Pelvic Health

What does pelvic health cover?

Pelvic health covers many common conditions, including ovarian cysts, polycystic ovary syndrome (PCOS), endometriosis and pelvic floor disorders.

The pelvic floor is a group of muscles and ligaments that help support crucial organs like the bladder, bowel and uterus. When the pelvic floor is weakened – by pregnancy, childbirth or other conditions that may put strain on this area – certain issues may arise including:

• Frequent urination
• Accidental leakage of urine (incontinence)
• Vaginal dryness (not relieved by lubricants)
• Painful sexual intercourse and/or low sex drive (libido)
• Pressure or heaviness in your pelvic area
• Bulge in the vaginal area

Depending on your needs, your personalized treatment plan will manage and potentially alleviate pelvic symptoms and may include physical therapy, pelvic floor exercises, medication or surgery.

Sexual and pelvic health are closely related. Pelvic floor health symptoms are often accompanied by reduced arousal, infrequent orgasms and other sexual concerns. Your provider may want to consider your sexual activity when treating pelvic pain.

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When is pelvic pain cause for concern?

Pelvic pain can indicate anything from a urinary tract infection (UTI) to a severe condition like cancer of the reproductive organs. It can even be a normal (though uncomfortable) part of premenstrual syndrome (PMS). If you experience pelvic pain — especially if it's serious or ongoing — you should see your physician. They can determine what's causing the pain and design a personalized plan for relief. 

Pelvic health and pregnancy care

Pregnancy puts extra demands on your pelvis and pelvic floor muscles. As a result, your pelvic health needs extra attention before, during and after pregnancy. If you're trying to conceive, don't wait until you're pregnant to start thinking about a pelvic checkup.

Pregnancy brings hormonal changes that can soften or loosen your pelvic floor muscles. And delivery puts extra strain on the pelvic floor. As a result, some women experience complications such as incontinence or pelvic organ prolapse. Talk to your provider about a personalized plan to maintain and improve your pelvic health as soon as you're pregnant or planning to conceive.

What is pelvic congestion syndrome (PCS)?

Pelvic congestion syndrome occurs when varicose veins form in the pelvic area. Those veins swell and can become twisted, causing dull pain in the pelvis. Symptoms of PCS vary but may include painful periods, fatigue, swelling around the vagina and abnormal vaginal bleeding or discharge.

What causes PCS?

Pregnancy is the most significant risk factor for PCS. And women who have had more than one pregnancy are more likely to develop PCS. When you get pregnant, your pelvic area undergoes structural changes that can weaken or complicate blood flow to the vessels in your pelvis and cause them to become varicose, resulting in PCS. Polycystic ovaries are another risk factor for PCS.

How is PCS identified and treated?

Your provider may need to perform multiple tests to diagnose PCS since it shares symptoms with many other pelvic health conditions. They may suggest imaging such as an ultrasound or minimally invasive surgery like a laparoscopic procedure to investigate inside your pelvis. Your symptoms and health history will help to determine if you're at risk or if your pelvic pain points to PCS. Questions your physician might have include:

• How many times have you've been pregnant?
• What does your pelvic pain feel like?
• Do your pelvic pain symptoms worsen in specific situations, such as during or after sex or at certain times of day?

If your provider determines you have PCS, your personalized treatment plan may include anti-inflammatory or pain medications to manage your symptoms. They may also recommend a minimally invasive surgery called a pelvic vein embolization to close off the veins that are causing pain.

What are uterine fibroids?

Uterine fibroids are noncancerous growths in the uterus made of muscle and fibrous tissue. On their own, they aren't dangerous and don't pose a significantly increased risk of cancer. However, depending on the size, number and location of fibroids, they can cause pelvic pain, frequent or difficult urination and heavy or prolonged periods. If they grow too large, they can create a feeling of pressure or weight in the pelvis and can be externally visible.

How are uterine fibroids treated?

If fibroids aren't causing discomfort or symptoms, you may not need treatment beyond periodic checkups. If your provider recommends treatment, there are medications and surgical options. Medications generally don't get rid of fibroids, but they can improve symptoms and reduce their size.

Several minimally invasive surgical options are available to treat uterine fibroids including laparoscopic fibroid removal that can eliminate them with minimal scarring and quicker recovery times. There's also uterine artery embolization, which blocks the blood supply to the fibroid, causing it to die.

Uterine artery embolization recovery

The risk of complications after uterine artery embolization (UAE) is similar to other surgical methods. You can typically return to your normal activities after a couple of weeks, and your symptoms should improve. Your period may be interrupted but should gradually return to normal over a few months.

The procedure is safe and generally effective, but fibroids can return after a UAE. About one-third of women who get a UAE will repeat the process within five years. 

Pelvic health and cancer

Regular screenings with your ob-gyn or midwife are an important tool in the detection and prevention of some cancers. According to the CDC, more than 90% of cervical cancers could be prevented through proper screening and vaccination.

Family history, age, and sexual history are some risk factors for cancer. Novant Health offers genetic counseling that can help identify any genetic risk factors you may have and help you plan for a healthy future.

Gynecologic cancer services

At Novant Health, we're committed to all aspects of your well-being. Our holistic approach includes the most advanced, minimally invasive surgical techniques to remove cancerous growths. We also offer psychological support, financial guidance to help you pay for treatment and specially trained patient navigators who coordinate your care and answer questions from diagnosis through treatment and recovery. Novant Health also participates in clinical trials that make the latest potential cancer treatments available to our patients before they become widely available.

Learn More About Gynecologic Cancers