HomeAnswersInternal Medicinepelvic inflammatory diseaseI have been having chronic pain in my pelvis region followed by fatigue, muscle weakness, insomnia, GI distress, abdominal pain, headache, and PMDD. Why?

What causes constant pain in the pelvic region?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At November 11, 2023
Reviewed AtDecember 11, 2023

Patient's Query

Hello doctor,

I live in a well-developed country and the healthcare system is not helping me. I have had chronic pelvic pain since last year along with extreme fatigue, muscle weakness, insomnia, GI distress, general abdominal pain, headaches, and PMDD. The pelvic pain is constant; I either feel swollen and achy, or I will have intense bouts where I am doubled over and can't move until the pain passes, which takes about 10 to 30 minutes. There is no rhyme or reason to it, though activity and sex have sparked some of the bouts of pain. The fatigue and muscle weakness are so bad sometimes that I cannot do normal tasks, like standing, writing, or carrying my toddler. I experience shortness of breath and what I refer to as 'zaps' of pain, where I cannot breathe deeply without severe pain in my chest and/or the base of my skull. The diarrhea is constant, and to the point where I do not eat when I am not home. I have been to multiple doctors ranging from Ob-gyn, GI, general practice, ENT specialist, and endocrinology (I have a microadenoma). I swear that because my diagnosis is complicated, nobody wants to bother me. I am so discouraged as normal tasks are sometimes unbearable and I am only 29 years old.

I also have a history of ovarian cysts, GI distress, and Lyme disease when I was young. I have had gallbladder surgery. I have been sick since childhood and have been on antibiotics. I have prolactinoma and CIN2 dysplasia in my cervix followed by recurrent urinary infections and kidney infections. Kindly give your suggestions.

Hello,

Welcome to icliniq.com.

I have read your query and understand your concern. It seems you have multiple medical issues and you have been to many doctors regarding this. Let me read your query again and formulate or connect the dots if possible. I would like to know

1. What is your OB-GYN (obstetrician and gynecologist) opinion regarding CIN (cervical intraepithelial neoplasia) 2 or cervical dysplasia?

2. Have you done an MRI (magnetic resonance imaging) pelvis or not?

3. Whether PID (pelvic inflammatory disease) was diagnosed before?

4. What medications are you taking for chronic pain and fatigue?

5. What medications are you currently taking and for what symptoms?

I would need medical reports of MRI and CT (computed tomography) scans (most recent ones) to proceed further in your medical history. I will ask follow-up questions related to your current medical problem and please reply to them so that I can locate the root of the problem if possible and connect symptoms together. As of now please reply to the above questions for suggestions.

Thank you.

Patient's Query

Hello doctor,

Thank you so much for your response. I feel like you have already been more of a help than the other doctors I have seen in just the last year or so. Here are my answers:

1. My last Pap smear came back clear. I would like to add that my LEEP procedure was extremely unpleasant. Pain and discomfort during sex has been worse since then. I have had multiple scans done due to the chronic pain and my history of ovarian cysts. I will attach the latest from my visit to the ER last month.

2. It is amazing that you brought up PID because after tracking my symptoms and being my healthcare provider, I have not ruled out PID. Yet, not one doctor has brought it up. I did have Chlamydia a few years ago, but I was retested after treatment and it was clear. I had BV sometime back and was admitted but did not finish that treatment. I have had multiple UTIs (despite not being sexually active for a long time), yeast infections (only started during and after pregnancy), and kidney infections. I have been in a monogamous relationship for two years and during that time, had a baby so I was tested for STIs and all were negative. Last night when I was so out of breath and weak that I had to lay down, I was researching anemia of inflammation and I saw PID listed. It might be a stretch but please understand that I have no medical help and I am left to my research.

3. I do not take anything for chronic pain and fatigue. My stomach is really sensitive so I try not to resort to OTC pain relievers, but sometimes (especially with the recent severe headaches) I have to take them to get through the day. Since I have no help or guidance, I have taken it upon myself to eat a clean diet, drink a lot of water, limit my caffeine, etc. If I hear all of my medical issues are because I am stressed, I will scream. I know stress is a powerful thing, but my goodness, for years now, these symptoms have plagued me. It is not just stress doing this to me. I have never been talked to about medications for fatigue or pain.

4. I am currently taking Yaz, which I started taking about a week ago. Ever since I gave birth last year, my menstrual cycles have been horrendous. I bleed more than I ever have; the cramps, back pain, and fatigue are awful. And the mood swings, which my therapist suggested could be PMDD based on the fact that seven to ten days before I started my period, I was uncharacteristically angry.

I will send over the most recent scans. Thank you so much.

Hello,

Welcome back to icliniq.com.

Thanks for the follow-up and replying to my questions. I have read your reply and seen your scan reports (attachment removed to protect the patient's identity). Give me some time to think over it and reply to you afterward. I may take a few hours to reply to you as I have to go to the hospital in an hour and hence do not anxiously wait for it. I will definitely reply to you.

Thank you.

Patient's Query

Hello doctor,

I would like to add that I have been a sufferer of eczema since childhood. It has gotten worse as an adult as it has spread to the palms of my hands, my toes, and sometimes my eyebrows. Whereas when I was a child, it was the crooks of my elbows and behind my knees.

With all of this, I feel like I am constantly torn between the physical and mental symptoms I experience daily vs. feeling crazy and thinking maybe I should just accept that this is life. But I know at 29 years old, not overweight, eating a good diet, and not a smoker nor a drinker- I should not be this weak, fatigued, and plagued with such great pain (pelvic, joint, or otherwise).

I have always had strange, "only you" things happen to me. I had to have my tonsils and adenoids out twice some years ago. I had my gallbladder removed five years ago, only to be told my hepatic artery is weirdly placed. I have never really healed well- I have had more broken bones that required longer healing than most. I've had two spinal taps in my life, the first when I was in the thick of Lyme disease before they knew that's what it was. And then again in college (2013) when suddenly and inexplicably, all my joints stiffened. I have had multiple concussions, with the last one in 2009 putting me out of commission for weeks.

Strangely enough, I had a great pregnancy. Despite my baby being almost 10 lbs and me gaining 80+ lbs, I never had gestational diabetes or any other complications, at that time. I do feel like all of my symptoms were exacerbated postpartum, though. I have always felt exhausted, even falling asleep in the middle of a task. But it would get better, then get worse, get slightly better, etc.

I want to note that I went in for a laparoscopic exploratory surgery a few months back to rule out endometriosis (which was ruled out). That's when I developed the most severe kidney infection I have ever experienced. After the surgery, the medical staff blamed it on the catheter used during surgery.

What really scares me is that all of these symptoms point to something that without proper treatment or even proper acknowledgment, I am going to get irreparably worse. My aunt, though I am not very close to her to know exactly the process, has had progressively worse heart and kidney conditions that at this point, she is on dialysis throughout the night and needs multiple transplants. My grandmother also has kidney issues but was just recently ruled out of dialysis because of her health and age.

I am so discouraged and feel like I am fighting an invisible fight that only myself and my family can see.

Hello,

Welcome back to icliniq.com.

Thanks for providing further medical information. I know you are struggling with health issues that need proper guidance and solution for it. I know this is a very short reply which may frustrate you but I am gonna reply to you after I share your medical history details with my Ob-Gyn colleague and will let you know about it. If I would need to ask you any further questions then I will mention them in my reply and kindly answer accordingly. Give me some time to ponder over it and I will message you afterward. I would try my best to guide you through tests that could help you to get the reason or etiology for the current medical issue.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Basuki Nath Bhagat
Dr. Basuki Nath Bhagat

Family Physician

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