Psychosomatics of chronic pelvic pain
Pelvic pain is felt low in your tummy, below your belly button. It is called chronic if it lasts six months or more. There are many causes: periods, endometriosis, an ovarian cyst, cystitis, the bowel, infections, and sometimes the cause is hard to find. That does not make the pain imagined. A doctor chooses the treatment. The Ladder method adds questions about what you have endured in silence for years, and it does not replace a doctor.
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When to see a doctor
A gynaecologist usually looks at pelvic pain in women first, sometimes together with a urologist and a gastroenterologist. The doctor asks about the pain and your cycle, examines you, takes swabs and a urine test and does an ultrasound. Sometimes a laparoscopy is needed. Treatment is chosen to fit the cause.
In the Ladder method
In the Ladder method pelvic pain is not explained as "you are punishing yourself for being a woman". You are not to blame. It is worth having a check-up with a gynaecologist first and not giving it up halfway. Questions to yourself belong next to treatment, not instead of it.
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In the method the pelvis fits the image of "support and safety": where you tense up and stay on guard, what you have endured in silence for years, whether you can relax with the people close to you. Many women get used to enduring pain and not talking about it. It is an image, not the cause, and it does not replace treatment.
On the ladder this shows up as the steps "I have to endure it" and "you do not talk about such things". You can work through them at your own pace alongside treatment and physiotherapy.
These are questions for reflection, not an explanation of what causes the condition and not a treatment.
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How it shows up
Book a doctor’s appointment if you notice:
- Pain or heaviness low in your tummy for more than six months
- Pain that gets worse during your period
- Pain during sex
- Pain when you pee or go to the toilet
- Dragging pain in your lower back and thighs
- Pain that makes it hard to sit, work and sleep
What medicine knows
The NHS says pelvic pain is felt low in your tummy, below your belly button. It can be sudden or long-lasting, and it is called chronic if it lasts six months or more.
Common causes are period pain, endometriosis, an ovarian cyst, a urinary tract infection, constipation and irritable bowel syndrome, and sexually transmitted infections. Chronic pain can have several causes at once.
MedlinePlus says the cause of chronic pelvic pain can be hard to find. That does not mean the pain is imagined, and it is worth finishing the tests.
Treatment depends on the cause: antibiotics for an infection, painkillers, hormonal treatment for endometriosis, physiotherapy for the pelvic floor muscles. With long-lasting pain, working with stress also helps alongside treatment. Do not diagnose yourself, see a doctor.
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Frequently asked questions
When is pelvic pain called chronic?
When it lasts six months or more. The pain can be constant or come in waves, for example during your period (NHS).
What does pelvic pain mean in psychosomatics?
There is no proven "meaning". In the Ladder method pelvic pain becomes a reason to ask yourself what you have endured in silence for years and where you are allowed to relax. It is a question to yourself, not a diagnosis.
What if no cause has been found?
The cause of chronic pelvic pain can be hard to find (MedlinePlus). That does not make the pain imagined: it is worth continuing the tests, and pain relief, pelvic floor physiotherapy and working with stress help even without an exact diagnosis.
Related topics
Psychosomatics does not replace tests and treatment. Only a doctor can make a diagnosis.