NICHD is currently conducting a one-year longitudinal study on bacterial vaginosis and the factors associated with the condition. Results from the study are expected in 2005.

The National Vaginitis Association also provides patient information on these types of infections.

Pelvic Floor Disorders

The term "pelvic floor" refers to the group of muscles that form a sling or hammock across the opening of the pelvis. These muscles, together with their surrounding tissues, keep all of the pelvic organs (bladder, uterus, and rectum) in place so that the organs function correctly. A "pelvic floor disorder," then, is a problem with these muscles or the surrounding tissues that leads to dysfunction of one or more of the pelvic organs.

This understudied area of women's health includes a variety of problems, the most common of which are:

• Pelvic Organ Prolapse--Includes: Uterine prolapse--A woman's uterus drops down into her vagina. Vaginal prolapse--Often occurs after a hysterectomy (when the uterus is removed); the top of the vagina loses its support and drops.
• Urinary Incontinence--Can occur when the bladder drops down into the vagina. Because the bladder is not in its proper location, urine can leak out easily and without a woman's control.
• Anal Incontinence--Can occur when the rectum bulges into or out of the vagina. The rectum's location makes it difficult for a woman to control leakage. Anal incontinence can also occur when there is damage to the anal sphincter, the ring of muscle that keeps the anus closed. An estimated one-third of all women are affected by one type of pelvic floor disorder. Nearly 10 percent of that group will undergo surgery to correct a pelvic floor disorder.

While some pelvic floor disorders may result from pelvic surgery or radiation treatments, in some of cases, the initial trigger for the problem is vaginal delivery of a child. However, researchers don't clearly understand how vaginal delivery is related to pelvic floor disorders; they can't determine which women will develop pelvic floor disorders based on length or intensity of labor.

Many women with pelvic floor disorders also reported chronic pain as a symptom of their condition. These women noted that the pain's frequency and intensity had a major affect on their quality of life. Because of its chronic pain feature, vulvodynia is sometimes included as a pelvic floor disorder.

Although researchers know little about the causes or features of pelvic floor disorders, research in underway on a variety of topics related to pelvic floor disorders. In July 2001, the NICHD established the Pelvic Floor Disorders Network (PFDN) to support research projects that examine problems related to pelvic floor disorders. The PFDN includes seven clinical sites around the country, and a central data collection center. Through this research, the NICHD hopes to learn more about: normal pelvic floor function, the characteristics of known pelvic floor disorders, the effects of hormones on these conditions, injury during vaginal delivery and how it is related to these conditions, and the development of tools to help health care providers understand the level of function, dysfunction, or pain.

Pelvic Pain

Pelvic pain is a general term that health care providers use to describe steady pain, or pain that comes and goes, that occurs mostly or only in the lower abdomen area. In some cases, the pain might be severe and might get in the way of daily activities; in other cases, the pain might be dull and occur only during the menstrual cycle. Pelvic pain also describes pain that occurs during sexual intercourse.

In general, pelvic pain signals that there may be a problem with one of the organs in your pelvic area: uterus, ovaries, fallopian tubes, cervix, vagina, lower intestines, or rectum. Or, it might be a symptom of an infection.

Your health care provider will likely conduct a number of tests to find the cause of your pain. Treatment varies by what the cause is, how intense the pain is, and how often the pain occurs. Sometimes pain medication is the best option. Other times, an antibiotic may be necessary. If the pain results from a problem with one of your pelvic organs, for example, if you find out that you have endometriosis, then your treatment may be more involved.

The International Pelvic Pain Society offers patient information about pelvic pain and chronic pelvic pain, as well as some suggestions for how to talk with your health care provider about pelvic pain.

Source: National Institutes of Health (www.nih.gov)