When to Talk to A Healthcare Provider About Pelvic Pain

One third of women will experience pelvic pain over their lifetime. Anytime you notice a change in what is normal for you, it is important to keep track of this change and speak with your doctor. If your doctor dismisses you, make sure to seek out a second opinion. Below are 5 symptoms that you should talk to your health care provider about:

1. Pain with penetration: Penetration could include pain with sex, inserting a tampon or during a pelvic exam. Pay attention to where the pain is located: the vulvar area, at the entrance, or deeper inside. Deeper pain is usually associated with endometriosis, bladder disorders or issues with the cervix. Pain at the entrance or vulvar area may be vulvodynia or vaginismus. It is also important to note that regardless of the location of the pain, it could be caused by pelvic floor muscle dysfunction which is very treatable with physical therapy. Make sure to tell your doctor what the pain feels like (burning, stinging, stabbing, stretching, etc.).
2. Bleeding after sex: If you notice consistently you seem to be bleeding after sex make sure to tell your doctor about this. Is there pain associated with the bleeding? Or does the bleeding seem to come without warning and without pain? Sometimes bleeding could be a skin related issue, or it could be a sign of endometriosis or issue with the cervix.
3. Urine leakage: If you notice you are “peeing” yourself, even if it’s a small amount, when you sneeze, laugh or work out this could be a sign of pelvic floor muscle dysfunction. Many women out of shame are specifically afraid to tell others about this symptom. However, this symptom is common and usually very treatable with physical therapy.
4. Vulvar Skin Irritation: Any number of things can cause changes to the vulvar skin (imbalance of vaginal ecology, allergic reactions, and even skin disorders like psoriasis). Once the vulvar skin becomes irritated it can feel very uncomfortable and painful. These skin irritation and discomfort can lead to pelvic floor muscle dysfunction if not treated.
5. Changes in discharge or odor: This can be an embarrassing symptom to talk about, but changes in discharge or smell are usually indicative of a bigger issue. Some women will also note skin irritation with these changes, thus causing pain. As noted above, if left untreated this irritation can lead to pelvic floor muscle dysfunction.

Sadly women often have the experience of being dismissed by their doctor. If this has been your experience I would encourage you to different find a healthcare provider. Ask friends and family members if they have a doctor they like or check online message boards for recommendations. Another good place to start is seeking an evaluation from a pelvic floor physical therapist. Pelvic floor physical therapists are well connected to other healthcare providers who treat pelvic pain disorders and will make a referral if they believe it is necessary.