Pelvic Pain

Pain is considered persistent if it lasts for more than three to six months. Acute pain, in
most cases, is manageable, but when it gets chronic, medical care is necessary. Pelvic pain can
either be acute or chronic. During menstruation, women may experience acute pain in the pelvic
area, which goes away after some time. However, some women experience
chronic pelvic pain, which lasts for a long period and becomes severe and unmanageable.
Chronic pelvic pain causes a lot of discomfort among women all over the world, both at the point of
social costs as well as managing it medically (Triolo, Laganà, & Sturlese, 2013). When a
diagnosis is made, it is often not because of a certain cause, and even when the cause is
identified, it is usually after a series of diagnostic tests on the patient, some of which are
invasive. There are several causes of chronic pelvic pain, and endometriosis stands out as one of
the causes of the syndrome.
Most women living with endometriosis have had to go through a long, frustrating, and
painful road before a diagnosis is reached and treatment started. The symptoms of endometriosis
vary from one woman to another in terms of severity and presentation, but pelvic pain is the most
prevalent. The pain tends to begin a few days, mostly one or two, before menses, and then lasts
until the end of the periods. In some women, this pain may be debilitating and even make them
unable to go on with normal daily activities (Bloski & Pierson, 2008). Surprisingly, the degree of
the pain is not directly correlated with the severity of the condition. Therefore, in most cases,
severe conditions may miss a diagnosis.
Endometriosis is also associated with pain during intercourse. A woman experiences pain
either during or after sex. Another symptom is pain with urination or bowel movements (Yusuf,

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Iwanaga, & Marios, 2018). These symptoms are usually common during menstruation. Also, a
woman who has endometriosis may also experience excessive bleeding during menstruation. In
some cases, there is intermenstrual bleeding, and this refers to bleeding between periods. Women
who are seeking treatment for infertility are first diagnoses with endometriosis. Thus, infertility
could be indicative of endometriosis, although this may not always be the case. There are other
signs and symptoms of endometriosis, such as nausea and bloating, which mostly occur during
menstruation.
If a patent presents with pelvic pain, I would prefer them to a pelvic floor physical
therapist if they present with chronic pelvic pain, constipation, difficulty with bowel movements
or urination, and pain during or after intercourse. When making a referral, the nurse practitioner
must establish and document in the form of writing the reason for referring the patient (Geisler et
al., 2015). The information must be documented in the patient’s records. Then, the NP explains
to the patient the reason for making a referral. In the explanation, the NP should make the patient
understand why a referral is necessary, what to expect from the specialist, and they should
answer questions asked by the patient. The NP should put it in writing that the patient has been
informed about the referral.
An NP maintains responsibility for follow-up after a referral to determine the
effectiveness of the treatment plan. Also, the NP makes a follow-up to determine the
effectiveness and timeliness of the specialists. In case a specialist turns out to be unreliable, then
the NP should consider making referrals to a different specialist. Also, it enables the NP to
understand the report made by the specialist when the patient returns to them for review.

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References

Bloski, T., & Pierson, R. (2008). Endometriosis and chronic pelvic pain: unraveling the mystery
behind this complex condition. Nursing for women’s health, 12(5), 382-395.
Geisler, C., Cheung, C., Johnson Steinhagen, S., Neubeck, P., & Brueggeman, A. D. (2015).
Nurse practitioner knowledge, use, and referral of complementary/alternative
therapies. Journal of the American Association of Nurse Practitioners, 27(7), 380-388.
Triolo, O., Laganà, A. S., & Sturlese, E. (2013). Chronic pelvic pain in endometriosis: an
overview. Journal of clinical medicine research, 5(3), 153.
Yusuf, A., Iwanaga, J., & Marios, L. (2018). The Clinical Anatomy of Endometriosis: A
Review. Cureus, 10(9).