Pelvic pain in women is not limited to gynecological disorders. It can also stem from intestinal issues, musculoskeletal problems, or even infections such as the herpes virus. This perspective comes from a urogynecologist and a neuroinstitute physician at the Semeynaya Clinic in Moscow, working with researchers from Pirogov St. Petersburg State University. Anna Berdichevskaya, a specialist in this field, emphasizes a broad view of the causes behind pelvic discomfort.
“Chronic pelvic pain can be connected to gynecological conditions such as endometriosis, adenomyosis, polycystic ovary syndrome, and pelvic inflammatory disease,” Berdichevskaya notes. “However, the underlying cause may lie in gastroenterological problems as well, including irritable bowel syndrome, which can manifest with pelvic symptoms.”
Urological issues also play a significant role. Conditions like cystitis, recurrent infections, and hypersensitive bladder can contribute to ongoing pelvic pain. In addition, musculoskeletal factors may present as myofascial pain in the pelvic floor muscles. When this happens, secondary problems like pudendal nerve neuropathy or cystitis-like symptoms can arise, complicating the clinical picture.
In a documented case, Berdichevskaya recalls a patient who endured pelvic pain for three years. During examination, a recurring hip rash appeared, coinciding with monthly episodes. Testing revealed herpes zoster as the culprit. The virus affected peripheral nerves on one side of the body, and the patient reported relief after starting an antiviral regimen. This example highlights how a viral infection can trigger pelvic pain that might otherwise be mistaken for a purely gynecological issue.
When symptoms persist for three months or more, qualified clinicians may diagnose chronic pelvic pain syndrome. The experience can be intermittent or continuous, with triggers such as certain foods, changes in body position, sexual activity, or contact with the vulvar area intensifying the discomfort. A careful history, targeted examination, and appropriate testing help distinguish the contributing factors and guide effective management. (Clinical guidance from Semeynaya Clinic and Berdichevskaya)