Is Chronic Pelvic Pain Normal, or Should You Get It Checked?

Pelvic pain that persists for months, disrupts your daily routine, or steadily worsens over time is worth evaluating properly. Some discomfort around your cycle is expected, but pain that reorganizes your life around it is not something you should simply absorb.

September is Pain Awareness Month, and Dr. Joseph Leveno evaluates chronic pelvic pain at his Medical City Plano office for patients across Richardson and the surrounding area.

What Commonly Causes Chronic Pelvic Pain?

The list is long, which is part of why diagnosis usually takes patience and a sequence of steps rather than a single decisive test.

Conditions frequently involved include:

• Endometriosis, often with pain that tracks the cycle
• Uterine fibroids causing pressure or heaviness
• Ovarian cysts that persist or recur
• Pelvic floor muscle dysfunction

Causes outside the reproductive system, including bladder and bowel conditions, can present very similarly and are considered as part of a proper evaluation.

When Does Pain Stop Being Normal?

The more useful question is not how bad the pain is on a scale, but how much of your daily life it has started to dictate.

Pain that causes missed work or school, that does not respond to over-the-counter measures, that has clearly worsened, or that has lasted more than a few months has crossed out of the range worth ignoring.

Being told previously that everything looked fine does not settle the matter permanently, particularly if your symptoms have changed since that assessment was made.

Why Can Diagnosis Take So Long?

Several different conditions produce overlapping symptoms, and some of them are not visible on standard imaging at all.

Endometriosis in particular can be difficult to confirm without laparoscopy, which is why an evaluation often proceeds in stages rather than resolving neatly in a single visit.

A slow diagnosis is frustrating, but a methodical process is more likely to land on the actual cause than a fast guess would be.

What Does an Evaluation Involve?

It starts with a detailed history, since the pattern of the pain is very often the most informative piece of the entire picture.

Useful to describe:

• Where the pain sits and whether it moves
• How it relates to your cycle, if at all
• What makes it better or worse
• How long it has been going on and whether it has changed

A pelvic exam and an ultrasound commonly follow, with any further testing depending on what those initial findings suggest.

How Can You Manage While You Wait for Answers?

Diagnosis can take time, and living reasonably well during that stretch matters as much as the eventual answer.

Keeping a simple record of when pain occurs, what preceded it, and what helped gives the evaluation something concrete to work from. It also makes appointments considerably more productive than trying to recall months of symptoms on the spot.

Interim measures to make daily life manageable can usually be discussed before a final diagnosis is reached. You do not have to wait for a name to get relief.

Can It Be Treated Without Surgery?

Frequently, yes. Surgery is one option among several rather than the default destination for pelvic pain.

Depending on the cause, treatment might involve hormonal management, pain-directed medication, pelvic floor physical therapy, or treating a non-gynecologic condition entirely. Surgical options are considered when other approaches have not helped or when a specific finding calls for it.

"Patients often apologize for bringing it up again," says Dr. Leveno. "Persistent pain deserves persistence from us too."

Frequently Asked Questions

When is pelvic pain considered abnormal?

Pain that lasts more than a few months, worsens over time, or interferes with work, sleep, or daily activity is worth evaluating. Cycle-related discomfort is common, but pain that dictates your schedule falls outside that range and deserves a proper look.

What tests are used to find the cause of pelvic pain?

Evaluation usually begins with a detailed history and a pelvic exam, often followed by ultrasound imaging. Depending on the findings, additional testing or a diagnostic laparoscopy may be recommended. There is no single test that identifies every cause.

Can pelvic pain be treated without surgery?

In many cases yes. Hormonal management, targeted medication, and pelvic floor physical therapy all help depending on the underlying cause. Surgery is generally considered when other approaches have not worked or when a specific finding calls for it.

If pain has been part of your routine for longer than it should be, schedule an evaluation at our Plano office.

Is Dr. Leveno's Office Open on Labor Day?

The Plano office is closed for the Labor Day holiday itself, and routine appointments resume on the following business day. Delivery coverage continues without interruption, because babies pay no attention whatsoever to the federal calendar.

The irony of the name is not lost on anyone here. Dr. Joseph Leveno delivers at Medical City Plano, where the labor and delivery floor runs every day of the year.

What Happens to Scheduled Appointments?

Routine visits are not scheduled on the holiday itself, so the majority of patients are unaffected by the closure.

If you had an appointment that happens to fall inside the holiday window, the office will already have contacted you to move it. If you are not sure where yours stands, calling ahead is faster than guessing.

The days immediately after a holiday tend to book up quickly, which is worth knowing if you need something soon.

Anything urgent should not wait for the office to reopen. The after-hours line exists precisely for that.

What If You Go Into Labor on the Holiday?

Nothing about your plan changes at all. Obstetric care does not observe holidays, and the hospital remains fully staffed throughout the weekend.

Follow exactly the same instructions you were given for any other day, including when to head to the hospital and which number you should call. Coverage is arranged so that someone is always available.

If you are close to your due date, this is a good week to confirm that you still have the correct after-hours number saved somewhere you can find it quickly.

What Counts as Worth Calling About?

Holiday or not, certain things should never wait for the office to reopen the next morning.

Call rather than wait for:

• Regular contractions or any sign that labor has begun
• Leaking fluid or any vaginal bleeding
• A noticeable decrease in your baby’s movement
• Severe headache, vision changes, or sudden swelling

Those are the same guidelines that apply on an ordinary Tuesday. A holiday does not raise the threshold in any way.

How Does Coverage Work Behind the Scenes?

Holiday weekends require rather more advance planning than most patients would guess from the outside.

Delivery coverage is arranged in advance, hospital staffing is set well ahead, and the answering service knows how to reach the right person quickly. Patients close to term are generally flagged before the weekend begins.

None of this is visible from the outside, which is rather the point of doing it properly in the first place.

From a patient perspective, a holiday delivery should feel no different from any other day, and that is the standard being aimed at.

Planning Around the Long Weekend

A few small things make a long holiday weekend considerably easier when you are late in pregnancy.

Worth sorting beforehand:

• Prescription refills requested before the office closes
• Your hospital bag packed and in the car
• The after-hours contact number saved in your phone
• A plan for travel if you are leaving town

If you are traveling for the weekend and are near term, mention it at your prior visit so travel plans can be discussed sensibly.

Why We Still Smile About the Name

An obstetric practice observing a holiday called Labor Day is a joke that writes itself, and it duly gets made every single year without fail.

General questions about office logistics are also collected on the practice FAQ page if you want to check something without calling.

"Somebody makes the joke every September," says Dr. Leveno. "And somebody always goes into labor, so it stays funny."

Frequently Asked Questions

Will my scheduled appointment be affected if it falls near Labor Day?

Routine appointments are not scheduled on the holiday itself, and the office contacts patients in advance to reschedule anything affected. If you are unsure about your appointment, calling the office directly is the quickest way to confirm.

What if I go into labor on a holiday?

Follow exactly the same instructions you were given for any other day. Delivery coverage runs continuously, the hospital is fully staffed, and someone is always reachable through the after-hours line.

When does the office reopen after Labor Day?

Regular office hours resume on the next business day following the holiday. The days right after a long weekend tend to fill quickly, so calling early helps if you need a prompt appointment.

If you need to schedule or reschedule around the holiday, contact our Plano office and we will find a time that works.

What Is the Difference Between Baby Blues and Postpartum Depression?

The baby blues are common, mild, and short-lived, usually beginning within the first few days after delivery and easing within about two weeks. Postpartum depression is more intense, lasts longer, and interferes with daily functioning in a way the baby blues do not.

Dr. Joseph Leveno provides postpartum depression care at his Medical City Plano practice, working with patients from McKinney and across the surrounding area.

What Do the Baby Blues Usually Look Like?

Most new mothers experience some version of this, and it does not indicate that anything has gone wrong with you or with your baby.

Typical features include:

• Mood swings and unexpected crying spells
• Anxiety, irritability, or feeling generally overwhelmed
• Trouble sleeping even when the baby is asleep
• Reduced concentration and changes in appetite

These usually begin two to three days after delivery and resolve on their own within a week or two without any treatment at all.

Sleep deprivation and the abrupt hormonal shift after birth account for much of it, which is why nearly everyone experiences some version.

How Does Postpartum Depression Differ?

The distinction is largely about intensity, duration, and how much it affects your ability to function.

Postpartum depression symptoms tend to be stronger, last longer, and can eventually interfere with caring for your baby or managing ordinary daily tasks. They typically develop within the first few weeks after birth, though they can begin during pregnancy or emerge up to a year afterward.

It is not a character flaw or a failure of effort. It is a recognized complication of childbirth, and it responds to treatment.

What Symptoms Should Prompt a Call?

Some patterns are worth raising promptly rather than waiting to see whether they pass.

Reach out if you notice:

• Symptoms that have not eased after about two weeks
• Feelings that are getting worse rather than better
• Difficulty bonding with or caring for your baby
• Any thoughts of harming yourself or your baby

That last one warrants a call right away rather than at your next scheduled appointment. Nobody will think you are overreacting.

Why Does Screening Happen at Every Visit?

Because symptoms rarely announce themselves, and because many patients will not volunteer them without being asked directly.

Routine screening removes the burden of having to raise it yourself, and it catches situations that would otherwise go unmentioned out of embarrassment or a sense that this is simply how new motherhood feels.

Answering honestly is far more useful than answering reassuringly, even when the reassuring answer feels easier in the moment. Nobody is grading the responses.

Can Partners and Family Help Spot It?

Often they notice before the patient does, particularly when symptoms have come on gradually.

What tends to be visible from the outside is withdrawal from people, a marked drop in interest in things previously enjoyed, persistent hopelessness, or a level of exhaustion that sleep does not touch.

New fathers and partners can also experience postpartum depression, and the same encouragement to seek care applies to them.

What Does Support Actually Look Like?

Treatment is individualized and can include counseling, medication, or a combination, alongside practical support at home.

Recovery timelines differ considerably, and it is normal for progress to be uneven rather than steady. Postpartum concerns can be raised at any wellness visit, not only at the scheduled postpartum checkup.

"There is nothing brave about suffering through this quietly," says Dr. Leveno. "Ask early, and let us help."

Frequently Asked Questions

How common is postpartum depression?

It is one of the more common complications following childbirth, affecting a meaningful share of new mothers. Because many cases go unreported, the real figure is likely higher than what is recorded. It is common enough that routine screening is standard practice rather than an exception.

When should I reach out for help?

If symptoms persist beyond about two weeks, are worsening, or are making it hard to care for yourself or your baby, contact your provider. If you have any thoughts of harming yourself or your baby, call right away rather than waiting for a scheduled visit.

Can postpartum depression start months after delivery?

Yes. While symptoms often appear within the first few weeks, they can begin during pregnancy or emerge as late as a year after birth. A later onset does not make it any less treatable or any less worth addressing.

If something has felt off since your delivery, contact our Plano office and let us talk it through with you.

Why Is September One of the Most Popular Months for Babies?

September consistently ranks among the busiest birth months in the United States, and the arithmetic is straightforward. Counting back roughly nine months lands in December, when holidays, time off, and colder weather all coincide.

Dr. Joseph Leveno delivers at Medical City Plano and sees plenty of September due dates among patients from McKinney and the surrounding area.

What Explains the December Connection?

No single factor accounts for it. Several fairly ordinary ones simply happen to stack up within the same few weeks of the year.

Commonly cited contributors:

• Extended time off work around the winter holidays
• Colder weather and more time spent indoors
• Couples timing a pregnancy around a school or work calendar
• Shorter daylight hours affecting sleep and routine

The pattern holds year after year, which is why late summer and early fall stay reliably busy on labor and delivery floors across the country.

Does a Busy Birth Month Change Your Experience?

Generally not in any way you would notice. Hospitals staff around predictable seasonal patterns rather than being caught out by them.

Delivery units plan for volume the same way any other hospital department does. A busier month does not translate into less attention, and your care team remains the same either way.

Where it can matter slightly is in scheduling non-urgent things, such as an elective induction date, which may offer less flexibility than it would in a quieter month.

How Firm Is a Due Date, Really?

Considerably less firm than most people treat it. A due date is an estimate rather than a schedule, and only a small share of babies arrive exactly on it.

Most deliveries happen within a window of a couple of weeks on either side of that date. Early ultrasound dating is generally the most accurate, and a date may be adjusted slightly if later measurements disagree meaningfully.

Treating it as a range rather than a fixed appointment tends to make the last few weeks considerably easier on everyone involved.

What Should You Do If You Are Due This Fall?

Mostly the same things you would do for any due date, ideally started a little earlier than strictly feels necessary at the time.

Worth having sorted in advance:

• Your hospital bag packed by around thirty-six weeks
• A plan for getting to the hospital at any hour
• Pediatrician selected and the first appointment understood
• Any questions about labor written down for a prenatal visit

If your pregnancy involves any additional monitoring, confirm what the plan looks like as you approach term.

Does the Season Itself Affect Late Pregnancy?

Somewhat, though mostly in terms of day-to-day comfort rather than anything strictly clinical.

Late-summer heat in North Texas can make the final weeks noticeably harder, particularly with swelling and fatigue. Staying hydrated and out of the worst of the afternoon heat helps more than most patients expect.

Anything that feels beyond ordinary discomfort, including sudden swelling or persistent headaches, is worth a phone call rather than a wait until the next visit.

Marking the Milestone Before It Arrives

Plenty of families add a 3D ultrasound session in the third trimester as a keepsake, which tends to be popular ahead of a fall arrival.

It is entirely optional and separate from clinical care, but many parents are glad to have the images afterward, particularly grandparents who live out of state.

"September gets busy around here, and we like it that way," says Dr. Leveno. "It makes for a good few weeks."

Frequently Asked Questions

Does a September due date mean a busier delivery experience?

Not in any way that affects your care. Hospitals plan their staffing around predictable seasonal patterns, and busier months are entirely routine rather than exceptional. Your care team and the attention you receive during delivery stay the same either way.

Can my due date change as my pregnancy progresses?

It can. Early ultrasound dating is generally the most accurate, and a date may be adjusted if later measurements differ meaningfully. Any change will be explained to you along with the reasoning behind it.

Should I do anything differently if I am due during a busy month?

Nothing clinically, though having your hospital bag and logistics sorted a bit earlier never hurts. If you are considering a scheduled induction, ask about timing sooner rather than later, since dates can fill up.

If you are expecting this fall and want to talk through your delivery plan, contact our Plano office to schedule a prenatal visit.

What Are the Real Signs of PCOS and Why Does Diagnosis Take So Long?

PCOS commonly shows itself through irregular or absent periods, acne, unwanted hair growth, thinning scalp hair, and difficulty losing weight. Diagnosis often takes years because each symptom gets treated separately by different providers rather than considered together.

September is PCOS Awareness Month, and Dr. Joseph Leveno has a longstanding clinical interest in polycystic ovarian syndrome at his Medical City Plano practice, seeing patients from Frisco and across the area.

Which Symptoms Get Dismissed Most Often?

Individually, each one has a dozen possible explanations. Considered together, they form a recognizable pattern that is much harder to explain away.

Symptoms frequently attributed to something else:

• Cycles that are irregular, very long, or missing entirely
• Persistent acne beyond the teenage years
• Hair growth on the face, chest, or abdomen
• Weight changes that do not respond to usual efforts

Patients are often told each of these is normal for them, which is how years pass without the pattern being named.

Why Does Diagnosis Take So Long?

Largely because the symptoms cross specialty lines. Skin concerns go to dermatology, weight concerns to primary care, and cycle concerns to gynecology.

Each provider may treat their piece appropriately without anyone assembling the whole picture. There is also no single definitive test, so diagnosis depends on someone actively considering it.

This is why describing all of your symptoms in a single visit matters, even the ones that seem entirely unrelated to the reason you booked the appointment.

How Is PCOS Actually Diagnosed?

Diagnosis rests on a combination of findings rather than one result, which is part of what makes it easy to miss.

The evaluation usually includes a discussion of your cycle history, bloodwork looking at hormone levels and related markers, and often a pelvic ultrasound. Other conditions that can mimic PCOS are ruled out along the way.

Not everyone with PCOS has visible ovarian cysts, despite what the name implies, which trips up plenty of patients and occasionally delays a diagnosis further.

Does PCOS Affect Fertility?

It can, primarily because irregular ovulation makes conception less predictable. That is different from being unable to conceive.

Many patients with PCOS do conceive, some without assistance and some with treatment aimed at supporting ovulation. Fertility evaluation and care is available for those who need it, and outcomes vary from person to person.

If pregnancy is a goal in the near or medium term, it is worth saying so early, since it shapes which treatments make sense.

What Should You Bring to a First PCOS Visit?

Because diagnosis depends on assembling a pattern, the details you bring in matter more than usual.

Useful to have ready:

• A rough record of your cycles over the past year
• Any skin or hair changes, including when they started
• Family history of PCOS, diabetes, or thyroid conditions
• Previous lab results if another provider has run any

Mention symptoms even if a different provider has already dismissed them. The point is to see them together rather than one at a time.

What Does Management Look Like?

There is no cure for PCOS, but the symptoms are manageable, and any plan should be tailored to whatever is actually bothering you most.

Depending on priorities, a plan may address cycle regulation, skin and hair symptoms, metabolic markers, or fertility. It also includes ongoing well-woman care, since PCOS carries longer-term health considerations worth monitoring.

"Most patients have already been told it is nothing," says Dr. Leveno. "Putting a name to it is often the part that changes things."

Frequently Asked Questions

How is PCOS diagnosed?

It is diagnosed using a combination of cycle history, hormone bloodwork, and often a pelvic ultrasound, with other possible causes ruled out. There is no single test that confirms it on its own, which is why a thorough evaluation matters.

Does PCOS mean I cannot get pregnant?

No. PCOS can make ovulation irregular and conception less predictable, but many patients with PCOS do become pregnant. Some conceive without help and others with treatment that supports ovulation. Individual outcomes vary.

Do I need medication if I have PCOS?

Not necessarily. Management depends on which symptoms actually affect you and what your goals are, and some patients are managed largely through monitoring and lifestyle approaches. Treatment is built around your own priorities rather than applied automatically to everyone with the diagnosis.

If these symptoms sound familiar and no one has connected them for you, schedule an evaluation at our Plano office.