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Chronic Pelvic Pain: What is My Condition?

Pelvic Pain

Minimally Invasive GYN Surgeons Dr. Paul MacKoul, MD and Dr. Natalya Danilyants, MD Help Patients with Chronic Pelvic Pain

If you have suffered for more than 6 months with pelvic pain, severe enough to interrupt your life, or require treatment, you have chronic pelvic pain (CPP). CPP can keep you from work, family or enjoying activities you love. Up to 15% of women in the U.S. experience chronic pelvic pain, but only 1/3 seek medical care. That leaves a lot of women who unnecessarily continue to cope with debilitating pain.

While any one condition may be the cause of CPP, pain can also be the result of multiple conditions existing simultaneously. For example, women with endometriosis may also be suffering from pelvic adhesions caused by the endometriosis.

The causes of CPP can be exceptionally difficult to diagnose. It can be caused by the intestines, bladder, pelvic muscles and joints, psychological distress as well as gynecological conditions.


Gynecologic causes account for 20 percent of CPP. GYN Conditions That May be Causes of CPP include:

  • Fibroids-Benign tumors that may grow very large; can also affect urinary and bowel function.
  • Endometriosis-the presence of endometrial tissue outside of the uterus.
  • Pelvic adhesions-Scar tissue resulting from previous surgeries or infections/sexually transmitted diseases.
  • Adenomyosis-The presence of endometrial tissue in the uterine wall.
  • Ovarian Cysts/Pelvic Mass-In most cases, cysts are small and harmless. If they grow or twist, pain can occur and immediate treatment is necessary. Pelvic mass is a general term for any growth or tumor on the ovary or pelvis.
  • Ovarian Cancer-Malignant tumors, the majority develop from cells in the lining of the ovary.

Additional conditions include:



  • Irritable Bowel Syndrome (IBS)-Chronic or intermittent pain related to bowel function or dysfunction.
  • Inflammatory Bowel Disease (Crohns or Ulcerative colitis)
  • Diverticulitis
  • Colon Cancer
  • Chronic Constipation
  • Celiac disease


  • Fibromyalgia
  • Pelvic Floor Muscle Spasms
  • Chronic Abdominal Wall Pain
  • Inflammation of Bones or Joints: Swelling of pubic bone, hip joint or muscle tendon abnormalities.

Women Need GYN Specialists in Diagnostics & Treatment

Women with CPP need to seek a GYN specialist in diagnostics and treatment. For complex GYN conditions, the wrong treatment can actually make some conditions worse. Approximately 20 percent of hysterectomies performed are due to chronic pelvic pain. Not every woman with CPP will need a hysterectomy. It is essential to find a specialist who will discuss your options, especially if you wish to be able to get pregnant.

Advanced techniques make it possible for highly skilled minimally invasive GYN surgeons to treat pelvic pain. At The Center for Innovative GYN Care, Dr. Paul MacKoul, MD and Dr. Natalya Danilyants, MD are fellowship trained in minimally invasive procedures, and have developed DualPortGYN and LAAM techniques to treat all GYN conditions. In addition, they also perform laparoscopic removal of adhesions from the bowel, and can repair the bladder or bowel in patients with extensive adhesive disease.

Read more about symptoms of GYN conditions

Abnormal Bleeding: When Should I Worry?

Don’t Waste Time With The Wrong Diagnosis: Pelvic Pain

On The Other Side Of Endometriosis Pain



Surgical specialists can often see patients sooner because they are focused entirely on surgery. Each patient gets detailed, in depth attention from Dr. Danilyants and Dr. MacKoul. This personalized care helps patients understand their condition and the recommended treatment so that they can have confidence from the very start. Our surgeons have performed over 20,000 GYN procedures and are constantly finding better ways to improve outcomes for patients.

Book a consultation today with Dr. Paul MacKoul, MD or Dr. Natalya Danilyants, MD.


Dr. Paul MacKoul Reviews

Dr. Natalya Danilyants Reviews


CIGC travel program

Even if you are not from the DC area, many patients travel to The Center for Innovative GYN Care for our groundbreaking procedures. We treat women from around the world who suffer from complex GYN conditions.

Learn more in our travel program.