Pain in the Pelvis: A Holistic Treatment Approach

Pelvic Pain and its Impact

Pelvic pain can have a profound impact on quality of life, affecting both physical and mental health.  You may find yourself missing work or school or having to cancel social plans.  You may find that daily activities such as showering and toileting take so much energy that you are drained before you even start your day. Your intimate life may be suffering due to pain, fatigue, or bladder or bowel dysfunction. 

Some types of pelvic pain have a clear medical and biomechanical cause, and other types of pelvic pain have a less clear etiology. Pain is a protective response in the body to a threat or perception of threat. Pain can occur in response to tissue damage, pressure, posture, movement, fear, or even anticipation of pain based on prior experience. Sometimes we can experience pain just from thinking about movement or looking at a picture of something frightening.   Chronic pain can result in changes in the brain and body tissues that can perpetuate pain going forward.  Sometimes pain can be a protective response following a traumatic experience, or in anticipation of something that feels frightening.  Treating pelvic pain holistically ensures the whole person is considered within the context of each person’s own life.

Some Examples of Pelvic Pain in Women:

  • Dyspareunia: General term to describe pain experienced with intercourse.
  • Vaginismus: Pain and fear with vaginal penetration, or an inability to experience penetration.
  • Vulvodynia: Chronic pain experienced in the vulva, without an alternate medical explanation.
  • Endometriosis: Endometrial tissue grows outside the uterus, often causing pain, difficult periods, and other symptoms.
  • Menstrual pain: Abdominal pain experienced during or prior to menstruation.
  • Interstitial Cystitis: Chronic pain in the bladder and/or chronic sensation of bladder fullness.  

Treating Pelvic Pain:

Pelvic Pain is best addressed with a multidisciplinary approach.  Often, this includes a team approach with a pelvic therapist and a mental health therapist, to address both the physical and psychosocial aspects of pelvic pain.  For example, you might see a pelvic therapist for hands on treatment, and an OT, psychologist, or somatic therapist for the psychosocial aspects of treatment.  The combined treatment might include manual therapy, learning about how breathing and posture affect the pelvis, supporting the nervous system to come out of a hypervigilant or dissociative state, or supporting the body to move towards safety, comfort, and pleasure. Often, it is a combination of all of these.

Some treatment approaches for pelvic pain include the following:

  • Learning about your nervous system, pain system, triggers, and helpers.
  • Becoming more comfortable with being present in your own body.
  • Increasing access to comfort and pleasure through the senses.
  • Exploring your sexual health goals and addressing barriers through education, activity modification, and energy conservation principles.
  • Reprocessing and integrating past traumas (medical trauma, birth trauma, sexual trauma).
  • Manual therapy with a pelvic therapist.
  • Creating a personalized graded exposure plan for reintroducing challenging activities.

Next Steps:

If you would like to see if this approach is the right fit for you, you can contact me at or visit the website to set up a free discovery call.

Watch for next month’s blog about Vaginismus!