What Is Pelvic Pain?

By Shannon Pacella, PT, DPT

Pelvic pain is a common yet often misunderstood condition that affects people of all ages and genders. Whether it’s a dull ache, sharp stabbing pain, or persistent discomfort, pelvic pain can significantly impact daily life, intimacy, mobility, and emotional well-being. At Wellest Integrative Health, we specialize in pelvic floor physical therapy to help patients better understand and manage this complex issue.

1. What Is Pelvic Pain?

2. What Causes Pelvic Pain?

   1. Pelvic Pain in Women

   2. Pelvic Pain in Men

   3. Pelvic Pain in All Genders

3. Why an Accurate Diagnosis Matters

4. Signs You May Have Pelvic Floor Dysfunction

5. How Pelvic Floor Therapy Can Help with Your Pelvic Pain

6. You Don’t Have to Live with Pelvic Pain

What Is Pelvic Pain?

Pelvic pain refers to discomfort felt in the lower abdomen, pelvis, or perineal region. It can be acute (short-term) or chronic (lasting longer than three months), and its intensity can range from mild to severe. Pelvic pain may be constant, come and go, or only appear during certain activities, such as sitting, exercising, using the bathroom, or having sex. 

What Causes Pelvic Pain?

Pelvic pain can stem from a wide range of musculoskeletal, neurological, urological, gynecological and colorectal sources. Some are related to the pelvic floor muscles—the group of muscles that support the bladder, bowel, and reproductive organs. When these muscles are too tight, too weak, or not coordinating properly, they can contribute to pain and dysfunction. Understanding the root cause is essential for effective treatment, and that’s where pelvic floor physical therapy can play a vital role.

Pelvic Pain in Women

Women may experience pelvic pain related to hormonal changes, reproductive organs, muscle dysfunction, or past surgeries. Some of the most common causes include:

• Endometriosis

  A condition where tissue similar to the uterine lining grows outside the uterus, causing inflammation, scarring, and intense pain—especially around menstruation or ovulation.

  
  

• Interstitial Cystitis (IC) / Painful Bladder Syndrome

  A chronic condition that causes bladder pressure, bladder pain, and sometimes pelvic pain. People with IC may feel like they have a constant urinary tract infection, even when no infection is present.

  
  

• Vulvodynia / Vestibulodynia

  Chronic pain or discomfort around the vulva or vaginal opening that’s often described as burning, stinging, or rawness—particularly during intercourse, tampon use, or prolonged sitting.

  
  

• Pelvic Organ Prolapse

  Occurs when the pelvic organs (bladder, uterus, or rectum) descend from their normal position due to weakened pelvic floor muscles. This can cause pressure, bulging sensations, and discomfort.

  
  

• Postpartum Pelvic Pain

  Childbirth can affect the pelvic floor muscles and nerves. Conditions like perineal tearing, diastasis recti, or episiotomy scars can all contribute to ongoing pelvic pain.

  
  

• Menstrual Pain / Dysmenorrhea 

  While some discomfort with periods is normal, excessive cramping that interferes with daily life may be due to underlying conditions like fibroids, adenomyosis, or hormonal imbalances.

Pelvic Pain in Men

Pelvic pain in men is less often talked about, but it’s very real—and treatable. Some common male-specific causes include:

• Chronic Prostatitis / Chronic Pelvic Pain Syndrome (CP/CPPS)

  The most common form of prostatitis, CP/CPPS is not caused by infection, but by inflammation or tension in the pelvic floor muscles. Symptoms may include pelvic pain, painful urination, and sexual dysfunction.

  
  

• Post-Surgical Pain

  Hernia repairs, prostate surgery, or vasectomies can lead to scar tissue, nerve irritation, or muscular dysfunction in the pelvic area.

  
  

• Testicular, Groin, or Perineal Pain

  Often misdiagnosed, these symptoms can sometimes be traced back to tight or overactive pelvic floor muscles rather than an issue with the testicles or prostate themselves.

Pelvic Pain in All Genders

Some causes of pelvic pain are not gender-specific and may affect anyone, regardless of anatomy or identity:

• Pelvic Floor Muscle Dysfunction

  One of the most common causes of pelvic pain. Muscles can become tight (hypertonic), weak (hypotonic), or poorly coordinated, leading to pain, incontinence, constipation, or sexual dysfunction.

  
  

• Irritable Bowel Syndrome (IBS)

  IBS can cause cramping, bloating, and referred pain into the pelvic region. Chronic straining or bowel irregularities can also irritate pelvic floor muscles.

  
  

• Constipation / Chronic Straining

  Ongoing issues with bowel movements can increase pressure on the pelvic floor, leading to muscle fatigue and pain.

  
  

• Nerve Entrapment or Neuropathy

  Nerves like the pudendal nerve or genitofemoral nerve can become compressed, resulting in sharp, radiating, or burning pain.

  
  

• Pudendal Neuralgia

  A sharp, burning, or aching pain caused by irritation or compression of the pudendal nerve, which runs through the pelvic floor and can be affected by prolonged sitting, cycling, or injury.

  
  

• Musculoskeletal Dysfunction

  Pain from the hips, lower back, or sacroiliac joints can mimic or contribute to pelvic pain. Poor posture, muscle imbalances, or injury can refer pain into the pelvic floor.

  
  

• Trauma (Physical or Emotional)

  A history of pelvic surgery, falls, car accidents, or sexual trauma can contribute to pelvic pain. Emotional trauma and stress can also lead to chronic muscle tension in the pelvic region.

  
  

• Sexual Pain (Dyspareunia)

  Pain with penetration, arousal, or orgasm can be rooted in muscle tension, past trauma, nerve sensitivity, or hormonal changes. This affects people across the gender spectrum.

Why an Accurate Diagnosis Matters

Because pelvic pain can be caused by so many different issues—often overlapping—it’s essential to take a whole-person approach to assessment and care. A skilled pelvic floor physical therapist will look at your full history, posture, movement, muscle function, and daily habits to help uncover contributing factors and create a customized treatment plan.

Signs You May Have Pelvic Floor Dysfunction

Pelvic pain is often linked to dysfunction of the pelvic floor muscles. Common signs include:

• Pain during or after sitting

• Pain with intercourse

• Urinary urgency, frequency, or incontinence

• Bowel movement difficulties or discomfort

• A sensation of heaviness or pressure in the pelvis

If any of these symptoms sound familiar, it might be time to consult a pelvic floor therapist.

How Pelvic Floor Therapy Can Help with Your Pelvic Pain

Pelvic floor therapy is a specialized approach that targets the muscles, joints, and nerves of the pelvic region. Our therapists use evidence-based techniques to address muscle tightness, weakness, coordination issues, and nerve sensitivity.

Treatment may include:

• Manual therapy to release tight muscles and fascia

• Neuromuscular Re-education to improve muscle control

• Therapeutic exercises to build strength and endurance

• Breathing and relaxation techniques

• Education on posture, toileting habits, and lifestyle modifications

Our goal is not just to reduce pain, but to restore comfort, function, and confidence in your daily life.

You Don’t Have to Live with Pelvic Pain

Pelvic pain is real, valid, and treatable. Unfortunately, many people go years without a proper diagnosis or effective treatment. At Wellest Integrative Health, we’re committed to listening, evaluating, and creating a personalized plan to help you heal and thrive.

If you’re experiencing pelvic pain or have questions about your symptoms, don’t hesitate to reach out. You deserve care that understands the full picture—and we’re here to help.

Schedule a consultation today to take the first step toward relief.

CONTACT US