If you are a woman, consider this fact: The average girl typically starts her period at age 12, whereas the average woman enters menopause around age 51. That's approximately 40 years of menstruation and possible gynecologic complications.
Some gynecologic problems are nothing more than a nuisance, while others are more serious and require the expertise of a medical team. The question is, how do you know what's normal and what's not? More specifically, how do you know when it's time to schedule an OBGYN office visit to get a problem checked out?
"Sometimes it's hard for women to know when to schedule an appointment and when to watch and wait," said Kourtney Morris, MD, a Franciscan Physician Network board-certified obstetrician/gynecologist at Franciscan Physician Network Obstetrics & Gynecology Lafayette. "A good rule of thumb is to watch and wait for three months if you are experiencing bleeding irregularities, but if you are experiencing any sort of sudden pelvic pain, try to get in within a couple weeks."
While a woman can face many gynecologic problems during her pre-menopausal years, some are more common than others. Four of the most common gynecological conditions women face are:
- Abnormal bleeding
- Pelvic pain
- Uterine fibroids
One of the most common reasons women visit their OBGYN is for abnormal bleeding, which includes everything from spotting to extremely heavy bleeding. This issue is frequently caused by changing hormone levels, which is why Dr. Morris advocates the watch and wait method for abnormal bleeding.
"There are so many reasons a period can fluctuate, one of the biggest of which is normal hormone changes," she said. "Sometimes you need to wait a few months to look for a pattern or see if it goes away on its own."
Another common reason for abnormal bleeding can be a growth or structural problem such as a polyp or uterine fibroid, both of which may require medical intervention and removal, said Kelli Crowley, MD, a Franciscan Physician Network board-certified obstetrician/gynecologist at Franciscan Physician Network Schererville Health Center. Whenever possible, a minimally-invasive procedure is used to remove the growth.
Endometriosis is a common, painful disorder in which uterine tissue grows outside the uterus, most commonly on the ovaries, fallopian tubes and the tissue lining the pelvis. With this condition, the abnormal tissue thickens and bleeds with each menstrual cycle, with no way to exit the body. The condition is typically diagnosed at an early age – in the late teens to early 20s.
Endometriosis can cause cysts, irritation, excessive bleeding, scar tissue, fertility problems and pain associated with periods, intercourse, urination or bowel movements. Many effective treatments are available for endometriosis including hormone therapy and different types of surgery, many of which can be performed laparoscopically. In some cases, a hysterectomy may be recommended.
"While women with endometriosis frequently experience infertility difficulties, most women do go on to have healthy pregnancies and healthy babies," said Dr. Morris. She stresses the most important part of endometriosis is getting diagnosed early and starting treatment early, as the condition can get worse if left untreated.
Pelvic pain is a general term that encompasses any type of pain – not just gynecologic pain – in the lowest part of the abdomen, between the belly button and groin.
This type of pain is categorized as either acute, meaning the pain comes on suddenly but is short-term, or chronic, meaning the pain is constant or comes and goes for a period of six months or longer. Pain resulting from menstrual cramps, appendicitis and urinary tract infections are examples of acute pelvic pain, whereas endometriosis, pelvic inflammatory disease and irritable bowel syndrome are examples of chronic pelvic pain.
Because there are so many reasons for pelvic pain, some of which are serious, women should definitely schedule an appointment if they are experiencing any sort of sudden onset pelvic pain, Dr. Crowley said.
Uterine fibroids are non-cancerous growths in the uterus. Many women who have fibroids have no symptoms at all and may only have their fibroid diagnosed as part of a pelvic exam or prenatal ultrasound. Those who do experience symptoms may have heavy menstrual bleeding, frequent urination, constipation and backaches and leg pain.
Most uterine fibroids aren't dangerous, and Dr. Morris says gynecologists only treat fibroids that cause symptoms. If a fibroid does need to be removed, the most common fibroid removal procedure is a myomectomy, which is frequently performed laparoscopically or robotically.
"Nowadays most women are very open about discussing gynecologic problems they are experiencing and almost all women can experience an improved quality of life after seeking treatment," said Dr. Morris. "There are many options available to women."