1 in 100 women open their bowels less than once per week – 1 in 1000 women open their bowels less than once per month
These alarming figures may understate the position. Some women with chronic pelvic pain have serious problems with their bowels. Persistent straining during defaecation causes injuries to pelvic nerves in a particular pattern. Nerves do not like being stretched – they tear – and regrow around small blood vessels. After several years, instead of one nerve there are now hundreds that encase small pelvic blood vessels. When pelvic blood flow increases in the second half of the menstrual cycle, it distends these blood vessels and results in severe premenstrual pain, that improves with the onset of menstrual bleeding.
Abnormal Uterus. There are masses of abnormal nerves running around small blood vessels in this section.
Treatment is directed at reducing pelvic blood flow in the second half of the menstrual cycle using a Mirena IUS, OCP, GnRH agonists, etc. The most effective are the injections of GnRH agonists though most gynaecologists will not prescribe them for more than six months e.g. Prostap, Zoladex, etc. They make you menopausal by turning off your hormones – including oestrogen – and reducing the blood flow in your pelvis.
It is important to realise that most forms of chronic pelvic pain reduce at the menopause because of these reductions in pelvic blood flow associated with loss of oestrogen.
These patterns may be found in all parts of the lower genital tract and adjacent organs inlcuding the vulva, vagina, uterus, cervix, urethra and bladder. For a library of images click here.