Pain relief
Suitable medicines, including anti-inflammatory medicines for period pain, can help. We review what you have tried, how you take it and any reasons a medicine may be unsuitable.
Painful-period treatmentGYNAECOLOGY & PELVIC FLOOR CARE
Pelvic pain &
painful periods
Pain that affects work, sleep, movement or intimacy deserves attention. I consider gynaecological causes alongside the bladder, bowel and pelvic floor, and discuss treatment that fits your priorities.
FIND YOUR STARTING POINT
What would you like help with?
Start with the symptoms you recognise, or explore a condition that has been suggested.
Start with your symptoms
Painful periods
Cramps that disrupt school, work, sleep or everyday activities.
Ongoing pelvic pain
Pain between periods or pain that continues after treatment.
Pain with sex
Discomfort at the vaginal entrance or deeper in the pelvis.
Bladder or bowel-related pain
Pain with bladder filling, passing urine or bowel movements.
Understand a possible diagnosis
YOUR CONSULTATION
How I assess pelvic pain.
Understand the pattern
We discuss when pain occurs, its effect on daily life and links with periods, sex, the bladder or bowel. Previous treatment and pregnancy plans help guide the discussion.
Choose useful investigations
Assessment may include an examination and pelvic ultrasound to look at the womb and ovaries. A vaginal scan may be recommended, with alternatives discussed if it is unsuitable or you prefer not to have it. A normal scan does not exclude every cause of pain or every form of endometriosis.
Agree a plan and review it
We discuss treatment, the changes you hope to see and when to review progress. Treatment for suspected endometriosis can often start without an operation.
We discuss the reason for any examination and what it involves. It takes place with your consent, and you can ask to pause or stop. Tell me about previous difficult examinations or concerns so we can plan the assessment together.
TREATMENT WITH DR JAN ADLAM
Treatment options for pelvic pain.
Several approaches may be useful together. What helps depends on the findings, your health, preferences and plans for pregnancy.
Surgical care at Life Kingsbury Hospital. I offer laparoscopic care for pelvic pain and endometriosis where appropriate. We discuss the purpose, alternatives and limits of an operation before deciding on surgery.
LOOKING AT THE WHOLE PICTURE
Other pelvic pain concerns.
Persistent pain or pain after previous treatment
Pain may involve the pelvic organs, muscles and pain-processing system at the same time. A normal scan does not make the pain less real. Treatment can still be useful when there is no single explanation.
We review previous diagnoses, medicines and operations, and set practical goals such as easier movement, better sleep or more comfortable intimacy. Pain-focused psychological or psychosexual support can help some people manage the effects of pain; it does not mean the pain is imagined.
After surgery, bring the operation report and results if available. Persistent pain should not automatically be attributed to adhesions or treated with another operation. New or changing symptoms need reassessment.
Pelvic floor, bladder and bowel symptoms
Pain with bladder filling, passing urine, bowel movements or sex can help direct the assessment. Pelvic muscles, constipation and bladder conditions may overlap with gynaecological causes.
New blood in urine or stool, unexplained weight loss or a persistent change in bowel habits needs medical assessment rather than being assumed to be part of an existing pain condition.
New pain after menopause
Arrange assessment for new or persistent pelvic pain after menopause. Mention bloating that persists, feeling full quickly, changes in bladder or bowel function, weight loss or bleeding. Any bleeding after menopause needs prompt assessment, even if it is light.
Possible pelvic infection
Pelvic inflammatory disease is an infection of the upper reproductive tract. Symptoms can be mild; pelvic pain with unusual discharge, fever or bleeding deserves prompt medical advice. Pregnancy-related causes also need consideration.
Assessment may include an examination and infection tests. Treatment and follow-up should not be delayed when infection is suspected; partner care may be needed if a sexually transmitted infection is involved.
OPTIONAL SYMPTOM DIARY
Make the patterns easier to explain.
Record pain, periods, bladder and bowel symptoms, and what helps. My printable diary also includes a one-page appointment summary to bring to your visit.
You can also use this diary without a confirmed endometriosis diagnosis. Complete only the pages that help you. You can book without a diary or a full cycle of records.
Endometriosis & menstrual symptom diary
Printable PDF · 8 pages · 41 KB
BEFORE YOUR VISIT
Questions before your appointment.
What should I bring?
Bring previous scan and operation reports, a list of medicines and what has or has not helped. A short record of pain, periods, bladder or bowel symptoms can be useful. You can use the optional symptom diary above. You can book without a diary, tests or a diagnosis.
Will I need an operation?
Many patients can begin with medical or other non-surgical care. Surgery is one option when it is likely to answer a useful question or treat a relevant problem. We discuss the alternatives and what symptoms might remain afterwards.
What if my scan was normal?
That result is useful, but it does not explain every source of pain. We consider the symptoms and examination alongside the scan, including whether further investigation or attention to pelvic-floor, bladder or bowel contributors would help.
YOUR NEXT STEP
Discuss your symptoms and options.
Consultations in Claremont, with additional appointments in Simon’s Town on selected Mondays. Reception will confirm your date, time and venue.
General information to support your consultation. Your assessment and treatment plan are individual.
Page updated: .
Sources & further reading: NHS: pelvic pain · NICE: endometriosis · EAU: persistent pelvic pain · RCOG: examination and consent · CDC: pelvic infection