Turning Pain into Purpose
When Lauren Spivack, MD, treats women with chronic pelvic pain, she draws not only on her medical expertise as a Rowan Medicine OB/GYN and gynecologic surgeon but also on her personal experience having once lived with chronic back pain.
“I remember standing in clinic several years ago – my back was killing me, my neck was killing me – and hearing the patient describe their pain,” she says. “Before, I could understand pelvic pain intellectually, but when you feel every day how pain impacts everything, even your mental health, it’s a whole different experience.”
That insight shapes how Dr. Spivack practices today as director of the Rowan Center for Chronic Pelvic Pain, caring for women who have often spent years searching for answers.
“Pelvic pain isn’t an easy problem,” says Dr. Spivack. “It takes time to get to the bottom of why patients are having pain, to explain it to them in a way they can understand, and to validate their experience.”
Before each appointment, patients complete a detailed questionnaire, allowing her to focus her time on understanding what has been happening and finding a path to relief.
The condition that brings the most patients to her office is endometriosis, a disease where tissue similar to the uterine lining that is shed every month during menstruation grows outside of the uterus, typically within the pelvis, causing pain, inflammation, and often scarring, alongside a myriad of bowel, bladder and other systemic symptoms.
“Endometriosis affects 10% of women,” Dr. Spivack says. “There is an average delay of diagnosis of 7-10 years. People see an average of 3 doctors until they get a diagnosis.”
Too often, women are told painful periods are normal or sent for tests that miss the real issue, she adds. Once patients finally get answers to what has been causing their pain, the relief can be profound, both physically and emotionally.
Dr. Spivack treats the condition with medication and minimally invasive robotic laparoscopic surgery, which allows most patients to go home the same day and recover within a few weeks. Because endometriosis is a chronic condition, she continues to work closely with them on long-term strategies for pain management, which often invovles a multi-disciplinary treatment team approach.
In addition, Dr. Spivack treats pelvic floor dysfunction, vulvodynia, pudendal neuralgia, and interstitial cystitis, to name a few. Care may include pelvic-floor physical therapy, medications, injections or integrative approaches including acupuncture and osteopathic manipulation through Rowan’s Neuromusculoskeletal Institute.
“The goal is to make everyday life more tolerable, and often, a lot better,” she says.
Dr. Spivack also focuses on perimenopause, menopause and sexual medicine, seeing patients in person at Rowan Medicine and via Alloy, a telemedicine platform.
Her dedication to women’s health research recently earned her the New Jersey Health Foundation’s Excellence in Research Award for 2024-2025, recognizing her work on a federal project to identify endometriosis earlier in women receiving treatment for opioid use disorder.
“I work to understand what their pain is and why it’s happening,” says Dr. Spivack. “When I can explain it in a way they understand, it empowers them and validates their experience.”
Signs of Chronic Pelvic Pain You Shouldn’t Ignore
Severe or Persistent Period Pain
Menstrual cramps that interfere with daily life may signal endometriosis.
Pain During or After Sex
Recurrent discomfort may indicate endometriosis, pelvic floor dysfunction (muscle pain) or GSM (genitourinary syndrome of menopause).
Bladder or Bowel Pain
Pressure or pain during urination or bowel movements can be a sign of endometriosis, pelvic floor dysfunction (or interstitial cystitis if just bladder).
Pain Lasting More Than 3 to 6 Months
Chronic pelvic pain that continues for months often has underlying cause(s) that can be diagnosed.
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