Getting help for persistent pelvic pain

Seeing a doctor about persistent pelvic pain

Book a long appointment with your doctor so you have time to talk about your pain. You can also bring a support person to your appointment if you need one.

It can take time to get a diagnosis of persistent pelvic pain. Depending on your symptoms, your doctor may refer you to different health care professionals.

Investigating your pain

It's important to give your doctor as much information about your pain as possible. This will help them to investigate potential causes.

It’s a good idea to bring:

• your medical records, including your past medical history
• blood test results
• x-rays and other scans, such as pelvic ultrasound reports
• information about previous surgeries
• records of your symptoms, for example, a pain diary.

You can also download our Seeing your doctor about persistent pelvic pain resource and record important information to discuss with your doctor.

Your doctor may ask questions about your pain and how it affects your life. For example:

• How and when did your pain begin?
• How would you describe your pain?
• How long does your pain last?
• What makes it better or worse?
• How does your menstrual cycle affect your pain?
• Does your pain affect your sleep?
• Has your pain spread or become worse since it began?

They may also ask:

• Do you have pain when going to the toilet?
• Do you have constipation or diarrhoea?
• Does the pain affect your mood?
• Which medicines have you used in the past? Have they helped?
• Which medicines or supplements are you taking now?
• How does your pain affect your daily life, such as work, study and social activities?
• Does your pain affect your relationships or sex life?

Physical examination

Your doctor may ask to do a physical examination. They may check:

• your posture and the way you walk and move (gait) – this may suggest pelvic muscle pain
• your lower back, hips, tailbone (coccyx) and pelvic joints – this is often associated with pelvic muscle dysfunction
• your lower abdomen – for lumps or tender points
• your vulva and vagina
• your pelvic floor muscles
• your skin – to see if you have a skin condition, numbness or tenderness.

Tests and procedures

You may also need to have some tests and procedures to check for other causes of pain, such as:

• blood or urine (wee) tests
• swabs to check for sexually transmitted infections (STIs), bacteria or other infections
• a cervical screening test
• imaging tests, such as an abdominal x-ray, ultrasound, CT scan or MRI scan of your abdomen and pelvis
• keyhole surgery to examine your internal organs, such as your uterus or stomach
• a procedure to examine your bladder called a cystoscopy.

Questions to ask your doctor

It’s important to ask questions and learn as much as possible about persistent pelvic pain. These questions may also help you find the best doctor to treat your pain.

You can ask:

• What experience do you have in managing persistent pelvic pain?
• Do you work with other health professionals to manage persistent pelvic pain?
• Which other health professionals should I see for my pain?
• Which tests will I need?
• How much will the tests cost?
• Where can I have these tests?

You can also ask:

• What kinds of treatments are available and how much do they cost?
• Are there any potential side effects?
• What practical things can I do to help manage my pain?
• Can you recommend any resources to learn more about my condition?
• Can I access any programs that make it more affordable to see different allied health professionals? For example, a GP Chronic Disease Management Plan and Team Care Arrangement?
• Can I access a Mental Health Care Plan to make it more affordable to see a psychologist?

A person-centred approach for persistent pelvic pain

Persistent pelvic pain is a complex condition that’s influenced by physical, psychological and social factors.

Everyone has a different experience, which is why treatment should be person-centred. Your treatment plan should focus on managing symptoms that bother you. It might include one or more of the following:

• pain education
• lifestyle changes, including diet, physical activity and sleep
• psychotherapy, such as cognitive behavioural therapy (CBT), relaxation and mindfulness techniques
• pelvic floor physiotherapy
• pain-relief medicine
• hormone medicines
• complementary therapies, such as acupuncture
• surgery for certain health conditions, such as endometriosis.

Your health care team for persistent pelvic pain

Persistent pelvic pain is best managed by a team of health care professionals. But it can be hard to find the right help, especially in regional and remote areas. You can ask your doctor to help you find local specialists or look for specialists who offer Telehealth appointments.

Depending on your situation, you might see different health care professionals.

Doctor (GP)

Your doctor will provide most of your care and will start your treatment. They will refer you to specialists and coordinate care with the rest of your health care team. They will also continue to manage your overall health.

Gynaecologist

A gynaecologist is a specialist in the female reproductive system. They can diagnose and treat conditions like endometriosis, adenomyosis, fibroids and complex period problems.

Pain specialists

Pain specialists are medical doctors with advanced training in pain management. They understand the complex nature of pain and use different approaches to help reduce your pain.

Pelvic floor physiotherapist

Pelvic floor physiotherapy is widely used to manage persistent pelvic pain. Pelvic floor physiotherapists have extra training and special skills in women’s health.

They can:

• help improve how your pelvic floor and abdominal muscles, back and hips work
• help you learn how to move and exercise in a way that’s right for you
• help you learn about pain, which is an important part of managing pain
• explain basic pain-relief techniques.

Psychologist

Psychologists may use a range of techniques, including cognitive behavioural therapy (CBT) to help manage your pain.

They can:

• help you understand how your thoughts, emotions, physical sensations, behaviours and pain are linked
• recommend coping strategies to help manage your pain.
• help with anxiety and depression, which are common in people with persistent pelvic pain.

Sex therapist

Sex therapists can help you understand how persistent pelvic pain might cause painful sex. Past experiences of painful sex may cause you to fear pain. This fear can create stress, tension and reduced sex drive and arousal. If you want to improve your sexual experience, it may help to discuss your feelings with a sex therapist.

Dietitian

Dietitians can help you identify food that might trigger a pain flare. They can also recommend a balanced diet to help reduce your pain.

Naturopath

Naturopaths can provide complementary ways to manage your pain, including supplements, herbal medicine, acupuncture and lifestyle changes. Many women use these therapies to manage their health, but there is limited evidence to support their safe and effective use. If you’re using complementary therapies to manage your pain, it’s important to discuss the risks and benefits with your doctor.

Urogynaecologist

Urogynaecologists are specialists in pelvic health. They can diagnose and treat bladder and pelvic floor problems that may contribute to pelvic pain.

Gastroenterologist

Gastroenterologists specialise in conditions that affect the digestive system. They can diagnose and treat digestive conditions that may be causing pain.

Sleep specialist

Sleep specialists are doctors who diagnose and treat sleep disorders. They can help with medicines and sleep routines to improve the quality of your sleep.

Exercise physiologist

Exercise physiologists develop exercise programs that are safe and effective for each individual.

Medicine to help manage your pain

Medicine can be used to help manage persistent pelvic pain. While this may be useful, it should only be one part of your treatment plan.

Your health care team may recommend short-term pain-relief medicine, for example, paracetamol, ibuprofen or naproxen. These may be useful for certain types of persistent pelvic pain, for example, period pain.

Health care professionals may also suggest medicines that target nerve pain, or hormone medicines, such as the Pill, an intrauterine device (IUD) or injections.

Opioids (strong pain-relief drugs) are not recommended for persistent pelvic pain as they can make the pain worse and might lead to dependency with regular use.

How long will it take to reduce your pelvic pain?

It may take time and different approaches to reduce your pelvic pain. It can take 3 to 6 months for your treatment to start working. During this time, it’s important to be patient and follow your plan, even if you don’t notice any difference straight away.

Successful treatment may not get rid of your pain completely, but it will help you manage pain in the future.

Related resources

Download our persistent pelvic pain fact sheets.