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A Cause Of Pain Your Doctor Might Miss

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A Cause Of Pain Your Doctor Might Miss

As an OB/GYN, I have examined and treated thousands of women who complain of pelvic pain. Sometimes the diagnosis is easy — itís pelvic inflammatory disease, a ruptured ovarian cyst, a twisted ovary, or an ectopic pregnancy. But more often than not, the cause doesnít jump out and whack you on the white coat.

How We Evaluate Pelvic Pain

In most cases, we start with a pelvic exam, which may not reveal any helpful information. So we dig deeper, ordering a pelvic ultrasound, which will usually rule out ovarian cysts or fibroids, or we get a pregnancy test, meant to rule out ectopic pregnancy. These tests wonít pinpoint a diagnosis of endometriosis or scar tissue or interstitial cystitis (inflammation of the bladder wall).

So if we find nothing, we wind up scratching our heads, prescribing pain pills, and scheduling surgery so we can go hunting with various scopes and try to determine the cause.

Once we put a laparoscopic camera inside a womanís abdomen, we can get up close and personal with her ovaries, the outside of her uterus, the lining of her abdomen, the outside of her bowel. We can look for little lesions that resemble burn-marks or red blebs or clear blisters, which can signal endometriosis. Or we can track down and cut up scar tissue.

What If You Find . . . Nothing?

But way too often, we do all that, we invade a womanís body, we look inside and we findÖ.nothing. Which should be good news, right? Congratulations! You donít have cancer or any bad disease we can see with a laparoscope! But our patients donít usually celebrate. They cry, because many have suffered for years and we have failed to diagnose or fix the cause of their pain.

So what do we do? We ship them off to chronic pain clinics, shrinks, and pelvic physical therapists, who drug them up with painkillers and antidepressants and teach them exercises intended to help them change the experience of their pain. But so many of these women lose their mojo. They become despondent. They wind up cutting back on activities until many are stuck in bed, hooked on narcotics. As a doctor, itís frustrating and defeating — and as a patient, it must be a million times worse.

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Lissa Rankin

Lissa Rankin, MD is a mind-body medicine physician, founder of the†Whole Health Medicine Institute training program for physicians and other health care providers, and the New York Times bestselling author of†Mind Over Medicine: Scientific Proof That You Can Heal Yourself.† She is on a grassroots mission to heal health care, while empowering you to heal yourself.† Lissa blogs at† and also created two online communities -† and† She is also the author of two other books, a professional artist, an amateur ski bum, and an avid hiker. Lissa lives in the San Francisco Bay area with her husband and daughter.


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8:30AM PDT on Jun 13, 2011

Thank you.

1:36AM PDT on Jun 6, 2011

*sigh* My pain has nothing to do with my feminine parts, and an MRI revealed nothing... So, since I can't afford acupuncture for my back, they're talking about deadening nerves... I keep saying it's not the external nerves... NO one wants to believe me.

1:20PM PDT on Jun 4, 2011


6:52AM PDT on Jun 2, 2011

I could have used some kind of diagram or drawing.

9:07AM PDT on May 30, 2011

thank you for posting this.

1:08AM PDT on May 30, 2011

A very important post for women.

6:44PM PDT on May 29, 2011

Now if only I can win the lottery to afford the test. Good info!

6:40PM PDT on May 29, 2011

Thanks for the info, more women need to receive this vital information.

9:06AM PDT on May 29, 2011

Thanks for the info. I currently don't have any worries in regards to this thank goodness, but if I or any woman I know ever has pelvic pain that can't be explained I'll definitely remember this!

6:18AM PDT on May 29, 2011

Thank you! Your insight is much appreciated.

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Disclaimer: The views expressed above are solely those of the author and may not reflect those of
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