Endometriosis Pelvic Pain Specialist

Gary Harvey, MD

Urogynecologist located in Missoula, MT

Endometriosis is a common cause of pelvic pain that affects more than 11% of women (6.5 million) ages 15-44. Pelvic pain is a common women’s health concern, but it may be a sign of a serious underlying condition, such as gynecologic cancer. As a skilled urogynecologist and certified robotic surgeon, Gary Harvey, MD, diagnoses and treats all types of pelvic pain at his practice in Missoula, Montana. If you’re worried about pelvic pain, don’t hesitate to call the office or book an appointment online today.

Endometriosis Pelvic Pain Q & A

What is endometriosis?

Endometriosis is a gynecologic condition that causes the tissue that normally lines the inside of your uterus (endometrium) to develop in places it shouldn’t. The most common locations for endometriosis to develop include the ovaries, fallopian tubes, and on the outer surface of the uterus.

When you have endometriosis, the displaced tissue continues to thicken, break down, and shed with your menstrual cycle. However, since there’s no way for this tissue to exit your body, it becomes trapped.

Endometriosis irritates surrounding tissues and eventually leads to scar tissue and adhesions, which are abnormal bands of tissue that cause your pelvic organs to stick together. This may cause severe pelvic pain and make it difficult to get pregnant.

What are the symptoms of endometriosis?

Pelvic pain is the primary symptom of endometriosis. This pain may worsen during your menstrual period. Other common signs and symptoms of endometriosis include:

  • Pain during or after sex
  • Heavy menstrual bleeding
  • Bleeding between periods
  • Painful bowel movements

Infertility is another sign of endometriosis. Some women find out that they have endometriosis while seeking treatment for infertility.

How is endometriosis diagnosed and treated?

Dr. Harvey reviews your medical history and asks you to describe your pelvic pain and when it occurs. Then he performs a thorough physical and pelvic exam. If he suspects you have endometriosis, he may perform diagnostic tests, such as a pelvic ultrasound or laparoscopy.

Laparoscopy is a minimally invasive surgical technique that involves inserting a thin viewing instrument into a tiny incision in your abdomen. This provides Dr. Harvey with a clear view of your pelvic organs. If he finds displaced endometrium, he may be able to remove it in the same procedure so you only need one surgery.

The type of treatment Dr. Harvey recommends depends on the severity of your endometriosis and whether you want to have a baby in the future. Treatment usually involves medications, such as hormonal birth control, or surgery.

If you’re trying to get pregnant, Dr. Harvey may recommend surgically removing the endometrial tissue to increase your chances. He performs a minimally invasive, robot-assisted procedure called an endometriosis resection that preserves your uterus while removing endometriosis.

What is pelvic pain?

Pelvic pain is discomfort in the area below your navel and in between your hip bones. This pain may occur as one or more of the following:

  • Sharp and stabbing
  • Dull and achy
  • Cramping

You may experience pain intermittently, constantly, or it may come in waves. Pain may occur during or after a particular event, such as your menstrual period or ovulation. Pelvic pain that lasts longer than 4-6 months is considered chronic.

Pelvic pain that’s sudden and excruciating may be a sign of a medical emergency, especially if it occurs with fever, nausea, or vomiting.

What causes pelvic pain?

Many women experience pelvic pain related to their menstrual cycles. However, pelvic pain may be caused by a gynecologic condition, such as:

  • Endometriosis
  • Uterine fibroids
  • Ectopic pregnancy
  • Pelvic inflammatory disease
  • Ovarian cyst rupture

Pelvic pain is also a symptom of most types of gynecologic cancer, including endometrial, ovarian, and cervical cancer.

Because the pelvis is home to many different organs, your pelvic pain may be caused by a problem outside of the reproductive system. Nongynecologic conditions that cause pelvic pain include:

  • Urinary tract infection
  • Irritable bowel syndrome
  • Kidney stones
  • Appendicitis

Pelvic pain is an extremely complex symptom that’s common to many medical conditions. In some cases, pain persists without any diagnosable cause.

How is the cause of pelvic pain diagnosed and treated?

To determine what’s causing your pelvic pain, Dr. Harvey begins with a thorough review of your symptoms and medical history. He may ask you to describe the sensation, location, and severity of the pain, as well as any factors that worsen or relieve it.

He also performs a physical and pelvic exam to check for abnormalities, and he may do tests, such as:

  • Urinalysis
  • Pregnancy test
  • Pelvic ultrasound
  • Laparoscopy

Laparoscopy is a minimally invasive surgical technique that involves inserting a thin tube with a camera (laparoscope) into a tiny incision in your abdomen. This provides Dr. Harvey with a clear view of your pelvic organs. If necessary, he may insert surgical tools into the laparoscope to take a tissue sample (biopsy) or perform treatment.

Treatment for pelvic pain varies depending on the cause, but may include:

  • Pain-relieving medications
  • Lifestyle changes, such as exercise
  • Physical therapy

If your pain is severe and doesn’t improve with treatment, Dr. Harvey may recommend surgery, such as a minimally invasive hysterectomy.

To find relief from pelvic pain, call the office of Gary Harvey, MD, or book an appointment online today.