Pelvic Pain Treatment in Hyderabad — Expert Diagnosis of Women's Pelvic Pain

Chronic pelvic pain is pain in the lower abdomen or pelvis that has been present for 6 months or longer. It may be constant or cyclical (worse at certain times of the menstrual cycle), and it may be dull or sharp. See a gynaecologist if pelvic pain is interfering with your daily life, is worsening over time, is associated with heavy periods or difficulty conceiving, or has not been fully investigated. Pelvic pain should never be dismissed as 'normal period pain' — it almost always has an underlying cause that can be identified and treated.

The most common gynaecological causes are: endometriosis (accounts for approximately 30–35% of cases of chronic pelvic pain in women), adenomyosis, uterine fibroids, ovarian cysts, and pelvic inflammatory disease (PID). Non-gynaecological causes — including irritable bowel syndrome (IBS), interstitial cystitis, and musculoskeletal pain — can also cause pelvic pain, either independently or alongside gynaecological conditions. A thorough investigation is needed to identify all contributing causes, as many women have more than one.

Endometriosis is one of the most common causes of pelvic pain and is frequently underdiagnosed — on average, it takes 7–10 years from symptom onset to diagnosis worldwide. Symptoms that suggest endometriosis include: severe period pain (dysmenorrhoea) that worsens over time and does not respond well to painkillers, deep pelvic pain during or after sex (deep dyspareunia), pain with bowel movements or urination especially during periods, heavy periods, and difficulty conceiving. If you have these symptoms, please seek specialist evaluation without further delay. Dr. Prashanthi has expertise in diagnosing and treating endometriosis laparoscopically.

Pelvic inflammatory disease (PID) is an infection of the upper female reproductive tract — the uterus, fallopian tubes, and/or ovaries. It is usually caused by sexually transmitted infections (chlamydia, gonorrhoea) ascending from the vagina and cervix, though it can also occur after gynaecological procedures. PID causes pelvic pain, abnormal vaginal discharge, fever, pain during sex, and irregular bleeding. If untreated, PID causes scar tissue in the fallopian tubes, leading to chronic pelvic pain, ectopic pregnancy risk, and infertility. It is diagnosed by clinical examination, swabs, and blood tests and treated with a course of antibiotics. Prompt treatment is essential to preserve fertility.

Investigation begins with a thorough history (onset, character, timing, triggers) and pelvic examination. Tests typically include: pelvic ultrasound (for fibroids, cysts, adenomyosis, and free fluid), STI swabs (to exclude PID), blood tests (full blood count, CRP for infection, CA-125 if endometrioma suspected, beta-hCG to exclude ectopic pregnancy). If ultrasound and blood tests are normal but symptoms are significant, an MRI pelvis provides detailed imaging of deep infiltrating endometriosis and adenomyosis. The gold standard for endometriosis diagnosis remains laparoscopy — direct visualisation with the ability to treat at the same time.

Sudden, severe one-sided pelvic pain associated with nausea, vomiting, and an inability to find a comfortable position may indicate ovarian torsion (the ovary has twisted on its blood supply) or a ruptured ectopic pregnancy. Both are surgical emergencies — delay in treatment can result in permanent loss of the ovary or life-threatening internal haemorrhage from ruptured ectopic. If you have a positive pregnancy test and develop pelvic pain with or without vaginal bleeding, go immediately to the nearest hospital emergency department. Any sudden, severe pelvic pain that is unlike your normal period pain warrants urgent, same-day evaluation.

Pelvic pain is very rarely caused by cancer in women of reproductive age. The vast majority of cases have benign (non-cancerous) causes — endometriosis, fibroids, ovarian cysts, PID, or adenomyosis. However, an ovarian cyst with solid components, unexplained weight loss, a rapidly enlarging mass, or significantly elevated CA-125 should be further investigated to exclude malignancy. Dr. Prashanthi will conduct a thorough assessment including pelvic ultrasound and blood tests to identify the cause of your pain and appropriately exclude sinister causes where the clinical picture warrants.

Yes — for many causes of pelvic pain, laparoscopy is both diagnostic and therapeutic in a single procedure. During diagnostic laparoscopy, Dr. Prashanthi can directly visualise the pelvis and identify endometriosis, adhesions, ovarian cysts, or other pathology. If endometriosis is found, it can be excised or ablated at the same operation. Ovarian cysts can be removed while preserving normal ovarian tissue. Adhesions (scar tissue) can be divided. After laparoscopic treatment of endometriosis, 60–80% of women experience significant improvement in pain. For women who do not respond fully, medical management (hormonal suppression with GnRH agonists or the Mirena IUS) is added post-operatively to delay recurrence.