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Dr. Joon Song Lists the Most Common Causes of Chronic Pelvic Pain

Many women suffer from chronic pelvic pain. There are many conditions which can cause chronic pelvic pain, and no one should try to live with this pain without seeing a qualified gynecologist. Conditions which cause pelvic pain could be dangerous and could cause infertility if not properly treated. Dr. Joon Song explains the most common sources of chronic pelvic pain and describes the ways in which gynecologists can help women live happier, pain-free lives.


Endometritis, not to be confused with endometriosis, is an inflammation of the lining of the uterus. It is one of the most common causes of infection after childbirth. Women with abdominal swelling, abnormal bleeding or discharge, constipation, fever, a general feeling of malaise, and pelvic pain should see their gynecologist to determine whether they have endometritis.

Risk factors for endometritis include a cesarean delivery or long labor. Other risk factors include procedures where the uterus is entered through the cervix. This includes hysteroscopy, IUD placement, and dilation and curettage or the scraping of the lining of the uterus.

Treatment of endometritis is usually accomplished through a course of antibiotics. Most women who have endometritis respond well to antibiotics and do not have any other complications. 

Complications can happen, and they include pelvic peritonitis or a general pelvic infection, septicemia or bacteria in the blood, sepsis and septic shock, and in some cases infertility. It is imperative that women who present with possible symptoms of endometritis see their gynecologist as soon as possible for treatment.


Adenomyosis happens when the endometrium, or the lining of the uterus, grows into the wall of the uterus. The tissue which has been displaced to the wall of the uterus continues to respond to hormonal cues, going through the menstrual cycle. This can cause an enlarged uterus and heavy periods with a great deal of pain.

Possible symptoms of adenomyosis include prolonged or heavy periods, serious cramps or sharp pain during menstruation, and general pelvic pain. The uterus may enlarge, causing a feeling of tenderness or pressure in the lower abdomen.

Adenomyosis can be caused by a cesarean section, causing the cells of the uterine lining to move into the uterine wall. It can also be caused by uterine inflammation after childbirth. It may also be caused by developmental abnormalities in the fetus. Some new theories suggest that stem cells normally contained in bone marrow invade the uterine wall.

Treatment for adenomyosis can take many forms. For some women, hormonal medications offer some relief. For others, it is more complex and results in the removal of the uterus through hysterectomy. Most women are relieved of the condition at menopause.

Risks of adenomyosis include chronic anemia from the heavy uterine bleeding experienced during a period. Pain and bleeding may cause women to miss out on enjoyable activities due to the discomfort of the condition.


Uterine fibroids are a common condition. 20 to 80 percent of all women develop fibroids by late middle age. Many women experience no symptoms and are unaware that they have fibroids until they have an ultrasound or an examination from a qualified gynecologist. However, fibroids can cause serious problems including infertility.

Fibroids are a type of benign muscular tumor in the uterine wall. These tumors do not generally develop into cancer. The symptoms of fibroids include heavy periods and pelvic pain. Other symptoms include increased urination and rectal pressure. Fibroids can also cause the uterus to protrude as if the patient is pregnant.

Treatment may include surgery, either myomectomy where only the fibroids are removed or a hysterectomy which removes the entire uterus. Pregnancy is possible after a myomectomy, but patients may require a cesarean section to deliver.

Endometrioma Cysts

Endometrioma cysts are most common when a patient has polycystic ovarian syndrome or PCOS. They can happen in all women, and they can at times be extremely painful. However, many women with Endometrioma cysts never experience symptoms.

Endometrioma cysts can be caused by hormonal issues, endometriosis, pregnancy, and pelvic infections. If painful endometrioma cysts occur, they may lead to the removal of the ovaries, causing infertility.

Symptoms of endometrioma cysts include chronic pain in the pelvis, lower back aches, pain during sex, weight gain, menstrual pain, heavy periods, and breast tenderness. They can lead to infertility in extreme cases.

Endometrioma Cysts can be treated with hormonal birth control. This helps to even out the hormonal load in the body and restrict the monthly effect of periods. They also may require surgery if they are causing too many problems.

Chronic Pelvic Pain

Women should always get in touch with their gynecologists when they are experiencing pelvic pain. Any one of these conditions can cause infertility if not properly treated. Dr. Joon Song recommends that women receive an ultrasound in the doctor’s office to pinpoint the cause of their pelvic pain.