Pelvic Pain Awareness Month: 6 Types of Pelvic Pain Women Are Told to "Just Live With"

Every May, the International Pelvic Pain Society recognizes Pelvic Pain Awareness Month — and every year, we are reminded of how many women walk through our doors at Revelle having spent years being told their pain is normal, in their head, "just part of being a woman," or something they should learn to manage rather than treat.

It is not normal. It is not in your head. And in almost every case we see — across our Atlanta, Alpharetta, and Denver/Greenwood Village clinics — there is something we can actually do about it.

So in honor of Pelvic Pain Awareness Month, we want to name six of the most common types of pelvic pain women are routinely told to "just live with" — what each one actually feels like, what is usually happening underneath, what helps, and when to see a pelvic floor physical therapist.

When to See a Pelvic Floor PT

Before we get into specifics: if any kind of pelvic pain has been present for more than a few weeks, is getting in the way of your daily life, your intimacy, or your movement, or if it started after a specific event (birth, surgery, injury, infection) and never fully resolved — yes, that warrants an evaluation. You do not need a referral in Georgia or Colorado. You do not need to wait until it is "really bad." Earlier is always better.

1. Painful Sex (Dyspareunia)

What it feels like: Burning, tearing, or deep aching with penetration. Sometimes pain only at initial entry, sometimes only with deeper thrusting, sometimes both. For some women it has always been this way; for others it started after birth, perimenopause, surgery, or for no obvious reason at all.

What's actually happening: In the vast majority of cases we see, painful sex is a pelvic floor problem — overly tight, guarded, or hypersensitive muscles that simply will not yield to penetration. It can also involve scar tissue (from tears, episiotomies, or cesareans), hormonal tissue changes, vaginismus, or underlying conditions like endometriosis or vulvodynia.

What helps: Pelvic floor physical therapy is first-line treatment for most causes of painful sex. We work on releasing the muscles that are gripping, restoring tissue mobility, addressing scar tissue, and helping your nervous system stop bracing for pain. Many patients see significant improvement within 6–10 visits.

Internal link: Read more in our painful sex condition guide.

2. Vulvodynia and Vestibulodynia

What it feels like: Burning, stinging, rawness, or hypersensitivity of the vulva or vestibule (the area just inside the vaginal opening). It might happen with touch, with tampons, with sitting, with tight clothing, with sex — or sometimes seemingly out of nowhere. Many women describe it as feeling like a constant sunburn or paper cut.

What's actually happening: Vulvodynia is a pain condition involving the nerves and tissues of the vulva, almost always with a pelvic floor muscle component. The muscles around the vulva tighten in response to the pain, which then makes the pain worse, which then makes the muscles tighter — a loop that can spiral for years.

What helps: A combined approach: pelvic floor PT to address the muscle component, dermatologic and gynecologic care for the tissue component, and sometimes nervous system regulation work to break the pain cycle. Vulvodynia is one of the most under-treated conditions in women's health, and progress is absolutely possible.

3. Endometriosis-Related Pelvic Pain

What it feels like: Cyclical pain that worsens around your period — but for many women, also chronic, daily pelvic ache, painful sex, painful bowel movements, painful urination, and bloating ("endo belly"). Pain that does not match what bloodwork or basic ultrasounds can detect.

What's actually happening: Endometriosis is a systemic inflammatory condition where tissue similar to the uterine lining grows outside the uterus. The pain is real, it is physical, and it is wildly under-diagnosed — average diagnostic delay is 7–10 years. Even after excellent surgical care, the pelvic floor often remains chronically guarded from years of pain, which is why so many post-excision patients still hurt.

What helps: A multidisciplinary team — an excision-trained surgeon when needed, plus pelvic floor PT to address the secondary muscular component that surgery alone does not fix. We frequently work alongside Atlanta and Denver excision specialists for exactly this reason.

Internal link: Read more in our endometriosis condition guide.

4. Pudendal Neuralgia

What it feels like: Burning, electric, or stabbing pain along the path of the pudendal nerve — typically felt in the vulva, perineum, rectum, or sit bones. Often worse with sitting, sometimes better with standing or lying down. Many patients describe it as "sitting on a hot poker" or "a constant nerve ache that no one can find."

What's actually happening: Irritation, compression, or hypersensitivity of the pudendal nerve. The pelvic floor muscles surround and travel alongside this nerve, and when those muscles are too tight, scarred, or in spasm, they can compress the nerve — or amplify its sensitivity.

What helps: Pelvic floor PT to release the surrounding muscles and create more space and mobility around the nerve, postural and seating modifications, and sometimes coordination with a pelvic pain physician for medications or nerve blocks. Pudendal neuralgia responds well to skilled, patient care.

5. Interstitial Cystitis / Bladder Pain Syndrome

What it feels like: A constant urge to pee, pain or pressure in the bladder that worsens as it fills and improves briefly after voiding, frequency (going every 30–60 minutes), pelvic pain, painful sex, and often low back pain — all with negative urine cultures. Many women are told over and over they have a UTI, treated with antibiotics that don't help, and sent home.

What's actually happening: IC is a chronic bladder pain condition with a major pelvic floor component. The muscles around the bladder become chronically tight and irritated, which then irritates the bladder, which then tightens the muscles. Diet (especially acidic foods, caffeine, and alcohol) can amplify symptoms, but the muscle component is what most patients are missing in their care plan.

What helps: Pelvic floor PT (specifically focused on releasing the gripping muscles, not strengthening them), dietary support, and sometimes bladder-directed medications from a urologist or urogynecologist who actually understands IC.

Internal link: Read more in our interstitial cystitis condition guide.

6. Coccydynia (Tailbone Pain)

What it feels like: Pain at the very base of your spine that worsens with sitting, with going from sit to stand, with sex, or with bowel movements. Often started after a fall, after birth, after a long car ride, or sometimes with no clear trigger at all.

What's actually happening: The coccyx (tailbone) is anchored by — and moves with — the pelvic floor muscles. When those muscles are too tight, asymmetric, or in spasm, they pull on the tailbone and create persistent pain. Postpartum tailbone pain is especially common because the coccyx moves significantly during birth.

What helps: Pelvic floor PT, including (with consent) gentle internal coccyx mobilization, postural work, and seating modifications. Many cases of "untreatable" tailbone pain resolve quickly once the muscle component is addressed.

What These Six Conditions Have in Common

Look at the list and you'll see the through-line: in every single one of these conditions, the pelvic floor is playing a starring role — usually as a muscle that has become too tight, too guarded, or too hypersensitive in response to pain or perceived threat. This is why "just do your Kegels" advice fails so spectacularly for women in pain. You cannot strengthen your way out of a muscle that needs to learn how to release.

This is also why pelvic pain so often gets dismissed in standard medical care: it doesn't show up on a typical scan, it's not visible on a routine pelvic exam, and the muscle component requires a clinician trained specifically to assess and treat it. That clinician is a pelvic floor physical therapist.

What Pelvic Pain Awareness Month Means at Revelle

Every May, we see an uptick of women finally booking an evaluation because someone — a friend, an Instagram post, a podcast, a blog like this one — finally said the words: this is not normal, and there is help.

If that's the message you needed today, we're glad it found you. Pelvic pain is real. It is treatable. And you deserve a clinician who will actually look for the cause instead of telling you to live with it.

If you're not sure whether what you're experiencing fits one of these patterns, take our 60-second pelvic floor quiz — it will give you a personalized starting point. If you're ready to book, our team in Atlanta, Alpharetta, and Denver/Greenwood Village specializes in exactly this work. You can also explore our pelvic pain condition guide for more depth.

You don't have to "just live with it." You never did.