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Pelvic pain can be caused by a variety of contributing factors. To further investigate, gathering a complete medical history including gynecologic in addition to a pelvic exam is necessary. A common disease associated with chronic pelvic pain is endometriosis which is when endometrium tissue is present outside of the uterus (Dydyk & Gupta, 2021). In addition to pelvic pain, individuals who suffer from endometriosis may experience dysmenorrhea, dyspareunia, infertility, gastrointestinal issues, and mental health disorders (Muhram et al., 2022). While primary care providers should be competent in conducting a womens health focused assessment including a pelvic exam, referral to a specialist such as a gynecologist or womens health provider is often warranted for further testing. For individuals with suspected endometriosis, diagnostic testing may include but is not limited to a laparoscopy, biopsy, transvaginal ultrasound (TVUS), magnetic resonance imaging (MRI) and CA125 levels (Tsamantioti & Mahdy, 2022). The steps to writing a referral vary by facility, but often require standard information such as patient information and reason for referral. Specialists may assist in a patients plan of care by conducting further testing, identifying diagnoses, providing recommendations, and guiding treatment if necessary. Nurse practitioners (NPs), along with all other primary care providers, serve as facilitators in care and are still responsible for following up with patients after referrals and guiding care.
References
Dydyk AM, Gupta N. Chronic Pelvic Pain. [Updated 2021 Nov 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554585/
Muharam R, Amalia T, Pratama G, Harzif AK, Agiananda F, Maidarti M, Azyati M, Sumapraja K, Winarto H, Wiweko B, Hestiantoro A, Suarthana E, Tulandi T. Chronic Pelvic Pain in Women with Endometriosis is Associated with Psychiatric Disorder and Quality of Life Deterioration. Int J Womens Health. 2022 Feb 4;14:131-138. doi: 10.2147/IJWH.S345186. PMID: 35153516; PMCID: PMC8824289.
Tsamantioti ES, Mahdy H. Endometriosis. [Updated 2022 Feb 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK567777/
