Chronic Pelvic Pain: When Endometriosis or Adenomyosis May Be the Cause

By Dr. Prithivi Perum, Obstetrician, Gynecologist, Fertility Expert & Laparoscopic and Robotic Surgeon at Mathrutva Women Healthcare, Manikonda, and Medicover Women & Child Hospitals, Hyderabad.

Quick answer: Chronic pelvic pain lasting months - especially with painful periods, pain during intercourse, or bowel/bladder symptoms around menses - deserves evaluation. Endometriosis and adenomyosis are frequent causes and are treatable.

At Mathrutva, Dr. Prithivi Perum assesses pain systematically and offers medical or laparoscopic options. Related: endometriosis treatments, adenomyosis explained.

When Period Pain Is Not Normal

• Pain that skips school, work, or sleep every month
• Pain needing frequent strong painkillers
• Pain with intercourse or bowel movements during periods
• Infertility with pelvic pain

Common Causes

• Endometriosis
• Adenomyosis
• Fibroids or ovarian cysts
• Pelvic infection history or adhesions
• Musculoskeletal or bladder-related pain (needs differential diagnosis)

How We Evaluate Pain

History, pelvic exam, and ultrasound are starting points. MRI or laparoscopy may be advised in selected cases. Pain diaries help track patterns across the cycle.

Treatment Options

• Anti-inflammatory medicines and hormonal suppression when appropriate
• Lifestyle support and physiotherapy referral when needed
• Laparoscopic excision/ablation for endometriosis
• Adenomyosis or fibroid-directed plans based on fertility goals

See endometriosis treatment and adenomyosis treatment.

“Pain is information. Women should not be told to endure disabling periods as a badge of strength.”

- Dr. Prithivi Perum

Summary

Chronic pelvic pain has medical causes and medical solutions. Early evaluation shortens years of unnecessary suffering.

Key Takeaways

• Disabling period pain is a reason to see a gynecologist.
• Endometriosis and adenomyosis are common treatable causes.
• Treatment can be medical, surgical, or both.
• Fertility goals shape the care plan.