Pelvic pain

Pelvic Pain: Understanding the Causes and Finding the Right Treatment

Persistent pelvic pain can be exhausting, disruptive, and deeply frustrating — especially when it’s misunderstood or dismissed. If you’re living with ongoing pain in your lower abdomen, 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, compassionate approach to diagnosing the underlying causes of pelvic pain and developing tailored treatment plans to help you feel better.

What Is Pelvic Pain?

Pelvic pain refers to 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 six months)

• Cyclic (linked to your menstrual cycle)

• Non-cyclic (not related to your periods)

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 abdomen.

Introduction to 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 it contains several organs, including the female reproductive organs, bladder, and colon. Pelvic pain can be acute or chronic, and it 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 essential to manage pelvic pain and improve quality of life.

Symptoms of Pelvic Pain

The 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 menstrual bleeding, while men may experience symptoms such as painful urination or ejaculation. It is essential to seek medical attention if symptoms persist or worsen over time.

Common Causes of Pelvic Pain

Pelvic pain can stem from a wide range of causes — some related to reproductive organs, some related 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 various aspects of pelvic pain is crucial for better management and patient decision-making.

Often, pelvic pain has more than one cause, which is why a careful, holistic assessment is essential. For example, endometriosis and fibroids can occur together, contributing to the complexity of the condition.

Women’s Health Considerations

Women are more likely to experience pelvic pain due to various factors, including hormonal changes, pregnancy, and childbirth. Female reproductive organs, such as the uterus, ovaries, and vagina, can be affected by conditions like endometriosis, fibroids, and infection. Women’s health considerations, such as menstrual cramps, pregnancy, and menopause, can also contribute to 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 Should You See a Gynaecologist?

You should seek advice if you experience:

• Pelvic pain that persists for more than a few weeks

• Pain that disrupts 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 significantly disrupts daily life

Early assessment can prevent small problems from becoming bigger ones — and ease the anxiety that comes from 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 process is crucial in diagnosing pelvic pain to ensure that patients receive the highest quality of care tailored to their values.

At Happiher, a detailed 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 (only 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 carefully 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 specific 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 dealing 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 is crucial to consider the needs and values of patients 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 that patients receive comprehensive services tailored to their specific 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 fiber 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. Additionally, 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, engaging in regular exercise, and practicing stress management techniques can help reduce the risk of pelvic pain. 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 well-being.

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 step.

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

Why Choose Happiher for Pelvic Pain Management?

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

• Private, compassionate consultations without long waits

• Expert ultrasound and advanced diagnostic imaging

• Minimally invasive and robotic-assisted surgical options

• Holistic, multidisciplinary care when needed

• A warm, understanding environment focused entirely on you

• Comprehensive women's health care, addressing conditions such as endometriosis, fibroids, and menopause

We work with you to restore comfort, confidence, and control over your health.

Final Thoughts

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

At Happiher, we’re here to listen carefully, diagnose thoughtfully, and treat effectively — helping you move from pain to empowerment.