What Causes Persistent Pelvic Pain?

Posted on Thu, 19 Oct 2017

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Thu, 19 Oct 2017 Answered on

Tue, 28 Nov 2017 Last reviewed on

Question : Hello,

I have had pelvic pain for 3 months now, every day, but not all day. The pain is mild, but it's definitely in my lower pelvis, and sometimes more sharp on my lower left side. I have had a colonoscopy a year ago, to reveal everything normal. I have had 3 ultrasounds, including a transvaginal ultrasound to reveal a couple of small cysts (endometrial), not ovarian. There are no ovarian cysts but I'm still getting pelvic pain. It seems to stop with my period and then start right after again. Would an MRI of the pelvis help with diagnosis? I just started birth control progestin only, and am on day 20 of it, to find no relief. Please advise!

Answered by Dr. Richa Agarwal (31 minutes later)

Brief Answer:
You can go for MRI pelvis.

Detailed Answer:
Hello dear,
Thanks for trusting hcm about your health care.
I have gone through your history and understand your concerns.
There are so many reasons of pelvic pain like endometriosis,fibroid,PID and with the help of MRI we can rule out the cause as you have normal colonoscopy and ultrasound.
As you are taking progesterone, you may get relief from your pain after 2-3 cycles.
You should review with your MRI report.
If MRI is normal and pain is their than we have to go for Laparoscopy which is diagnostic as well as therapeutic.
Hope found useful, feel free to ask more information.
Good luck.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Richa Agarwal (18 hours later)

Thank you,

I was wondering what a pelvic MRI is good at seeing. Could it see endometriosis? And how do you get any gynecologist to do laparoscopy, since here in Canada it seems impossible to get tests done. I am not in excrutiating pain, but I do have pain daily. And it gets to you!
XXXXXXX

Answered by Dr. Richa Agarwal (6 hours later)

Brief Answer:
Yes,MRI can see endometriosis.

Detailed Answer:
Hello dear,
Sorry for the delay in my response.
As your ultrasound is normal, and pelvic pain is persistent than MRI is diagnostic for pelvic organ because in CT scan you are unable to see anything.
As your pain is mild in nature but not relief by pain killer and progesterone, so laparoscopy is important to establish a diagnosis of your pain and laproscopy is investigation of choice in diagnosis of endometriosis.
If appointment is difficult we can wait for 4-5 months of progesterone therapy.
Hope found useful, feel free to ask more information.
Good luck.
Regards

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Richa Agarwal (36 hours later)

So an MRI is better than a CT scan to see the pelvic area? Can an MRI detect endometriosis or any other reason for pain? Or would it just check that everything is normal?

Answered by Dr. Richa Agarwal (1 hour later)

Brief Answer:
Yes, it is better.

Detailed Answer:
Hello dear,

Yes, MRI is a better investigation to see the pelvic pathology than CT scan.

It will be able to rule out endometriosis as well as other pathology of the pelvic region.

Hope you found this useful.
Good luck.
Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee