Pelvic Pain
What is pelvic pain? Pelvic pain can be felt differently for all women, from a dull ache to intense pain. Most commonly, women describe feeling a sudden sharp pain, a dull ache or cramping that may come and go. What causes pelvic pain? Pelvic pain is usually caused by bowel issues such as constipation, urinary tract infections, ovarian cysts, endometriosis, period pains. What
What it is
In women, common causes include endometriosis, adenomyosis, pelvic congestion, pudendal neuralgia, interstitial cystitis / bladder pain syndrome, and musculoskeletal pelvic-floor dysfunction. In men, chronic pelvic pain syndrome, pudendal neuralgia and chronic prostatitis are common. Structured assessment is the difference between years of "you'll just have to live with it" and a real plan.
Symptoms and signs
- Persistent or recurrent pelvic pain lasting more than 6 months.
- Pain on intercourse, defecation or urination.
- Cyclical pain with menstrual periods (consider endometriosis / adenomyosis).
- Burning, stinging or "sitting on a golf ball" sensation (pudendal neuralgia, pelvic-floor dysfunction).
- Urinary urgency, frequency or persistent bladder pain (interstitial cystitis).
How we investigate
Structured history, pelvic examination (with gynaecology / urology cross-referral as appropriate), pelvic ultrasound, MRI pelvis with endometriosis protocol, urodynamics where indicated, cystoscopy in selected cases.
Treatment options at The Vesey
- Identify and treat the underlying cause — endometriosis, adenomyosis, fibroids, interstitial cystitis, prostatitis all have specific pathways.
- Pelvic-floor physiotherapy — first-line for muscle-driven pelvic pain in both sexes.
- Neuropathic pain pharmacotherapy for pudendal and centrally-sensitised pain.
- Pudendal nerve, ganglion impar and superior hypogastric plexus blocks — image-guided, performed by Dr Arul James.
- Hormonal management — Mirena IUS, GnRH analogues for endometriosis-driven pelvic pain.
- Coordinated MDT — pain medicine, gynaecology, urology and clinical psychology working together.
What is pudendal neuralgia? +
Pudendal neuralgia is pain in the distribution of the pudendal nerve — perineum, genitals, anus and inner thighs. It is often described as burning, stinging or a "sitting on a stone" sensation, worse sitting and relieved standing or lying. It is underdiagnosed and responds well to targeted treatment including pudendal nerve blocks.
Can men get chronic pelvic pain? +
Yes. Chronic pelvic pain syndrome (CPPS) in men is relatively common. It causes pain in the perineum, testicles, penis and lower abdomen, sometimes with urinary or ejaculatory symptoms. It is not always due to prostatitis and often has a neuropathic component that responds to pain medicine approaches.
What is a superior hypogastric plexus block? +
The superior hypogastric plexus is a nerve network in front of the sacrum that carries pain signals from the uterus, bladder and rectum. An image-guided block of this plexus can significantly reduce pelvic pain from endometriosis, adenomyosis, bladder pain syndrome and pelvic congestion. Dr Arul James performs this procedure at The Vesey.
Is pelvic floor physiotherapy helpful for pelvic pain? +
Yes. For both men and women with muscle-driven pelvic pain — hypertonic pelvic floor, levator ani syndrome or vaginismus — specialist pelvic floor physiotherapy is first-line treatment and can be highly effective. We work with specialist pelvic physiotherapists and co-ordinate referral as part of the pain plan.
Pricing at a glance
Initial pain medicine consultation £260. MRI pelvis from £550. Pelvic nerve blocks from £750. Insurance accepted: BUPA, Vitality, AXA, WPA, Cigna, Aviva, Healix.
Book an appointment
When to see a specialist
Book if you have had pelvic pain for more than 6 months that has not been adequately investigated, or if you have a diagnosis but feel your treatment plan is incomplete.
Cost and pathway
Initial pain medicine consultation £260. MRI pelvis from £550. Pelvic nerve blocks from £750.
- Open 7 days including Sundays — 8am to 8pm, no weekend surcharge
- No GP referral required — book directly with our pain medicine team
- Sutton Coldfield location — serving Birmingham, Walsall, Tamworth, Lichfield and the West Midlands
- CQC-regulated — rated 4.87/5 on Doctify from 700+ verified reviews
View our pain medicine services →
Sutton Coldfield · Birmingham · Walsall · Tamworth · Lichfield · West Midlands · Open 7 days 8am–8pm
Open 7 days · 8am–8pm · 0121 387 3727