Top 5 Root-Cause Contributors to Pelvic Pain (That Often Get Overlooked)

For over a decade, I was told my pain was “normal.” That everything looked fine. That maybe it was all in my head.

Spoiler: it wasn’t.

Pelvic pain is complex, and while conventional care often focuses on symptoms, true healing starts when we ask why. Below are five root-cause contributors I see time and time again—many of which are rarely discussed in traditional settings.

1. Hormonal Imbalances

Your hormones influence everything from tissue health to nerve sensitivity. Long-term birth control use (as in my own case) can thin vaginal tissue or disrupt hormone signaling, making conditions like vestibulodynia or dyspareunia more likely.

2. Gut and Inflammatory Issues

Bloating, constipation, and chronic gut inflammation can increase pressure and tension in the pelvic region. Many of my clients with endometriosis, IBS, or SIBO also experience pelvic pain—and healing often requires supporting the gut, not just the pelvis.

3. Nervous System Dysregulation

Chronic stress or trauma can keep the body in a constant state of tension. If your nervous system doesn’t feel safe, your pelvic floor won’t either. This is why we often integrate breathwork, somatics, and nervous system support alongside physical therapy.

4. Postural or Muscular Imbalances

Pelvic floor muscles don’t work in isolation—they’re influenced by the hips, spine, and core. Imbalances here can create chronic tightness, overcompensation, and pain. My background in orthopedics helps me connect those dots.

5. Unprocessed Emotions

Emotions live in the body—and the pelvic bowl often holds onto grief, shame, or fear. While this isn’t always the case, I’ve seen clients make incredible breakthroughs when we hold space for the emotional layer of healing.