4 Common Causes of Pelvic Pain (And Expert Tips for Relief)
If you're living with pelvic pain, you're not alone. The challenge is that pelvic pain isn't a diagnosis, it's a symptom. There are many possible causes of pelvic pain, and identifying the root cause is essential for finding lasting relief.
At Peach Fit, we use pelvic floor physical therapy to assess how your muscles, joints, nerves, and organ systems may be contributing to your symptoms. Let's discuss four common causes of pelvic pain and expert advice for relief.
What is the Pelvic Floor?
The pelvic floor is a group of muscles and connective tissues that support:
· Pelvic organs
· Bladder and bowel function
· Sexual function
· Abdominal stability
· Pregnancy and childbirth
The pelvic floor is an area where bodily anatomy, function, and coordination are intersectional. Thus, dysfunction in one area can often contribute to pelvic pain.
Understanding these connections helps us identify the underlying causes of symptoms instead of simply treating them temporarily.
1. Gynecological Pelvic Pain
The pelvic floor muscles support and surround the female reproductive organs, including the uterus, ovaries, and vaginal canal.
When a gynecological condition causes inflammation, irritation, pressure, or pain within these structures, the pelvic floor often responds by tightening and guarding itself. Over time, this protective response can contribute to pelvic pain.
Gynecological conditions
· Endometriosis: A common, inflammatory condition where adhesions of endometrial tissue grow outside of the uterus (ovaries, fallopian tubes).
· Adenomyosis: Endometrial tissue grows inside of the uterus’ muscular wall.
· Fibroids: These are typically benign growths that occur in/on the uterus.
· Pelvic Inflammatory Disease (PID): A serious infection of the reproductive organs. Caused by bacterial transmission from vagina/cervix to upper organs (ovaries, fallopian tubes, uterus).
2. The Urinary System and Pelvic Pain
The bladder and pelvic floor work as a team. Your pelvic floor muscles help support the bladder and coordinate the storage and release of urine.
When the bladder becomes irritated, inflamed, or painful, the pelvic floor muscles frequently react by becoming tense and protective.
This creates a cycle where bladder symptoms contribute to pelvic floor dysfunction, and pelvic floor dysfunction can further worsen bladder symptoms such as urgency, frequency, and pelvic pain.
· Interstitial cystitis: Chronic bladder disorder that affects urinary urgency and frequency. Flare-ups can cause pain, pressure, and discomfort.
· Urinary tract infections (UTIs): Infection of the urinary system; pain and burning with urination can cause pelvic muscles to tighten protectively.
3. The Gastrointestinal System and Pelvic Pain
Your pelvic floor plays a major role in bowel function. These muscles help coordinate bowel movements and support the rectum and surrounding structures.
When digestive conditions create pain, constipation, inflammation, or frequent straining, the pelvic floor muscles are often affected as well.
Over time, chronic bowel dysfunction can lead to increased muscle tension, poor coordination, pelvic pressure, and pain throughout the pelvic region.
· Constipation: Difficult or infrequent bowel movements. Constant straining aggravates the pelvic floor muscles.
· Irritable Bowel Syndrome (IBS): Functional bowel disorder causing abdominal pain, bloating, diarrhea, and/or constipation.
· Inflammatory Bowel Disease (IBD): Chronic intestinal inflammation (ex: Crohn’s disease or ulcerative colitis).
· Anorectal Disorders (fissures, hemorrhoids, fistulas): Conditions affecting the anus and rectum.
4. Stress and Trauma Cause Pelvic Pain
Perhaps you’ve heard the phrase,“the body keeps the score”.
While we never want you to think that your pain is “all in your head”; ambiguous pelvic pain is often predicated by trauma and/or chronic stress.
When the nervous system remains on high alert, the pelvic floor muscles may stay contracted even when there is no physical threat present. This doesn't mean the pain is psychological. The pain is very real. It simply means that the nervous system may be one of several factors influencing how the pelvic floor muscles are functioning.
This response may lead to:
Hypertonic pelvic floor dysfunction (tightness, pain, burning)
Hypotonic pelvic floor dysfunction (incontinence, prolapse)
Pain during sex
Vaginismus
Nervous system dysregulation
Expert Tips to Address Pelvic Pain
Your pain is not something to be ignored or minimized. It’s time to break up with the “white knuckle” method- you deserve relief.
Advice from a pelvic floor physical therapist
· Don’t do Kegels excessively, if your pain is caused by a tight pelvic floor, Kegels can make your symptoms worse.
· Don’t allow yourself to become sedentary. Walking, mobility work, and stretching are helpful in reducing pelvic pain.
· Use diaphragmatic breathing daily. Controlled breathing helps calm the nervous system and encourages the pelvic floor to relax.
· Never strain to use to bathroom or force yourself to go “just in case”. These practices can increase pressure and muscle guarding. Stool softeners, hydration, fiber, and proper toilet posture (hello squatty potty!) are your best friends.
· Track triggers instead of eliminating random things (caffeine, alcohol, dehydration, constipation, posture, stress, etc.). Make it a daily habit to use an agenda or notes app to assess your triggers, symptoms, and pain level.
· Note if you feel discomfort in other areas of your body- tightness in the hips, lower back, abdomen, and jaw often coexist with a tight pelvic floor.
· Separate “common” from “normal”. Chronic pain is not normal and seeking treatment sooner rather than later is optimal to prevent nerve issues and muscle guarding.
Final Expert Tip: Start Pelvic Floor Physical Therapy
Our most important expert tip: to seek expert care for your pelvic pain. A pelvic floor physical therapist can assess your condition precisely and holistically.
At your first visit, we’ll focus on identifying the “why” behind your pelvic pain. Each patient’s history, anatomy, and symptoms are different, and require a unique action plan.
Pelvic floor physical therapy is an invaluable investment, especially if you have chronic pelvic pain.