First, what exactly is pelvic pain?
Pelvic pain refers to discomfort or pain in the lower abdomen and pelvic region. It can feel like cramping, aching, pressure, burning, or sharp, stabbing sensations. For some people, it comes and goes. For others, it's a persistent, unwelcome companion.
It can be associated with conditions like endometriosis, pelvic floor dysfunction, prolapse, bladder pain syndrome, or other reproductive, urinary, digestive, and musculoskeletal concerns. Sometimes, multiple factors contribute to the pain. But sometimes and often, the cause isn't immediately clear.
Whether your pain is occasional, cyclical, or chronic, it can begin to influence how you move through the world:
Going to work.
Making plans.
Sitting comfortably.
Having sex.
Exercising.
Even something as seemingly simple as deciding what to wear.
Will these pants make things worse?
Am I going to have enough energy to go out tonight?
What if it hurts again?
When you're living with pain, you may find yourself doing an extraordinary amount of thinking, planning, and negotiating with your own body.
Which can quickly become exhausting.
If you are experiencing pelvic pain, you're not alone.
Research suggests that approximately 15–20% of women experience chronic pelvic pain. That's potentially one in five women navigating an experience that, despite being relatively common, isn't always openly discussed.
And while much of the existing research focuses on women, pelvic pain can affect people of all genders, including men, transgender, and nonbinary individuals.
Yet, for something so common, pelvic pain can feel surprisingly isolating.
But you don’t have to navigate it alone.
1. Understanding the emotional impact of pelvic pain
Chronic pain can affect relationships, work, intimacy, mood, and your sense of independence.
Therapy can offer a place to explore those experiences without immediately turning them into another problem you need to solve.
Common emotional experiences among sufferers of chronic pelvic pain are: anger, disappointment, fear of flare-ups.
Maybe there’s even some resentment you feel toward your body or toward a healthcare system that hasn't always listened.
All of it is welcome.
It can be so important to have a safe place to acknowledge the emotional impact this pain has on your life.
2. Rebuilding trust in your body
There's something that can happen with those who have chronic health conditions, when your body has become an unpredictable place to live:
You start paying very close attention to it.
What's that sensation?
Is this going to turn into pain?
Should I cancel my plans?
Is something wrong?
And for good reason! If you're experiencing repeated pain, anticipating potential discomfort can become a way of trying to protect yourself.
But living in a constant state of anticipation can be exhausting, too.
Over time, you might begin to feel disconnected from your body, frustrated with it, or even betrayed by it.
Therapy can help you explore that relationship with curiosity and compassion.
For some people, this might involve learning to notice physical sensations with curiosity instead of anxiety. For others, it might mean recognizing when they're pushing past their limits and exploring what helps them feel safer and more comfortable.
Somatic and mindfulness-based approaches can sometimes be useful here, but they aren't about forcing yourself to tolerate uncomfortable sensations.
And you don't have to start with body-focused exercises if they don't feel safe or helpful.
The goal isn't to convince yourself that everything is fine.
It's to gradually develop a relationship with your body that includes more trust, care, and self-compassion.
3. Navigating relationships, intimacy, and boundaries
Chronic pelvic pain can impact romantic relationships in a variety of ways.
Because pain with sex is a common symptom for those who have pelvic pain, it’s not uncommon to develop an avoidance of sex or physical intimacy.
Which can understandably lead to a partner feeling guilty, disappointed, rejected, or anxious.
Even in a relationship, it can start to feel isolating and lonely.
Therapy can help you explore how pain is affecting your relationships, including your relationship with yourself.
This can involve practicing ways to communicate your needs, identifying boundaries, processing feelings of guilt, or considering how intimacy can look different when your body needs something different.
For people who have experienced sexual trauma, there may also be complicated feelings around physical safety, control, and consent.
It’s important to note, not everyone experiencing pelvic pain has a history of trauma. And having experienced trauma doesn't mean it caused your pelvic pain.
Whether or not trauma is part of your story, you deserve relationships where your comfort and boundaries matter.
And you don't have to push through pain to prove your affection, commitment, or worth.
4. Developing tools for coping with chronic pain
Living with pelvic pain can sometimes feel like an ongoing negotiation between what you want to do and what your body is willing to participate in.
You make plans, and then a flare-up happens.
You finally have a good day, and suddenly you're wondering whether you should catch up on everything you've been putting off.
Or maybe you’re finding yourself avoiding things you used to enjoy because you're worried about what might happen afterward.
It's frustrating. And it can make everyday life feel complicated.
Therapy can help you develop practical strategies for navigating those experiences.
For example, you might explore ways to recognize your limits without judging yourself for having them. You might work on managing the anxiety that accompanies unpredictable symptoms or develop strategies for communicating your needs when you're having a difficult day.
Some therapeutic approaches, including cognitive behavioral therapy (CBT) and acceptance-based approaches, can help people living with chronic pain develop coping skills, reduce pain-related distress, and improve daily functioning.
This doesn't mean thinking positively will make your pain go away.
It means recognizing that even when you can't control every aspect of your physical experience, there are ways to support yourself through it.
And those strategies get to work with your life, not become another exhausting list of things you're supposed to be doing.
You deserve support for the whole experience
Living with pelvic pain can change the way you move through the world.
It can affect your confidence, your relationships, your energy, and your ability to feel at home in your own body.
And while therapy may not be able to take the pain away, it offers a space to explore what living alongside that pain looks like.
Perhaps that means learning to communicate your needs more openly.
Perhaps it means reconnecting with parts of yourself that have gotten lost in the shuffle of appointments, symptoms, and uncertainty.
Or maybe it simply means having somewhere you don't need to pretend you're doing better than you are.
You deserve care that takes your physical experiences seriously while making room for the emotional ones, too.
You are a whole person. Not just a collection of symptoms.
And your life deserves attention beyond managing them.
If you're navigating chronic pelvic pain or PMDD and looking for emotional support, I offer online therapy for adults throughout Colorado. You can learn more about my approach to pelvic pain and PMDD therapy and what working together might look like.
About Lauren
Lauren Lottino, LMFT, is a Colorado therapist specializing in grief, anxiety, trauma, sexual assault and abuse recovery. Her approach to therapy is warm, direct, and focused on helping clients create meaningful change in their lives.
