May is Pelvic Health Awareness Month , a time to shine a light on the vital role the pelvis and
pelvic floor play in women’s overall well-being. Pelvic health involves taking care of the muscles
and organs in the lower belly so they function properly and feel good. Yet many women don’t
realize how important pelvic health is until problems arise. In fact, about one in three women will
experience a pelvic health condition at some point in their lives, and these conditions can
significantly impact daily comfort and quality of life. This month (and every month), we aim to
raise awareness, educate, and encourage open conversation about pelvic health
Common Pelvic Health Concerns
Women’s pelvic health can be affected by several common conditions. Here is a brief overview:
● Pelvic Organ Prolapse: This occurs when the muscles and tissues that support pelvic
organs (like the uterus, bladder, or rectum) weaken or loosen. As a result, an organ can
“drop” or press into the vaginal canal. Women with prolapse may feel a bulge or
heaviness in the pelvis, especially during activities or lifting, and sometimes experience
bladder or bowel changes. Many women are embarrassed to discuss these symptoms,
but prolapse is treatable with options like pelvic floor therapy, pessary devices, or
surgery
● Urinary Incontinence: Incontinence is the involuntary leakage of urine, ranging from
occasional drips (for example, when coughing or sneezing) to a sudden strong urge that
can’t be controlled. It affects about one in three women worldwide, often related to
pregnancy, childbirth, or menopause. Importantly, urinary incontinence is not a normal
part of aging and is treatable Treatments include pelvic floor muscle exercises and
other therapies. Early help can prevent it from seriously affecting daily life.
● Endometriosis: Endometriosis happens when tissue like the uterine lining grows
outside the uterus, on ovaries, fallopian tubes, or other pelvic sites This condition
affects roughly 10% of women of reproductive ageIt often causes severe pelvic pain
(especially with periods or intercourse), heavy menstrual bleeding, and sometimes
infertility Endometriosis can lead to chronic inflammation, scar tissue, and painful
adhesions, so early diagnosis and management are crucial.
● Chronic Pelvic Pain: Chronic pelvic pain is ongoing, non-cyclic pain in the pelvis lasting
six months or longer. It can have many causes (or even none clearly identified) and often
coexists with other issues like endometriosis, irritable bowel syndrome, or interstitial
cystitis Studies estimate that 6–27% of women worldwide suffer from chronic pelvic
pain. Because it can be complex, successful management usually involves a
multidisciplinary approach (medication, therapy, physical therapy, etc.) tailored to each
woman.
● Uterine Fibroids: Fibroids are benign (non-cancerous) tumors that grow in the wall of
the uterusThey are very common – up to 80% of women have fibroids by menopause –
though many have no symptoms. When fibroids do cause problems, women may
experience heavy menstrual bleeding, pelvic pain or pressure. Large fibroids can press
on the bladder or bowel, leading to urinary frequency or constipationTreatments range
from medication to minimally invasive procedures, depending on symptoms and goals.
Each of the above issues is common in women’s health and highlights why paying attention
to pelvic symptoms is so important. Future posts in this series will explore these topics in
depth, but first it’s key to recognize them and know that effective care is available.
Early Detection and Open Conversation
Early diagnosis and regular gynecologic care are vital for pelvic health. Women’s health
providers are trained to evaluate pelvic concerns. During a routine exam, your provider can
check for issues or recommend tests (like pelvic ultrasound) and treatments (such as pelvic floor
physical therapy) if needed If you notice any changes – for example, new pelvic pain, unusual
pressure, or bladder/bowel leaks – do not hesitate to mention them. Many women feel
embarrassed to bring up pelvic symptoms or think they are “just normal,” but that silence can
delay help
Remember that urinary incontinence and pelvic pressure are not “normal” parts of aging,
and there is nothing shameful about seeking help. Talking openly with your doctor can lead
to earlier, less invasive treatments. In fact, learning about the pelvic floor can help you spot
problems early. Being informed makes you an active partner in your care. Regular checkups
also allow your provider to address other aspects of pelvic health (for example, discussing
pelvic floor exercises, lifestyle changes, or preventive screenings). In short, don’t wait to speak
up – early action can make pelvic conditions much easier to manage.
Ready to Take the Next Step?
Dr. Hema Jonnalagadda and the team at Advocare Montgomery Gynecology are committed to
providing compassionate, expert care for all aspects of women’s pelvic health.
If you’re experiencing symptoms or simply want to stay proactive, we’re here to help.
👉 Visit our practice page to learn more or book an appointment today.
Your pelvic health matters—and you don’t have to navigate it alone.
What endometriosis actually is
Endometriosis is a condition in which tissue similar to the lining of the uterus grows outside the uterus. As the WHO describes it, this tissue causes inflammation and scar tissue, most often in the pelvis, and sometimes elsewhere in the body. It affects an estimated 10% of reproductive-age women worldwide, about 190 million people. It is a chronic disease, and there is currently no cure, though symptoms can be managed well with the right care.
Common symptoms
Pain severe enough to interfere with school, work, or daily life is not something to push through quietly. Common symptoms include:
- Painful periods (dysmenorrhea)
- Pain during intercourse (dyspareunia)
- Pain during bowel movements or urination
- Heavy menstrual bleeding
- Chronic pelvic pain that continues after your period ends
- Bloating, nausea, or fatigue
- Difficulty getting pregnant alongside any of the above
Why diagnosis took so long, and why that is changing
The old model treated laparoscopy as the only way to be sure. Because surgery carries risk, cost, and access barriers, many women waited years while their pain was normalized. The WHO puts the average time for diagnosis at 4 to 12 years. ACOG's clinical practice guideline shifts the entry point: clinicians should suspect endometriosis from symptoms, and can start treatment after a clinical diagnosis, rather than requiring surgery first. The WHO now agrees that a clinical diagnosis may be made from symptoms and imaging, and that surgery is not necessarily required before starting treatment.
What does NOT diagnose endometriosis
There is currently no blood test to diagnose endometriosis. ACOG strongly recommends against using blood, urine, or other biomarker tests to diagnose the condition, because none of them are as accurate as symptom-based assessment, imaging, or surgical confirmation. If you see a direct-to-consumer test marketed as a way to confirm endometriosis from a blood or saliva sample, current guidance does not support it as a diagnostic tool.
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When is surgery actually needed?
Surgery is no longer required simply to diagnose endometriosis. Under the latest ACOG guidance, it is reserved for specific situations:
- Severe, uncontrolled symptoms that do not respond to medication
- Deep infiltrating endometriosis lesions
- Ovarian endometriosis (endometriomas, sometimes called chocolate cysts)
- Fertility-related indications, such as blocked fallopian tubes before IVF
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How endometriosis is treated
Treatment is individualized. It depends on symptom severity, your preferences, side effects, and whether you are trying to become pregnant. Based on WHO and ACOG guidance, the main options are:
- Pain relief: non-steroidal anti-inflammatory drugs such as ibuprofen or naproxen
- Hormonal therapy: combined hormonal contraceptives, progestins (including the hormonal IUD), or GnRH analogues
- Surgery: minimally invasive removal of lesions, adhesions, and scar tissue when medication is not enough
- Fertility care: ovulation induction, intrauterine insemination, or IVF for those trying to conceive
- Whole-person support: physiotherapy and cognitive behavioral therapy can help reduce pain and improve quality of life
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Where surgery still fits
The new guidance does not mean surgery disappears. It means surgery is no longer the price of admission for being believed. When surgery is the right step, it can often be done through minimally invasive techniques, including daVinci robotic gynecologic surgery, which is designed for precision and shorter recovery. The point is sequencing: you should not have to wait for an operation to start feeling better.
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The honest limits.
A clinical diagnosis from symptoms and imaging is not as accurate as visual confirmation at laparoscopy, so some uncertainty can remain. Ultrasound can miss superficial disease, which is why a normal scan does not fully rule endometriosis out. There is no cure, and symptoms can recur even after successful treatment. None of this is a reason to wait years for care. It is a reason to start the conversation now.
Getting evaluated in Plymouth Meeting
Evaluation can begin with your history and an in-office pelvic ultrasound, using wireless ultrasound technology at the point of care. Dr. Hema Jonnalagadda, a Fellow of the American College of Obstetricians and Gynecologists, builds a plan around your symptoms and your goals, whether that is pain relief, fertility, or both. You do not have to prove your pain through surgery to be taken seriously.
Frequently asked questions
About the author & sources
Dr. Hema Jonnalagadda, MD, FACOG, is the founding physician of Advocare Montgomery Gynecology in Plymouth Meeting, PA, and a Member of The Menopause Society. She provides evidence-based women's health care from adolescence through menopause.
This article is for general education and is not a substitute for individual medical advice. If you are in severe pain or have new or concerning symptoms, please consult your provider.
Sources (primary)
- World Health Organization. Endometriosis fact sheet (updated October 15, 2025). https://www.who.int/news-room/fact-sheets/detail/endometriosis
- American College of Obstetricians and Gynecologists. Clinical Practice Guideline on evaluation and diagnosis of endometriosis, Obstetrics & Gynecology (2026). https://www.acog.org
- World Health Organization. Infertility fact sheet (2025). https://www.who.int/news-room/fact-sheets/detail/infertility
