Pelvic Pain In Women Often Goes Underreported, Untreated

Dr. Enrique Jacome

Although many women experience pelvic pain in their late teens and early 20s, a new University of Florida Health study indicates that only a small fraction of these women report their symptoms to their doctors and seek treatment, leaving some health problems unresolved.

Up to 72 percent of the women who responded to the survey reported experiencing pelvic pain in the past year, yet nearly three-quarters of them did not seek treatment from a physician. The study was published in the November issue of the Journal of Minimally Invasive Gynecology and was presented at the Society of Laparoendoscopic Surgeons meeting in August.

Led by Nash Moawad, M.D., the researchers surveyed 2,000 women and received nearly 400 responses. Almost 80 percent of respondents had reported painful periods, nearly one-third reported painful sexual encounters and one-fifth reported pain in external genitalia.

Some of the reasons women reported not talking to their doctors about the pain included embarrassment, difficulty with insurance or making appointments, or a lack of empathy and understanding from physicians.

"But a big part of the problem is that women often don't realize their pain is abnormal," said Moawad, the director of the Center of Excellence for Minimally Invasive Gynecology at UF Health.

"There is a significant lack of awareness about pelvic pain in general," Moawad said. "Some women thought their pain was normal. They think that is how periods are supposed to be. But if you are missing days from school or work or have to cancel activities, that is striking. No pain should ever be that severe. If a woman has to take narcotics for pain, or if she has had to drop out of classes, that is not normal. She should see a physician."

Aside from painful periods, other examples of conditions that cause pelvic pain include endometriosis, which occurs when the uterine lining begins to grow outside the uterus, usually on the ovaries or bowels; ovarian cysts; interstitial cystitis; irritable bowel syndrome and urinary tract infections.

Endometriosis, for example, is often described as an extremely painful condition, yet it typically takes women five to 15 years to receive a diagnosis for it, Moawad said.

It's important that women get treatment for pain, because aside from the obvious effects, pain also affects women's overall health and how they feel about themselves. The researchers found that women who reported higher levels of pain also reported having a lower overall quality of health. They reported a greater number of sad days and had more irregular sleep patterns, too.

"There is a big difference between those with pain and those without pain and their perception of their own health and how it affects their daily activities," Moawad said.

The study was the first of its type and examined pelvic pain and health in a group of college-educated women, a group that typically has access to medical care and is in good health. Studies examining how pelvic pain affects women in lower socioeconomic groups, who typically have less access to medical care, could reveal that pelvic pain is even more problematic for women, Moawad said.

"Women need to understand they do not need to wait so long to get help," Moawad said. "There are ways to diagnose and treat these conditions."

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