Gynecological pain

Gynecological pain is one of the most severe pains that can disturb a woman. Many women - up to 90% - have ever suffered from gynecological pain in their lives. Therefore, it is very important to understand the causes of this pain and the methods of fighting it.

[1], [2], [3], [4]

Endometriosis

This is the most frequent cause of pain that occurs in women in the abdomen and below. They can also give in the back.

[5], [6], [7], [8]

What is endometriosis?

Endometriosis is an abnormal growth of endometrial cells, a tissue lining the uterus. They germinate much further than the uterus, although this should not be. Endometrial cells are special cells that reproduce themselves every month during the menstrual cycle. These tumors are most often found on ovaries, fallopian tubes, the outer surface of the uterus or intestine, and on the surface of the mucous membrane of the pelvic cavity.

They can also multiply in the vagina, cervix, bladder, although this is less common than in other places in the pelvic region. Very rarely, the proliferation of endometriosis cells can be outside the pelvis, on the liver, in the area of old scars, and even in the lungs or around them - or the brain. Endometrial cells are benign formations. They are not cancerous.

Who suffers from endometriosis?

Endometriosis affects women most often in their reproductive years. The exact prevalence of endometriosis is unknown, since many women with this condition do not experience any visible symptoms. Experts estimate that endometriosis affects more than one million women (estimated at 3% to 18% of women) in the United States. This is one of the main causes of pelvic pain and the reasons for performing laparoscopic surgery and hysterectomy in connection with these pains.

Studies show that 20% to 50% of women are treated for infertility because of endometriosis and up to 80% of women suffer from chronic pelvic pain due to this disease. Although in most cases, endometriosis is diagnosed in women aged around 25-35 years, it also occurs in girls aged 11 years. Endometriosis is extremely rare in postmenopausal women.

Scientists write that endometriosis is more common in white women compared to African-American women and Asian women. Recent studies suggest that endometriosis is the most common disease that affects more high, thin women with a low body mass index (BMI). Girls who prefer to give birth for the first time after 30-40 years are more at risk of developing endometriosis.

Causes of endometriosis

They still remain completely unexplored. But there are several theories according to which the endometriosis arises and develops. One of the main causes of this ailment that affects a woman is retrograde menstruation. This medical term indicates a condition in which blood that contains small particles of the endometrium falls into the area of the fallopian tubes and the area of the abdominal cavity. The doctor will be able to determine this condition by taking a swab from the woman's vagina when viewed. If a woman's immune system is weakened, there is a predisposition to genital anomalies, as well as virus damage, trauma to the uterine region, the risk of endometriosis is even higher.

Smoking, alcohol abuse, elevated hormone levels of estrogen (sex hormones), genital diseases aggravate the risk of developing endometriosis.

[9], [10]

What are the symptoms of endometriosis?

Most women who suffer from endometriosis, in fact, do not feel any symptoms of this disease. As for those who experience symptoms, they manifest as pain (usually pelvic) and infertility (the inability to become pregnant within a year with a regular sexual life without protection). Pelvic gynecological pains usually disturb a woman during or just before menstruation and become weaker after menstruation. Some women experience pain during intercourse (dyspareunia) or spasms during intercourse and / or pain during bowel movements and / or urination. Even a gynecological examination by a gynecologist for such a woman can be painful.

The intensity of pain can vary from month to month, and varies greatly among women. Some women experience progressive worsening of symptoms, while others may have completely soluble pain without any treatment. Pelvic gynecological pain in women with endometriosis depends on where the overgrown tissue of endometriosis is located.

Other symptoms associated with pain in endometriosis include:

• pain in the abdomen, especially the lower part of it
• Diarrhea and / or constipation
• back pain
• irregular or severe menstrual bleeding
• blood in the urine.

Rare symptoms of endometriosis are chest pain or coughing with blood due to endometriosis cells that have penetrated into the lungs and headache and / or the penetration of endometriosis cells into the brain.

Diagnosis of gynecological pain in endometriosis

Endometriosis can be diagnosed on the basis of symptoms of pelvic pain and examination in the office of a gynecologist. Sometimes, during the rectovaginal test (one finger is in the vagina and the other enters the rectum), the doctor can feel the endometrial nodules behind the uterus and along the ligaments that are attached to the pelvic wall. In some cases, these nodules are not felt, but an examination by the doctor alone can cause pain or discomfort in the vagina.

Unfortunately, neither the symptoms nor the medical examinations can definitely be relied upon to definitively establish the diagnosis of endometriosis. Then research, such as ultrasound, will help, for example. It can be useful for the exclusion of other diseases, except endometriosis. For a more accurate diagnosis, you need a direct visual inspection inside the pelvic organs and abdominal cavity, as well as tissue biopsy.

Another accurate way to diagnose endometriosis can be laparotomy (small incisions of the abdominal cavity) or laparoscopy.

Laparoscopy is the most common surgical procedure for the diagnosis of endometriosis. Laparoscopy is performed under general anesthesia, and in some cases - under local anesthesia. It is usually performed as an outpatient procedure (the patient goes home on the same day).

Pelvic ultrasound and laparoscopy are also important for the exclusion of malignant tumors (such as ovarian cancer) that can cause symptoms that mimic the symptoms of endometriosis.

[11], [12], [13], [14], [15]

How to treat endometriosis?

Endometriosis can be treated with medications and / or surgery. The goals of treatment of endometriosis can be a reduction, the elimination of pain and an increase in fertility. For the treatment of endometriosis and gynecological pain, non-steroidal anti-inflammatory drugs (such as ibuprofen or naproxen sodium) are used. They are usually prescribed to help relieve pelvic pain and menstrual cramps. Since endometriosis with gynecological pain most often occurs in the reproductive age, many of the medical methods of treatment involve the interruption of normal cyclic production of hormones in the ovaries. Then use oral contraceptives and hormone treatment with progestins and estrogens in appropriate doses.

Surgical treatment of endometriosis can be prescribed by a doctor when the symptoms of endometriosis are very severe or when the body has responded to treatment with hormones or anti-inflammatory drugs inadequately. Surgery is usually prescribed for gynecological pains caused by endometriosis, with anatomical distortions of the pelvic organs or obstruction of the intestine or urinary tract.

Hormonal disorders

Disorders of the hormonal background can be the second most common cause of gynecological pain. Often, women do not associate these pains with impaired hormone production. And, meanwhile, this is so.

Symptoms of hormonal imbalance

Symptoms associated with hormonal disorders in women can manifest themselves most between 20 and 40 years. And the older a woman, the stronger her symptoms manifest, especially if no one paid attention to them for years. Here are the symptoms of hormonal imbalance associated with gynecological pains:

• allergy symptoms (difficulty breathing)
• depression, fatigue and anxiety
• endometriosis
• fibrocystic mastopathy
• sharp loss of hair on the head and growth of hair on the face
• headache, dizziness and confusion of thoughts
• increased sexual appetite
• osteoporosis
• PMS
• urinary incontinence
• weakening of immunity, frequent colds
• uterine fibroids
• weight gain, fluid retention in the body and swelling
• the appearance of early and premature wrinkles on the skin

Symptoms of hormonal imbalance are caused, first of all, by a weak relationship between the level of estrogen and progesterone in the body. Two female hormones, estrogen and progesterone, barely survive the delicate balance of doses and ratios. Changes in this balance can have dramatic consequences for health and identify symptoms of hormonal imbalance.

The amount of hormones that a woman's body produces from month to month depends on factors such as stress, diet, exercise and most importantly - ovulation or lack of it.

In the first 10-12 days of the menstrual cycle, the female body produces estrogen. When ovulation occurs, progesterone is produced in the ovaries. However, if ovulation does not occur, estrogens are still produced, but they are no longer balanced with the progesterone necessary to cause ovulation. This condition leads to symptoms of hormonal imbalance - the ratio of estrogen-progesterone drops to a very low level, although these hormones are produced in the body. But in very small quantities.

Causes of hormonal imbalance and related gynecological pain

There are several causes of hormonal imbalance, but in most cases, the main reason is the dominance of estrogens or an increased level of estrogen in the body and a shortage of progesterone. Other causes of gynecological pain with hormonal imbalance - is the reception of birth control pills, stress, abuse of cosmetics and non-organic products of animal origin.

There are also such important reasons as genetics (heredity), obesity and tumors. The causes of gynecological pain with hormonal imbalance may be a lack of exercise, pregnancy, lactation, the production of autoantibodies and a sedentary lifestyle. Of all these reasons, obesity is the number one cause for medical indicators, and the hormonal balance in pregnancy is the number one cause of hormonal balance due to lifestyle changes.

[16]

Diagnostics

How can a woman identify symptoms of hormonal imbalance? This can be done quickly and effectively, to conduct a hormonal test at the first sign of the menstrual cycle in women of reproductive age or signs of menopause. The hormonal balance test takes only a few minutes. First of all, it is necessary to check the level of hormones of estrogen and progesterone and their ratio.

[17], [18], [19], [20], [21], [22], [23], [24], [25], [26]

Treatment of hormonal imbalance

For women in the menopause period, this may be hormone replacement therapy. For women of reproductive age, this is usually the intake of hormonal drugs in the ratio recommended by the doctor. With gynecological pain associated with hormonal imbalance, anesthetizing and special diet can also help.

Gynecological pain due to abnormal genital structure

Peculiarities of anatomical structure of genital organs

Because of the wrong development of the genitals, a woman may experience gynecological pain. The most common and serious deviation among the genitals is the defects of the uterus. Almost 5% of female infertility is due to anatomical defects of the uterus. These defects are innate and acquired. Birth defects of the genital organs are those that are associated with the incomplete formation of the uterus during the embryonic period, and its changes such as the bicornylum and septa within it.

Acquired defects are those that develop during a woman's life, such as uterine fibroids, polyps and intrauterine adhesions. To the acquired defects of the genitals can also be attributed prolapse of pelvic organs or ovulation of the uterus and (or) the walls of the vagina.

Symptoms

Functional and anatomical defects can prevent a woman from becoming pregnant and bearing a child, but they can also be accompanied by severe gynecological pain. With uterine defects, women may also suffer from abnormal bleeding or self-abortion.

Diagnosis of anatomical defects and associated pains

Ultrasound examination of the uterus after the use of physiological solution

[27], [28], [29], [30], [31], [32], [33], [34], [35], [36]

Hysterosalpingogram

This method uses X-rays and a special chemical dye to detect uterine defects.

Hysteroscopy

This method uses a fiber optic telescope that is inserted into the uterine cavity.

Laparoscopy

This method involves the use of a small fiber optic telescope, which is inserted into the incision near the navel inside the abdominal cavity.

Treatment of anatomical defects of the uterus

As a rule, anatomical defects can be eliminated only by plastic surgery.

Vulvodina

First of all, this disease is characterized by pain in the perineum and pain at the entrance to the vagina.

The pain, burning or irritation associated with vulvodynia can make a woman's life so unbearable that even sex becomes unthinkable. This condition can last for several months or years.

Women with vulvodynia suffer from chronic pain in the vulva area for no apparent reason. Until recently, doctors did not even recognize vulvodynia as a real pain syndrome. Even today, many women can not get the diagnosis of this disease. They can also remain isolated from the environment, because vulvodynia is not so easy to discuss. Researchers are still working hard to discover the causes of vulvodynia and to find more effective ways to treat it.

Types of vulvodynia

Vulvodina affects the condition of the vulva, the external female genital organs: the labia, the clitoris and the vagina.

There are two main subtypes of vulvodynia:

• Generalized vulvodynia is a pain in various areas of the vulva, which bothers the woman at different times. Pain in the vulva can be permanent or occur at the same time every day. Even simple finger-touching can aggravate gynecological pain.
• Vestibulitis vulva - in a literal translation it sounds like pain in the vestibule - that is, the entrance to the vagina. This type of pain - strong and burning - occurs only after a touch or pressure, for example, during intercourse.

Possible causes of vulvodynia

Doctors still can not name most of the causes of vulvodynia. They have no evidence that infections that cause sexually transmitted diseases can be the cause of vulvodynia, as scientists have claimed for several decades to say.

The causes of vulvodynia can be

• Nerve damage in the uterus or its irritation
• Abnormal reaction of germ cells to infection or trauma
• Genetic factors that make the vulva insensitive to chronic inflammation
• Hypersensitivity of the vagina to yeast infection
• Muscle spasms
• Allergy or irritation with chemicals (or other substances)
• Hormonal imbalance
• Sexual violence
• Frequent use of antibiotics

Symptoms of vulvodynia and gynecological pain associated with it

Symptoms of vulvodynia usually begin suddenly and can last from several months to several years.

• Burning, tingling, sensation of abrasions in the vulva
• Pulsating pain in or around the vagina
• Itching in the vagina
• Inflamed or swollen vulva

Symptoms of vulvodynia can appear:

• All the time or from time to time
• During activities such as exercise, socializing or walking - or even during a rest period
• When riding a bicycle, inserting tampons or sitting for a long time in one place In one specific area of the vulva or in the entire vulva

Burning pain of a gynecological nature is the most common symptom of vulvodynia. Some women describe it as a knife pain or an intolerable pain as if from an acid spilled over the skin.

Treatment of vulvodynia

Medications

• Local anesthetics, such as lidocaine, novocaine
• Hormonal creams with estrogens
• Tricyclic antidepressants
• Anticonvulsants
• Interferon in injections

Therapy

Physical therapy for the treatment of pain in vulvodynia includes exercises to strengthen the pelvic muscles and reduce muscle spasms

Biological feedback, which will help you learn to relax the muscles of the vagina, to reduce the pain of the gynecological

Women with vulvodynia need to determine what works best for treatment, they may have to try a few drugs before finding the most winning combination. Here are a few things that women can do to relieve vulvodynia symptoms or keep them under control.

• Use dermatologically approved detergents and do not use air conditioners and odorants when washing underwear.
• Use 100% white cotton underwear, cotton menstrual pads and tampons.
• Avoid getting shampoo on the vulva area.
• Avoid scented creams and soaps, pads or tampons, creams with a high concentration of spermicides.
• Avoid hot baths or a pool with plenty of chlorine.
• Rinse the vulva with cool water after each urination and intercourse.
• Avoid foods that make decay products irritating the genitals. It can be greens, legumes, berries, chocolate and nuts.
• Wear loose clothing and exclude tight pants and skirts; Do not wear synthetic pantyhose.
• Keep the surface of the vulva clean and dry.

It should be noted that gynecological pain is necessarily associated with the health of the reproductive system. Therefore, it is necessary to avoid inflammation of the pelvic organs, especially chronic ones, and also regularly visit the oncologist for malignant and benign formations in the genitals.

What is acute gynecological pain?

This pain in the lower abdomen or in the back, which occurs suddenly, does not last long, but is accompanied by a strong pain symptom. Also, a woman may have fever, her bowel may work poorly, there is weakness and fatigue. It feels like a woman is gradually walking around life. If you ever experienced such a condition, in no case can not be tolerated, it is necessary to consult with a gynecologist in the women's consultation what to do. And it is better to call an ambulance right away.

The causes of this condition can be serious deviations in the sexual system of a woman: inflammation of the appendages or uterus, ectopic pregnancy, and the rupture of the neoplasm on the ovary (cysts) or its twisting, the causes may be other diseases that require an immediate call of a doctor.

Gynecological pain can be not only acute, but also chronic, that is, lasting for a long time and constantly. These pains are localized in women in the lower abdomen and can last for several years. The causes of chronic pain are completely different than the causes of acute pain, therefore we consider them separately. Chronic pain associated with gynecology, doctors register every fifth or sixth woman.

They are most often caused not by an individual disease, but by a whole complex of causes, so you need to pay special attention to such pains and not tolerate them, but diagnose and treat them. Sometimes it happens that the diagnosis of chronic gynecological pain is difficult, and the reasons to identify difficult, and sometimes not at all. Let's look at the main causes of gynecological pain in detail.