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There are many women who are told that the pelvic pain that they experience is just in their head, which is not the case. These women may face many years of searching and frustration before they receive a correct diagnosis. Here are four commonly missed conditions that may help you to better understand your own situation if you are walking in these shoes.

Urethral Diverticulum (UD)

UD is a condition that occurs when a “pocket” or sac filled with urine or pus forms next to the urethra. It’s correctly diagnosed more often today due to better diagnostics.

The urethra is a 4 cm long (in women) small tube that carries pee from the bladder to the loo (or the garden or whatever the situation maybe). If something’s up with this little passage, you will know it. The “why” unfortunately sometimes remains a frustrating mystery due to a rare condition called urethral diverticulum (UD). This is because in many cases UD is missed or misdiagnosed, simply because no one considered it.

This condition is characterised by various symptoms that may wax and wane, including

  • pain during urination,
  • blood in the urine,
  • pain with sex,
  • the need to pee more than once at night,
  • dribbling after urination,
  • difficulty emptying the bladder,
  • bladder accidents,
  • urinary urgency and
  • regular urinary tract infections (UTIs).

The cause of UD is unclear, but there may be a link to chronic bladder infections and birth defects. It’s more common in women between the ages of 40 and 70.

UD can present as a tender spot or mass along the front vaginal wall, which you may be able to feel yourself if you gently touch the area.

If you suspect you have UD, contact your health care provider for a referral to an experienced urologist, who can help you with diagnosis and treatment.

Vulvodynia

Vulvodnia is a condition where women experience chronic* vulvar** pain or discomfort without any evidence of other skin or gynaecological conditions.

  • Vulvodynia remains poorly understood and is often misdiagnosed.
  • An estimated 15% of women will suffer from it at some point in their lives.
  • 60% of women who suffer from the condition consult at least three health care professionals in seeking a diagnosis
  • 40% of them remain undiagnosed.

The most common symptom is burning, but other symptoms include aching, throbbing, itching, stinging, irritation and rawness. This may be felt occasionally or all the time, it may involve the entire area or just part of the vulva and it may be provoked (by sex or tight knickers) or spontaneous.

Vulvodynia can affect women of all ages, but it mostly occurs in women 18 to 25 years old. There is no one-fits-all solution for vulvodynia but luckily there are many kinds of treatments available. It may take a little time to find the right one, and it may take a combination of treatment strategies to relieve symptoms, restore the quality of life and prevent reoccurrence.

If you think you may have vulvodynia consult your general practitioner and gynaecologist who will begin by ruling out the most common causes of vulvar pain before diagnosing, you with vulvodynia.

*Chronic: lasts more than three months
** Vulva: the intimate zone excluding your vagina

Vaginismus

Vaginismus is a condition where a woman’s pelvic floor muscles spasm to prevent vaginal penetration, for example during sex, during a medical examination or when aiming to insert a tampon.

  • Two out of every 1,000 women have at least moderate vaginismus.
  • Some 53% of women with vaginismus are aged 25-35.
  • Many women do not seek help due to shame and embarrassment.

As you can imagine Vaginismus makes intimacy painful to impossible, and medical exams and tampon use very difficult.

Vaginismus can happen to sexually active women of all ages, perhaps as a response to a traumatic experience. It can also strike virgins who have never been able to have sex because of it. Some women experience vaginismus in all situations involving penetration, and others experience it only in certain scenarios.

The reason for vaginismus is not always clear. However, it may be linked to both emotional and physical triggers.

If you suspect that you have vaginismus, contact a physical therapist specialising in pelvic health. These professionals are effective at treating 90 percent of cases.

If emotional factors are at play, seeking guidance from a sex therapist or appropriate psychologist may be the best option.

Endometriosis

Endometriosis is a condition where the tissue that normally lines the inside of the uterus (the endometrium) grows in other areas where it’s not supposed to grow.

  • Period pain is not normal and can be a sign of endometriosis.
  • One in 10 Australian women will experience endometriosis.
  • Diagnosis can take 7-12 years on average.
  • There is no cure for endometriosis.

Endometriosis most commonly occurs in the fallopian tubes and ovaries, but it can grow in other places, such as in skeletal muscles and lungs, for example.

This can be a debilitatingly painful condition at period time. Alternatively, it may be completely symptomless. It can start as early as the teenage years and can affect fertility.

The only sure way of getting diagnosed with endometriosis is to have a laparoscopic biopsy.

Endometriosis treatment will depend on the individual case and might include medication, surgery and other supportive therapies like alternative medicine and physiotherapy.

If you think you may have endometriosis consult your general practitioner and gynaecologist.

Whatever your situation may be, living a pelvic floor-conscious lifestyle that incorporates exercises to keep your pelvic floor muscles in an optimal condition not only helps you have reliable bladder control, protection from prolapse and enhanced sexual sensations but also contributes to optimised general pelvic health.

Check out our blog from more tips on pelvic health.

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