Pelvic Pain: An Overlooked Intersection of Systems
May is Pelvic Pain Awareness Month
Each May, Pelvic Pain Awareness Month highlights a chronic condition that affects millions, yet remains stubbornly under-diagnosed and misunderstood. Often relegated to the margins of medical discourse, pelvic pain disproportionately affects women and marginalized populations—disrupting daily life with physical discomfort, emotional distress, and systemic dismissal.
Most Prevalent Pelvic Health Conditions in the United States
- Urinary Incontinence
- Loss of bladder control, affecting an estimated 25–33% of adults, especially women postpartum and during menopause.
- Pelvic Organ Prolapse (POP)
- When pelvic organs (bladder, uterus, or rectum) drop from their normal position, often after childbirth or with aging.
- Chronic Pelvic Pain (CPP)
- Persistent pain in the pelvic region lasting 6+ months; can stem from multiple sources (muscular, gynecological, urological).
- Endometriosis
- A condition where tissue similar to the uterine lining grows outside the uterus, causing pain, infertility, and pelvic adhesions.
- Irritable Bowel Syndrome (IBS)
- A gastrointestinal disorder often linked with pelvic floor dysfunction, presenting with abdominal pain, bloating, and altered bowel habits.
- Interstitial Cystitis / Bladder Pain Syndrome (IC/BPS)
- A chronic condition involving bladder pressure and pain, with frequent urge to urinate, not linked to infection.
- Dyspareunia (Painful Intercourse)
- Common in people with pelvic floor muscle tension, endometriosis, or postmenopausal tissue changes.
- Constipation / Obstructed Defecation Syndrome
- Chronic difficulty with bowel movements, often linked with pelvic floor dysfunction or rectal prolapse.
- Vulvodynia
- Chronic pain or discomfort around the vulva without a clear cause, often affecting sexual and daily function.
- Pelvic Floor Muscle Dysfunction
- Includes overactive, underactive, or uncoordinated pelvic floor muscles; can contribute to many of the above conditions.
The Pelvic Organs and Their Inter-Connectivity
What is less commonly understood is the intricate interplay between pelvic organs—specifically, the bladder, bowel, and reproductive system—and how dysfunction in one can reverberate across the others. These organs reside in close quarters within the pelvic cavity. Picture a basket holding two balloons: if one balloon—the rectum—becomes overly distended, it pushes against the bladder, potentially triggering urinary urgency or pain, even before the bladder is full.
The Pelvic Fascia System
Beyond spatial proximity, the fascia—a web-like tissue surrounding all organs—adds another layer of complexity. Restrictions in this tissue can create distant ripple effects, altering organ mobility and leading to a cascade of symptoms, from abdominal pressure to bladder pain and slowed digestion. Conditions like constipation may quietly underlie bladder symptoms, while fascial tension can contribute to painful intercourse or urinary frequency.
The Role of Pelvic Health Physical Therapy
Too often, patients receive fragmented care, with providers addressing symptoms in isolation. But integrated pelvic floor therapy can illuminate these connections, offering a more holistic path to relief. For those navigating pelvic pain, the message this month is clear: your symptoms are real, your experience is valid, and your care should reflect the full complexity of the pelvic system. We are here to help you through your symptoms. All of our physical therapists have a pelvic health specialty certification.
