Finding the right diagnosis and treatment for chronic pelvic pain

PHILADELPHIA (WPVI) -- There are many reasons why women suffer pelvic pain.

Finding a diagnosis and relief can take time, and a team approach is the best route for answers.

Laura VanDruff dealt with pain on and off for years.

"My symptoms were not in a little box typical of any particular diagnosis," VanDruff recalls.

Because of that, VanDruff felt her pain wasn't taken seriously by doctor after doctor.

"I'll never forget, this doctor patted me on the back and said. 'Oh, honey, you're going through the change of life," she says.

VanDruff rejected that assessment, but the doctor persisted and wasn't open to discussion.

"I walked home crying, and I cried, and I cried, and I cried," VanDruff says, still feeling the pain of that experience.

Finally, Dr. Jessie Huff at Temple Health believed her, and referred her to Dr. Anna Zelivianskaia, who sees many complex cases.

Dr Z, as patients call her, says monthly cramping is normal.

"If she's having bad nausea, vomiting, GI symptoms every time she gets her period, if she's having a lot of pelvic pain outside of her period, so at different points in the month, no, that's not normal," says Dr. Zelivianskaia.

Nor is missing work or school.

The doctor says an evaluation includes a thorough medical history, and a pain diary or journal helps detail symptoms.

"It's also very helpful to figure out if there's a correlation between symptoms and other factors, other influences in a patient's life," the doctor says.

It might be diet-related, occur at a particular time, or with a certain activity.

"In a fair amount of patients, there are multiple things going on at once," says Dr. Z, reinforcing the need for a multidisciplinary team.

Although there are many causes of chronic pelvic pain, such as fibroids, ovarian cysts, pelvic adhesions, G-I or bladder issues, Dr. Z says up to 40% have signs of endometriosis.

That occurs when pieces of uterine lining grow outside it.

After several measures didn't relieve Laura's pain, Dr. Z suggested laparoscopic surgery.

"Lo and behold, she found, we found endometriosis," VanDruff says, recalling that afterward, "My body felt so normal. And I had forgotten kind of what it felt like."

VanDruff said it was so important to be listened to, believed, and given options.

Dr. Z says there are many options, but they take time, so women shouldn't be discouraged.