Chronic Pelvic Pain

Mainstream ObGyn doctors will almost always recommend the birth control pill as first line treatment. The birth control pill will suppress your normal menstrual cycle and simply provides a band-aide for the underlying problem(s). 

Please know NaPro Providers to not prescribe the birth control pill. To the contrary, we believe the birth control pill is harmful to women physically, emotionally, and spiritually. We pride ourselves on taking our patients OFF hormonal contraception, finding the root cause of their symptoms, making a proper diagnosis and providing superior treatments for all of the conditions we treat. 

For more information about the spiritual harm brought  into the relationship via contraception, visit my  CrMS page, scroll to the bottom and read about SPICE. 

NaPro providers offer many types of pharmacological treatments, which are oftentimes inexpensive and/or able to be purchased without a prescription, such as: 

TO HELP WITH PAINFUL PERIODS:

• Ibuprofen 600 mg. Start 1 to 2 days prior to onset of menses. Twith food at the first twinge of pain, then repeat 600 mg every 8 hours if there is still a twinge of pain. Do not take if you have had or if you develop GI problems. Please see Handout #8 on my "Patient Handout" webpage, and read about "prostaglandin". 
• NAC (N-acetyl-cysteine) some studies (see bottom of this page) indicate NAC can help to decrease endometrial implants, which in turn, can help decrease your pain and also promote healthy ovulation and increase pregnancy outcomes. NaPro providers will vary in their personal preference for dosing regimens. I prefer 1200 mg taken in the AM and 600 mg taken in the PM, but only for FOUR days/week. Please do not take this supplement unless I have specifically recommended it for you.
• Naltrexone: see Premenstrual Syndrome (PMS) page for more detail. 

OTHER SUPPLEMENTS & MEDICATIONS THAT MAY BE RECOMMENDED:  

• Progesterone Replacement: if you are diagnosed with low Post-Peak progesterone levels, I would typically start with 200 mg of bioidentical progesterone  which you will take at bedtime on P+3 through P+12. This will help make your endometrial lining "secretory" so that if a baby is conceived, the embryo will be nourished and grow well, and you will maintain a healthy pregnancy moving forward.  
• Cervical Mucus Enhancers: Vitamin B6 SR 500 mg, the “sustained” or “extended” release formulation is very important. If this is not sufficient, we may add on Guaifenesin which is an over-the-counter medication for cough/colds. Lastly we may try an antibiotic called amoxicillin. All mucus enhancers should be done under medical supervision.  Please do not take this supplement unless I have specifically recommended it for you. 
• CoQ10, either Pure Encapsulations or Klaire Labs would be my favored brands. Co-Q10 is somewhat expensive. A dose of 200 to 300 per day is generally recommended to be combined with Vitamin D (at least 2,000 IU daily) and Omega 3's (at least 2-3,000 mg daily) to improve egg health. I may recommend this for you if your AMH is low or we have found that your peri-ovulatory estradiol is low. Please do not take this supplement unless I have specifically recommended it for you. 
• Omega 3's, Pure Encapsulations O.N.E. Omega are favored. This supplement may be helpful to both bring down your cholesterol and also improve egg health. This brand offers 1250 mg in one capsule. I may recommend 1-2 capsules daily. Please do not take this supplement unless I have specifically recommended it for you. 
• Myoinositol /D-Chiro Inositol, there are so many options for this supplement. Generally, I prefer Pure Encapsulations and KLAIRE products, but I am sure there are many others that work well. This can help decrease high insulin levels, which is often associated with both Infertility and PCOS. The dose is 2000mg/50 mg twice daily (2000 of myoinositol/50 mg of dchiro inositol). If this is a financial hardship, I am happy to prescribe metformin for you. Oftentimes, it will be more effective anyway. 
• Meftormin can also be added to help reduce insulin levels and also there is some literature that he will help promote ovulation. 
• Letrozole is a medication we may use to help stimulate ovulation. First we must demonstrate this is an appropriate medication for you. Generally speaking, letrozole will grow the follicle that is maturing your egg.  One way to know this medicine would be appropriate for you is if we demonstrate your peri-ovulatory estradiol is low or, if we demonstrate your follicles are not growing to the appropriate size via an Follicular Ultrasound Series. 

***If you are trying to achieve a pregnancy, please begin taking a prenatal vitamin if you are not currently already doing so. My preferred brand is KLAIRE Labs Prenatal & Nursing. 

IMPORTANT: 

Letrozole is now considered by the experts to be first line treatment to stimulate ovulation for women who have PCOS. However, it has not yet been FDA approved for this specific purpose. Clomiphene citrate (Clomid) has FDA-approval and has been used for about 50 years safely. Interestingly, metformin has also been used as an alternative treatment to induce ovulation. However, more recent research has shown that letrozole is more effective than both, and it has less side effects as compared to clomiphene, such as lowering cervical mucus and promoting less endometrial growth. Also, clomiphene has a higher risk of multiple pregnancies (twins, triplets, etc..).