Pelvic pain is something many young women live with, often quietly. About one in six women of reproductive age (15–45) experience chronic pelvic pain, yet too often their discomfort is dismissed as “normal period pain” or left unexplained.
Pelvic pain is not a single diagnosis. It is a symptom with many possible causes — from conditions like endometriosis or irritable bowel syndrome (IBS), to muscle tension, nerve pain, or even the way the brain processes pain. Like all chronic pain, it is shaped not only by biology but also by emotional and social factors.
Listening first
The first step in care is listening. Many women simply want their pain acknowledged and explained. Taking time to hear their story can be therapeutic in itself. Tools like a pain diary can help track patterns and triggers. If pain is clearly cyclical, hormonal treatments may be more useful than immediate surgery.
A broader picture
Pelvic pain rarely comes alone. Fatigue, poor sleep, anxiety, low mood, nausea, dizziness, and 'brain fog' often accompany it. These should be seen together as part of a Pelvic Pain Syndrome, not as isolated problems.
Symptoms tend to fall into three broad categories:
• Pain from pelvic organs (sometimes linked to endometriosis)
• Pain from pelvic muscles
• Pain from the nervous system itself
Endometriosis is a common part of this picture. Around one in five girls has severe period pain, and about half of them will be diagnosed with endometriosis at some point. But the severity of pain doesn’t always match the severity of lesions. Importantly, diagnosis is changing - once only confirmed by surgery, it can now often be identified through advanced ultrasound or MRI, thanks to updated international guidelines.
Why diagnosis matters
A confirmed diagnosis can be transformative. It validates a woman’s experience, counters the idea that pain is 'just normal', and guides treatment and life planning.
Treatment: More than surgery
Managing pelvic pain is not just about hormones or surgery. A multidisciplinary approach works best:
• Pelvic floor physiotherapists help relax and retrain muscles
• Pain specialists address nerve‑related pain
• Dietitians support bowel health and reduce flare‑ups
• Psychologists provide coping strategies for the emotional toll
• Fertility specialists help with early planning when needed
Even when surgery is required to remove lesions, it rarely solves everything. Muscle spasm, nerve pain, and fatigue often need ongoing care.
Supporting families and schools
Chronic pain in teenagers can disrupt family life, education, and friendships. Supportive families can help the young woman feel less isolated. Staying engaged with school is especially important: inactivity can worsen muscle stiffness and central pain sensitisation, while social withdrawal deepens the emotional burden.
Empowerment through understanding
Perhaps the most powerful tool is explanation. When women understand why they are in pain, they feel less frightened. Families, too, benefit from clear information and reassurance.
Pelvic pain is real, common, and complex. However, with listening, early support, and a team approach, young women can transition from fear and frustration to clarity, empowerment, and care.
Pain should never be normalised. When we listen, explain, and collaborate, we give young women back their dignity — and their future.
Quick facts about pelvic pain in young women
• Affects 1 in 6 women of reproductive age
• Often linked to endometriosis, but not always
• Symptoms include fatigue, poor sleep, anxiety, and brain fog
• Diagnosis is shifting from surgery to advanced imaging
• Best managed with a multidisciplinary team — not just hormones or surgery
• Staying engaged with school and social life improves outcomes
• Clear explanations empower women and families to take part in care
Dr Johnson Kuttiyil Joseph is a UK-trained, consultant gynaecologist & laparoscopy surgeon working in Nowra, NSW, Australia.
The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.