Q:
What is the best way to talk to my health care professional about my pelvic pain? Sometimes my symptoms make me feel like I'm crazy, and I don't want to sound crazy when I describe them.
A:
First, know that you are not crazy, although I'm not surprised you feel that way. Surveys find that it often takes 10 years between a woman's first symptoms of pelvic pain and a diagnosis and treatment. During that time, women often see several doctors and often have their pain minimized. Here's what one woman wrote in response to a researcher's request for narratives about chronic pelvic pain after she had been referred to an ob-gyn: "That's when I really felt like a hypochondriac. He was lovely, and I am sure that he did not mean to be condescending. 'Hello Mrs. N, you seem to be a mystery. You've certainly done the rounds on seeing doctors so you have ended up with me to find out what's causing this pain.' Here we go again; he thinks it's all in the mind."
This particular study found that women felt their version of "reality" was not believed, that the doctors failed to acknowledge their pain, and that the doctors were "dismissive in attitude." Bottom line: Many women with chronic pelvic pain feel their health care professionals do not "hear their stories."
So here's my advice. First of all, if you feel that your health care professional is not listening to you, and you have made this clear, it may be time to find another provider. You deserve to have your pain taken seriously, even if no overt cause can be identified. Having said that, it is important that you do whatever you can to help your health care provider identify any possible causes of your pain. A good idea is to track your pain in a monthly diary, ranking the level of pain from 1 to 5, with 5 being so excruciating you can't function and 1 being the level of mild menstrual cramps. Also note anything you were doing that might be related to the pain. For instance, did the pain occur during or after intercourse? After eating a large meal? During menstruation?
During the conversation with your health care provider, remain calm. Bring notes with you if you think that will help. Even try writing a narrative of your story, from the time the pain first began to the help you've sought and the steps you've taken to address the pain. And don't be afraid to tell your provider what you think is causing your pain. Did you have pain like this during a previous ectopic (tubal) pregnancy? When you had an ovarian cyst? This gives your health care professional a starting point for diagnosis.
It is also important to talk honestly with your health care professional about any abuse or sexual trauma you have experienced in the past or that may be occurring now. Such trauma can be a cause of pelvic pain.
Finally, don't give up! There are good options for treating chronic pain, regardless of the cause, and you deserve relief.
