial implant). It commonly involves ovaries, bowel or tissues lining your pelvis. The main symptoms are pelvic pain and infertility. While chronic pain exists throughout, it tends to aggravate during menstruation and / or sex. Though the cause is not entirely clear, women with a family history of the condition need to be extra cautious. Endometriosis is normally detected by its symptoms combined with a medical imaging. Though the growth is not generally cancerous, a biopsy is recommended to eliminate doubts. 

The condition of endometriosis is attached with social and psychological effects as it affects a woman's child bearing ability. Most minds race anxiously as to what the surgeon might find and will your body heal after the procedure. Here are some tips to prepare for your endometriosis laparoscopy

 Before the surgery: read up as much as possible about your condition and note down questions you want to ask your doctor. Get details about the entire procedure and how the doctor is treating your specific case. Having knowledge will help you stay calm and focused. Next, gear your home for the process. Stock your fridge with quick heat home made meals. It's best for you and the family to have healthy food than the store bought preservative laden food. Clean your home, change your sheets and purchase some loose fit clothing for later use. Last but not the least, stock up on some reading material that will come handy during your rest period. 
 On day of surgery: do not eat or drink anything from 12 midnight until the time of your surgery. You may also need the unpleasant enema procedure during your prep. Remove your nail polish and leave your jewellery, watch and valuables at home. Shower and get to the hospital early to get on with the forms you'll need to fill. The procedure requires anesthesia so do discuss your allergies or any concerns you may have with this aspect of the procedure. Once you are set with you iv and anesthesia, the doctor takes over to do what they do best cure you.
 The procedure: a small incision is made near the belly button and the abdomen is filled with co2 gas which lifts it away from other organs. During the laparoscopy, the doctor examines the pelvic organs, looking for obvious and atypical endometriosis lesions as well as endometriomas (endometriosis'filled cysts, adhesions, and scarring. He may then remove the lesions to send to a lab for biopsy
 After surgery: you'll most likely wake up groggy in the recovery room after your surgery. You may feel some pain as you come around but if it's a day procedure, you'll be able to leave as soon as you feel ready. 

Although pregnancy may temporarily suppress the symptoms of endometriosis, it does not eradicate the disease. The symptoms will almost always return after the baby is born. If you are suffering from this painful condition and want to seek help, you can consult here.

How To Prepare For Your Endometriosis Laparoscopy

Pelvic inflammatory disease (PID) refers to the infection that occurs in the female reproductive organs. It happens when sexually transmitted bacteria infect the uterus, ovaries or fallopian tubes on spreading from the vagina. Generally, the cervix plays the role of preventing the bacteria from entering the vagina and infecting the reproductive organs. But when the cervix becomes exposed to an STD, it loses its power to put a stop to the spread of these microorganisms to the reproductive organs.

What causes this condition?
STDs like gonorrhea and chlamydia have been found to be responsible for about 90% of PID cases.

Some of the other causes include
- Abortion
- Childbirth
- Pelvic procedures

The condition is only detected later in life when you face difficulty in getting pregnant or have chronic pelvic pain complaints. If you experience symptoms like vomiting, high fever, pain in the lower abdomen and instances of fainting, you should immediately seek a doctor.

What puts you at risk for PID?
Certain factors may put you at a higher risk for PID and these are:

- Instances of sexually transmitted diseases like Chlamydia (an STD that can occur from anal, oral or vaginal sex) and gonorrhea (a condition that causes discharge from the vagina or urethra) can make you prone to developing PID.

- Douching on a regular basis can increase your risk of PID as it disrupts the equilibrium of good and bad bacteria in your vagina, and may hide the symptoms of the condition as well.

- Even a previous history of PID can increase your chances of having another episode of PID.

- Compared to older women, teenagers who are sexually active are more prone to developing PID.

- Having multiple sexual partners can also put you at a greater risk for PID and STDs.

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Could you be at a risk of pelvic inflammatory disease (PID)?

Pelvic pain is generally referred to as the pain in the lower abdominal region. Pelvic pain might be acute, sudden, or chronic, recurrent, cyclical in nature. It may present as central or lateralized pain and might spread to the thighs and buttocks. Pelvic pain might be an indication that something is wrong with the internal reproductive organs located in the pelvic region such as ovaries, fallopian tube, uterus and vagina in which case occurrence of pain may be related to particular time in menstrual cycle.

Pelvic pain can be indicative of a pelvic infection or related to the pelvic bones/spine problems.

Also it may indicate that there is something wrong with the digestive system or urinary system.

Causes-

The causes are as follows:

Pelvic pain occurs commonly in disorders of the internal reproductive organs such as ovarian cysts or pelvic inflammatory disease (where in sexually transmitted bacteria spread through the reproductive organs and cause infection) or pain during ovulation.

Pelvic pain might also occur due to endometriosis (a form of disorder where the endometrial tissues that are located inside the uterus tend to grow outside the uterus resulting in severe pain), adenomyosis (a disorder wherein the endometrial tissues which line the wall of the uterus tend to grow within the uterus), , pelvic adhesions or ectopic pregnancy (when the fertilized egg gets inserted somewhere else other than the main uterine cavity),

Pelvic pain can occur due to bladder disorders, kidney stones, infection in the urinary tract, constipation, flatulence,inflammatory bowel disease, irritable bowel syndrome and chronic hernia.

It can also be a symptom in some cancers such as ovarian cancer, colonic cancer, advanced ovarian , endometrial and cervical cancer.

The following symptoms might occur along with pelvic pain:

Sustained pain in the hips and the groin

Sudden fever

Severe pain while urinating , passing stools or during sexual intercourse (dysparuenia)

Vaginal bleeding or vaginal discharge .

Blood in stool

Severe menstrual pain ( dysmenorrhoea)

Repeated instances of constipation or diarrhoea

Increase In pain with stress and physical movements

Investigations-

The Gynaecologist will do physical examination including bimanual internal examination. Also, complete blood count, urine for microscopy, vaginal swabs if discharge, stool examination. Ultrasound examination of the pelvis is an important investigation.

Treatment-

If the pain is gynaecological and depending on the cause doctors might suggest different therapies. In cases where pain is due to an ovarian cyst or endometriosis, doctors may prescribe birth-control pills. In cases of suspected pelvic infection, antibiotics are prescribed. Also, laparoscopic surgery might be advised in cases of acute pain due to cyst, endometriosis, or pelvic adhesions: for confirmation of diagnosis and excision or removal of cysts and endometriotic implants and division of adhesions respectively. In some cases of chronic pain, the gynaecologist may manage the case with inputs from gastroenterologist and pain consultant.

Causes and Symptoms of Pelvic Pain

In medical terms, the pelvic floor refers to a group of muscles in the pelvic area. These muscles provide support to the organs in the pelvic region, including the bladder, uterus (women), prostate (men), and rectum.

What is pelvic floor dysfunction?
This is a medical condition that is used to refer to a situation when you are unable to control the functioning of the pelvic floor. It means you fail to control the bowel movement. People suffering from pelvic floor dysfunction use these muscles to contract rather than to relax. It is for this reason that they cannot have a bowel movement. They often have an incomplete one.

What causes pelvic floor dysfunction?
In most of the cases, the exact reason behind this dysfunction is unknown. It is often believed that this condition is caused due to traumatic injuries to the pelvic area. This can happen after an accident and due to complications aroused after vaginal childbirth.

What are the symptoms?
There are several symptoms that are linked to this medical condition. You must visit your doctor if you come across the following signs:

The feel of having several bowel movements within a short period of time.
If you feel that you cannot complete a bowel movement.
When there is constipation pain linked with bowel movements.
A frequent urge to urinate.
Painful urination.
Pain in lower back.
Continuous pain in pelvic region, genitals, or rectum.
Pain during intercourse in women
How is pelvic floor dysfunction diagnosed?
It may be diagnosed through a physical examination by the doctor. You will ask several questions to know the case history and find out the cause. You may also be asked to take pelvic muscle control test by placing surface electrodes on the perineum or sacrum. A small device called a perineometer is also used for the same.

What are the best ways for treating pelvic floor dysfunction?
It can be treated without surgery. There are several techniques. Some of these are as follows:

Biofeedback: It is done with the help of a physical therapist.He uses special sensors to watch and monitor the muscles.
Medication: A low-dose muscle relaxant is prescribed to treat the same.
Relaxation techniques: Your therapist may ask you to take up techniques for relaxation such as warm baths, yoga, and exercises.
Surgery: If your physician finds out that the dysfunction is caused by a rectal prolapse or rectocele, he or she will take up surgery.
Pelvic Floor Dysfunction results in Urinary Dysfunction. Urinary incontinence is the unintentional passing of urine. It's a common problem thought to affect millions of people. There are several types of urinary incontinence, including:

Stress Incontinence   when urine leaks out at times when your bladder is under pressure; for example, when you cough or laugh
Urge Incontinence   when urine leaks as you feel a sudden, intense urge to pass urine, or soon afterwards
Overflow Incontinence (chronic urinary retention)   when you're unable to fully empty your bladder, which causes frequent leaking
Total Incontinence   when your bladder can't store any urine at all, which causes you to pass urine constantly or have frequent leaking
It's also possible to have a mixture of both stress and urge urinary incontinence.

Pelvic Organ Prolapse

Pelvic organ prolapse is a condition in which structures such as the uterus, rectum, bladder, urethra, small bowel, or the vagina itself may begin to prolapse, or fall, out of their normal positions. Without medical treatment or surgery, these structures may eventually fall farther into the vagina or even through the vaginal opening if their supports weaken enough.


Pelvic Floor Dysfunction - What is the Best Way to Treat it?

During pregnancy a woman s body undergoes constant changes. The entire body tries to accommodate place for the growing uterus as hormones levels drastically fluctuate and ligaments stretched. Pelvic pain and the ensuing discomfort around this time is a common phenomenon experienced by most women. 

Though the pain may be harmless, at times it may also lead to serious repercussions. Therefore the identification of the causes that lead to pelvic pain during pregnancy is crucial. Some of them are: 

1. Accommodation pain: In the initial stages of pregnancy, women may experience cramps which are akin to the pain that precedes menstruation. However, in the case of pregnant women, the pain leads to no bleeding, but in all probability, is caused due to the expansion of the uterus.
2. Round ligament pain: Amidst the host of changes that the body goes through, the ligament that goes from the uterus to the groin also undergoes a change; it expands. This is responsible for the pain in the sides especially when women are walking or getting up from a chair.
3. Baby s weight: As the weight of the fetus begins to increase it exerts a pressure on the nerves that move from the vagina to the legs. This causes a dull pain in the pelvic region which increases considerably with walking and riding a car. This is most commonly felt by women who are in their third trimester.
4. Urinary Tract Infection: According to reports, most women suffer from urinary tract infection or UTI during pregnancy. This results in uncontrolled, often times, bloody urination and a pain in the abdomen. This is a major cause of concern as, if untreated, it infects the kidneys which in turn increases the risk of an early labour.
5. Miscarriage: In the first trimester, a pain in the abdomen may be an indication of a miscarriage. In such a situation, the pain is followed by bleeding and cramps.
6. Early labour: During pregnancy, an intermittent pain in the pelvic area and a back ache can also be suggestive of an early labour. If the contractions continue for over two hours after taking the necessary precautions like urinating and taking rest, it may be a sign of an early labor.

Pelvic Pain During Pregnancy

If there is a recurrent pain in the lower pelvic and the lower abdomen region of the body, chances are you might be suffering from pelvic pain. In women, severe pelvic pain can be a warning sign of some internal damage in the reproductive organs (ovaries, fallopian tube, uterus, and vagina) present in the pelvic region or the digestive system of the body. Although not common in men, pelvic pain might be indicative of an infection or severe pain in the colon region or the pelvic bones. Pelvic pain might be acute or chronic in nature and the pain might spread to the thighs and buttocks of the body.

The causes of pelvic pain differ among the genders, which are as follows:
1. For women, pelvic pain can be an indication of more serious disorders in the internal reproductive organs such as uterine cancer, cervical cancer, ovarian cysts, ovarian cancer and other pelvic inflammatory diseases (when the sexually transmitted bacteria spread to the reproductive organs and causes infections).
2. In women, pelvic pain might also occur due to endometriosis (a disorder wherein the internal endometrial tissues grow outside the uterus resulting in severe pain), adenomyosis (a disorder wherein the endometrial tissues which line the wall of the uterus start growing within the uterus), severe pain during ovulation and miscarriages.
3. The causes of pelvic pain in both men and women include sexually transmitted diseases, a disorder in the pelvic region or the bladder, kidney stones, urinary tract infection, colon cancer, and chronic hernia.

If you suffer from the following symptoms, chances are you might be suffering from pelvic pain:
1. Severe pain in the hips and the groin
2. Sudden fever along with the presence of blood in the stool.
3. Severe menstrual pain
4. You might feel severe pain while urinating or in the middle of a sexual intercourse
5. Bloody vaginal discharge might be indicative of pelvic pain in women
6. Recurring episodes of constipation or diarrhoea
7. Pain resulting from stress and intense physical movements

Treatment
If the pain is chronic, doctors might suggest prescribed a dosage of birth-control pills, antibiotic (especially for blood in the stool and pain due to infection) and anti-depressants. In extreme conditions, the doctor might prescribe laparoscopic surgery (operation by making minor incisions performed far from the actual source).

Can Severe Menstrual Pain be a Sign of Pelvic Pain?

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