Pelvic pain

Pelvic Pain: What Causes It and How to Treat It

Pelvic pain is exhausting, disruptive and frustrating – especially when it’s misunderstood or dismissed. If you’re living with ongoing pain in your lower tummy, pelvis or lower back you deserve answers, support and expert care.

At Happiher, we take pelvic pain seriously. As a private gynaecologist in London, I offer a thorough and compassionate approach to diagnosing the underlying causes of pelvic pain and developing a treatment plan to help you feel better.

What is Pelvic Pain?

Pelvic pain is discomfort or aching felt in the pelvis area, below your belly button and between your hips. It can be:

• Acute (sudden and severe)

• Chronic (lasting longer than 6 months)

• Cyclic (linked to your period)

• Non-cyclic (not related to your period)

Pelvic pain can happen unexpectedly and vary in intensity. Pain may be dull, sharp, burning or cramping – and may radiate to your back, thighs or lower tummy.

What is Pelvic Pain?

Pelvic pain is a common condition that affects both men and women, causing discomfort or pain in the pelvic area. The pelvic area is the region between the hip bones and contains several organs including the female reproductive organs, bladder and colon. Pelvic pain can be acute or chronic and can range from mild to severe. In some cases pelvic pain can be a symptom of an underlying disease or condition such as endometriosis, fibroids or infection. Proper diagnosis and treatment are key to managing pelvic pain and improving quality of life.

Symptoms of Pelvic Pain

Symptoms of pelvic pain can vary depending on the underlying cause. Common symptoms include pain or discomfort in the pelvic area which can be constant or intermittent. Other symptoms may include bloating, constipation, bleeding or difficulty urinating. In some cases pelvic pain can be accompanied by other symptoms such as fever, chills or nausea. Women may experience symptoms such as heavy or irregular periods, men may experience symptoms such as painful urination or ejaculation. If symptoms persist or worsen seek medical attention.Pelvic pain can come from many causes – some related to the reproductive organs, some to the bowel, bladder or musculoskeletal system.

Common gynaecological causes include:

• Endometriosis (tissue similar to the womb lining growing outside the uterus)

• Adenomyosis (womb lining tissue growing into the uterine wall)

• Ovarian cysts or fibroids

• Pelvic inflammatory disease (PID)

• Pelvic adhesions (scar tissue from previous surgery or infection)

• Painful ovulation (mittelschmerz)

• Menstrual cramps (dysmenorrhoea)

• While rare, womb cancer and ovarian cancer can also cause pelvic pain.

Other possible causes:

• Irritable bowel syndrome (IBS)

• Urinary tract infections (UTIs) or bladder conditions

• Pelvic floor muscle dysfunction

• Past trauma or surgery

Understanding pelvic pain is key to better management and patient decision making.

Often pelvic pain has more than one cause, that’s why a thorough and holistic assessment is important. For example endometriosis and fibroids can occur together, making the condition more complex.

Women’s Health Considerations

Women are more likely to experience pelvic pain due to various factors, hormonal changes, pregnancy and childbirth. Female reproductive organs, the uterus, ovaries and vagina can be affected by conditions like endometriosis, fibroids and infection. Women’s health considerations, menstrual cramps, pregnancy and menopause can also cause pelvic pain. A consultant gynaecologist can help diagnose and treat pelvic pain in women and treatment options may include medication, surgery or lifestyle changes.

When to See a Gynaecologist?

You should seek advice if you have:

• Pelvic pain that lasts more than a few weeks

• Pain that interferes with daily activities, sleep, work or relationships

• Pain during sex, urination or bowel movements

• Severe menstrual cramps that don’t respond to usual painkillers

• Pain associated with abnormal bleeding, discharge or fever

• Chronic pelvic pain that affects daily lifeEarly assessment can prevent small problems from becoming big ones — and ease the worry of not knowing what’s wrong. If your symptoms are severe or worsening, ask for an urgent GP appointment.

How Is Pelvic Pain Diagnosed?

A systematic approach is key to diagnosing pelvic pain to ensure patients receive the best care possible.

At Happiher a thorough and thoughtful approach is key to understanding pelvic pain.

Your assessment may include:

• In-depth consultation about symptoms, menstrual cycles, sexual health, lifestyle and past medical history

• Pelvic examination (if appropriate and comfortable for you)

• Pelvic ultrasound to assess uterus, ovaries and pelvic organs

• MRI scan if deep endometriosis or complex pelvic pathology is suspected

• Swabs or blood tests if infection is suspected

• Laparoscopy (keyhole surgery) for definitive diagnosis and treatment of conditions like endometriosis or adhesions

Listening to your story often provides as many clues as any scan.

Treatment Options for Pelvic Pain

At Happiher pelvic pain is treated based on the underlying cause and severity. Treatment is always personalised based on the underlying cause, severity of symptoms and your health goals.

Options include:

Surgical Options: For some conditions surgical intervention may be necessary. Procedures such as hysteroscopy and hysterectomy are considered based on the individual needs of the patient.

Multidisciplinary Support: Our team offers advanced minimally invasive gynaecological procedures, including laparoscopic surgery and robotic-assisted surgery to provide comprehensive care for women with fertility and pregnancy related issues.

Medical Management

• Pain relief (e.g. NSAIDs, hormonal therapies)

• Hormonal treatments to suppress conditions like endometriosis

• Antibiotics for infections

It’s important to consider the patient’s needs and values in medical management to ensure compassionate and effective care.

Surgical Options

• Laparoscopic surgery to treat endometriosis, adhesions, ovarian cysts or fibroids

• Robotic-assisted surgery for complex pelvic disease, offering greater precision and quicker recovery. This procedure allows for minimally invasive interventions which can significantly improve patient care by reducing recovery times and minimising surgical risks.

Pelvic Floor Physiotherapy

Especially helpful for pelvic floor muscle dysfunction or pain without a clear gynaecological cause. Pelvic floor dysfunction is treated through physiotherapy which includes exercises and techniques to strengthen and relax the pelvic muscles.

Multidisciplinary Support

Relieving pain often requires addressing both the physical cause and the body’s response to ongoing pain signals. Collaboration with pain specialists, physiotherapists or dietitians when needed ensures patients receive comprehensive services tailored to their individual needs.

Self-Management of Pelvic Pain

Self-management of pelvic pain involves making lifestyle changes to reduce symptoms and improve quality of life. Exercise such as gentle stretching or yoga can help reduce tension and improve flexibility. Dietary changes such as increasing fibre intake or avoiding trigger foods can also help manage symptoms. Stress management techniques such as meditation or deep breathing can help reduce stress and anxiety. Getting enough sleep, practicing good bowel habits and avoiding smoking and excessive alcohol consumption can help reduce the risk of pelvic pain.

Preventing Pelvic Pain

While pelvic pain cannot always be prevented, there are steps that can be taken to reduce the risk. Maintaining a healthy weight, exercising regularly and practicing stress management techniques can help reduce the risk. Getting enough sleep, eating a balanced diet and avoiding smoking and excessive alcohol consumption can also help reduce the risk. Women can reduce their risk of pelvic pain by practicing good menstrual hygiene, getting regular check-ups and seeking medical attention if symptoms persist or worsen. Men can reduce their risk of pelvic pain by practicing good prostate health, getting regular check-ups and seeking medical attention if symptoms persist or worsen. By taking these steps individuals can reduce their risk of pelvic pain and improve their overall health and wellbeing.

Living with Pelvic Pain

Chronic pelvic pain can affect every part of life — from work and exercise to relationships and self confidence. It’s not just physical; it can impact your mental and emotional wellbeing too.

At Happiher we take your pain seriously — offering not just diagnosis and treatment but validation and support at every stage.

You are not “imagining” your symptoms. You deserve care that recognises the whole picture.

Why Choose Happiher for Pelvic Pain Management?

If you’re looking for a pelvic pain specialist in London Happiher offers:

• Private, no waiting list consultations

• Expert ultrasound and advanced diagnostic imaging* Minimally invasive and robotic-assisted surgery

• Holistic care when needed

• A warm and understanding space for you

• Women’s health care for endometriosis, fibroids, menopause and more

We help you feel comfortable, confident and in control.

Conclusion

Pelvic pain is common — but it’s never normal to live in pain. You deserve answers, relief and a way forward.

At Happiher we listen, diagnose and treat — and help you from pain to power.