Dear Anonymous,
OK, sounds pretty clear to me and apart from the PFO, pretty common.
1. When you have pain in the pelvis, of any kind really - bowel/period/bladder - there is a reflex tightening of the pelvic muscles. Often this goes unnoticed for some time. The muscle are tighter but not painful. Then something extra happens and they go from being tight, to going into spasm sometimes, especially when you have been in one position for a long time, maybe after sex, maybe after being stretched with a bowel action passing them, or after passing urine, or getting up, or standing for a long time, or doing a lot of core strength exercise. So, when you had the new copper IUD put in, this stimulated the uterus - with reflex tightening of the already tight pelvic muscles - and you had more of the stabbing pains. The reason you can't sit straight is because it is a muscle spasm problem.
2. Sure you have had a car accident, but most people with pelvic muscle pain have pain in the lower back too. It goes with it.
3. This type of pain doesn't show at a laparoscopy and doesn't show on ultrasound.
4. There are 2 types of pelvic muscles - the ones across the pelvic floor that when tight can cause pain opening bowels/sitting/passing urine - and the ones on the side wall (obturator internus) which cause pain on one side and often pain into the back or front of the upper leg
I recommend:
1. That it would have been better to have a levonorgestrel (mirena iucd) than a copper one, because the copper one works for contraception but doesn't help pain. The levonorgestrel releasing one makes periods lighter and less painful once it settles
2. That you should read our book 'Endometriosis and Pelvic Pain' before you even think about having any surgery or going to a gynaecologist as there is much more in it than you will get from any professional. You can order it from www.pelvicpainsa.com.au
3. That this website has stretches you can do that can help, and a relaxation CD for pelvic muscles - look at the physiotherapy section
4. The free e-booklet has an intro to pelvic pain you can download but the book has much more detail.
5. That you can still take norethisterone 5mg 1 daily with a PFO to try and keep periods away if you need to, as it doesn't increase clotting risk.
You might want to read some of the other posts on this blog to start learning more about pelvic pain, not just as something you have surgery for, but in a much wider and more comprehensive way. If you only think of surgery, you will be disappointed that it can only help some things.
Hope this helps.
The new website at www.pelvicpainsa.com.au and facebook at Pelvic Pain News are where we will keep putting up new information.
Best wishes,
Susan
