Women’s Health: Pelvic Pain and Endometriosis

• By:  Nikki Buccina and Scott Peters
• Posted:  August 30, 2024
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According to the National Institutes of Health, it is estimated that only a third of women in the U.S. who suffer from chronic pelvic pain seek medical care. As many as one in seven women are affected by chronic pelvic pain, which is defined as debilitating pain between the hips, below the navel and above the legs persisting for more than six months.

These staggering statistics inspired Allegheny Health Network's Radhika Patnam, MD, urogynecologist and reconstructive pelvic surgeon, to launch the AHN Pelvic Pain Clinic.

"Chronic pelvic pain is too often dismissed or ignored due to the complexities of its treatment and the ongoing nature of its management," Dr. Patnam said in the clinic's launch announcement. "My vision was to create one of Pittsburgh's first clinics where women can safely and openly express their concerns and receive comprehensive care to relieve their pain. As a care team, we approach each patient from both an anatomical and physiological perspective, focusing on their overall well-being and quality of life."

In addition to chronic pelvic pain, the clinic focuses primarily on vulvodynia and bladder pain syndrome and provides referral pathways for women who may be suffering from endometriosis, which affects a high percentage of women who report pain of this nature.

AHN Women's Institute Group Chat: Chronic Pelvic Pain and Endometriosis

The following videos are from an ongoing speaker series titled "Group Chat" hosted by AHN Women's Institute. The series focuses on the most prevalent health conditions affecting women and birthing people. It is free, virtual and open to all interested — check the Group Chat events page to view upcoming topics and register to attend online. Each session can also be viewed on YouTube.

The Group Chat videos below feature Dr. Patnam and Rachel Cullifer, MD, a minimally invasive gynecologic surgeon who specializes in the care and treatment of endometriosis at AHN West Penn Hospital.

Causes of Chronic Pelvic Pain

• Dr. Patnam defines chronic pelvic pain and explains its underlying causes. She covers the most common complications that may stem from gastrointestinal, neurological, musculoskeletal and urinary systems, helping viewers better understand and identify what could be causing persistent pain.
• She also details signs, symptoms and treatment pathways for conditions including irritable bowel syndrome, nerve injury and entrapment, pelvic floor dysfunction, vulvodynia and bladder pain syndrome.

Endometriosis: Signs, Symptoms and Therapies

• Endometriosis is common: it's estimated that up to 10% of women and birthing people of reproductive age suffer from the condition, and a high percentage of patients who report chronic pelvic pain go on to be diagnosed with endometriosis. Dr. Cullifer outlines its signs and symptoms as well as how best to detect and treat the condition.
• Acknowledging that the cause of endometriosis is still unknown, Dr. Culliver reviews the top theories that medical communities agree upon as the most plausible explanation. Genetics play a factor — someone is significantly more likely to develop endometriosis if they have a first-degree relative diagnosed with the condition.
• Dr. Culliver also discusses a common misconception that endometriosis inevitably means infertility or birthing complications. She notes that more than 70% of women and birthing people with endometriosis go on to conceive naturally.

Pelvic Floor Therapy

• Dr. Patnam and Dr. Culliver note that endometriosis and pelvic pain often cause tension and strain to the pelvic floor. They explain how pelvic floor therapy can help and AHN's team-based approach.

Q&A

• At the end of the event, Dr. Cullifer and Dr. Patnam fielded engaging, thoughtful questions from viewers. Topics include pain discernment, adenomyosis, pain and inflammation levels during the menstrual cycle, vulvodynia and endometriosis excision procedures.