Persistent Pelvic Pain
Persistent Pelvic Pain (PPP)
PPP is pain in the pelvic area lasting over six months and occurring most days. It affects 15–25% of women globally and can be physically and emotionally distressing. Pain may be cyclical (linked to menstruation) or constant, often impacting bladder, bowel, sexual health, and movement. While sometimes a clear cause is found, it’s usually due to a mix of contributing factors.
Why Does Persistent Pelvic Pain Happen?
PPP is best understood through four key components:
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Pelvic Organ Pain: Involves irritation or dysfunction of pelvic organs (e.g. uterus, ovaries, bladder, bowel). Examples: endometriosis, painful bladder syndrome, irritable bowel syndrome.
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Musculoskeletal Response: Chronic pain often causes overactivity or tightness in the pelvic floor and surrounding muscles.
Symptoms: pain with intercourse, sitting, or movement; hip or low back pain. -
Central Sensitisation: The nervous system becomes hypersensitive, so pain signals are amplified, even with minimal stimulation.
Symptoms: Pain that seems out of proportion such as gentle touch on the lower abdomen is perceived as painful or unpleasant, worsened by stress or fatigue. -
Mental and Social Health Effects: Ongoing pain impacts mood, sleep, relationships, and quality of life, often leading to anxiety or depression, which in turn, can increase the perception of pain.
How Can Pelvic Health Physiotherapy Help?
Physiotherapy plays a key role in managing persistent pelvic pain by addressing muscle, nerve, and emotional factors. Our holistic care includes:
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Full assessment of pelvic floor, posture, breathing, and movement
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Gentle manual therapy to ease tension and pain
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Techniques for relaxing overactive pelvic muscles
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Education on pain science and the mind-body link
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Advice on pacing, posture, and bladder/bowel habits
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Support for sexual health and intimacy
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Collaboration with your broader care team (GP, gynaecologist, psychologist, etc.)
Our goal is to restore comfort, function, and confidence in daily life.
We take a trauma-informed, whole-body and whole-person approach to care. This means we listen to your story, understand your goals, and tailor your treatment in a way that feels safe and empowering.Persistent pelvic pain can feel isolating, but support and relief are possible. With the right tools, education, and guidance, many people experience improved quality of life and reduced symptoms.
If you're experiencing pelvic pain that’s affecting your daily life, we’re here to help.