Pelvic Pain FAQ

Pelvic pain refers to discomfort or pain felt in the lower abdomen, pelvis, or vaginal area. It may be acute (sudden) or chronic (lasting more than 3–6 months) and can range from mild to severe. Pelvic pain may be constant, intermittent, or related to specific activities such as menstruation, intercourse, urination, or bowel movements.

Pelvic pain can have many causes, including:

• Gynecologic conditions (endometriosis, fibroids, ovarian cysts)
• Pelvic floor muscle spasm or dysfunction
• Painful bladder syndrome / interstitial cystitis
• Vulvodynia or vestibulodynia
• Prior surgery or scar tissue (adhesions)
• Nerve-related pain
• Hormonal changes (perimenopause or menopause)
• Infections or inflammation

Often, pelvic pain is multifactorial, meaning more than one issue may be contributing.

Chronic pelvic pain is pain lasting six months or longer that may persist even after the original cause has resolved. It often involves a combination of gynecologic, muscular, neurologic, and bladder or bowel factors.

Not always. While many causes are gynecologic, pelvic pain may also involve the pelvic floor muscles, nerves, bladder, or bowel. A comprehensive gynecologic evaluation helps determine whether the pain is gynecologic, non-gynecologic, or mixed.

Evaluation typically includes:

• Detailed medical and symptom history
• Pelvic examination focused on muscles, nerves, and organs
• Review of menstrual, sexual, bladder, and bowel symptoms
• Imaging (ultrasound or MRI when indicated)
• Review of prior surgeries or treatments

The goal is to identify all contributing factors, not just one diagnosis.

Yes. Pelvic floor muscle tension or spasm is a very common and often overlooked cause of pelvic pain. Tight or overactive pelvic muscles can cause pain with intercourse, tampon use, pelvic exams, or even sitting and exercise.

Vulvodynia is chronic pain or burning of the vulvar area without an identifiable infection or skin condition. It may be localized or generalized and is often related to nerve sensitivity, hormonal changes, or pelvic floor muscle dysfunction.

Pain with intercourse (dyspareunia) may be caused by:

• Pelvic floor muscle spasm
• Vulvar or vaginal tissue sensitivity
• Scar tissue from childbirth or surgery
• Hormonal changes causing vaginal dryness or thinning
• Endometriosis or deep pelvic pain

A targeted evaluation helps determine the cause and guide treatment.

Yes. Prior pelvic or abdominal surgery may lead to scar tissue, nerve irritation, or muscle dysfunction that contributes to pelvic pain. This may occur months or even years after surgery.

Treatment depends on the cause and may include:

• Pelvic floor physical therapy
• Medications (topical or oral)
• Hormonal therapy when appropriate
• Nerve-targeted treatments
• Trigger point injections
• Behavioral or pain-modulation strategies
• Surgery in select cases

Most patients benefit from a multidisciplinary approach rather than a single treatment.

No. Surgery is not the first-line treatment for most pelvic pain conditions. Many patients improve significantly with non-surgical therapies, particularly pelvic floor physical therapy and targeted medical management.

No. Pelvic pain is real and often involves complex interactions between muscles, nerves, hormones, and the nervous system. While stress can worsen pain, it does not mean the pain is imagined or psychological.

You should seek evaluation if:

• Pain lasts more than a few weeks
• Pain interferes with daily activities or intimacy
• Pain is worsening or recurring
• You have pain with intercourse, urination, or bowel movements
• Over-the-counter treatments are not helping

Early evaluation often leads to better outcomes.

Our approach focuses on identifying the true source of pain, not just suppressing symptoms. We evaluate gynecologic, muscular, neurologic, and pelvic floor contributors to develop an individualized treatment plan aimed at long-term relief and improved quality of life.

To schedule a confidential pelvic pain consultation or speak with our care team, please contact our office or request an appointment through our website.