Chronic Pelvic Pain — Treatment in Nagpur
Pain that is not tied to your cycle, and that nobody has yet explained. Assessed from the beginning by Dr. Kunda Shahane, who takes the history, performs the scan and holds the plan.
Chronic pelvic pain is pain in the lower abdomen or pelvis lasting six months or longer that is not confined to your periods. It is a description, not a diagnosis, and that is the whole difficulty: the pelvis holds the uterus and ovaries, the bowel, the bladder, muscles, ligaments and nerves, and every one of them can produce pain that feels the same from the inside. Most women who come here have already seen several doctors and been told their reports are normal. The purpose of this consultation is to assess all of those systems together, in one place, and to leave with a plan rather than another normal report.
Why this is so often missed
Pelvic pain is usually investigated one specialty at a time. A gynaecologist examines the uterus and ovaries, finds them normal and says so honestly. A physician considers the bowel, finds nothing and says so honestly. A urologist does the same for the bladder. Each is right within their own field, and the woman is left with three normal opinions and the same pain.
What is missing is the step where all of it is considered together, alongside the pelvic floor muscles and the nerves, which no scan shows and which very few assessments include. Pain during intercourse, pain that worsens on sitting, pain that moved after a difficult delivery — these point towards muscle and nerve rather than organs, and they are found by history and examination rather than by imaging.
The other thing missed is time. Pain present for years changes the way the nervous system processes signals, so the pain persists after the original cause has settled. That is a physical process with a name and with treatments. It is not the same as the pain being imagined, and a woman who has been quietly told it might be is owed that correction.
What can cause it
More than one of these is often present at the same time, which is part of why single-cause thinking fails here.
Endometriosis
The commonest gynaecological cause. Often invisible on ultrasound when superficial, which is why symptoms carry more weight than the scan.
Adenomyosis
Tissue growing into the muscular wall of the uterus, typically with heavy periods and a dragging ache.
Adhesions
Internal scarring after surgery, caesarean section or infection, binding organs that should move freely.
Chronic pelvic infection
Long-standing or inadequately treated infection, which may have caused little pain at the time.
Bowel and bladder
Irritable bowel syndrome and bladder pain syndrome both produce pain women reasonably assume is gynaecological.
Pelvic floor and nerve pain
Sustained muscle spasm or nerve irritation. No scan shows it; examination finds it; physiotherapy treats it.
How the assessment works
Starting from the beginning is not a criticism of the doctors you have already seen. It is the only way to see the pattern, and the pattern is usually where the answer is.
- The history, at lengthWhere the pain is, when it began, what makes it better and worse, how it relates to your cycle, your bowels, your bladder and intercourse, what you have already tried, and what happened when you tried it. This is the part that most often produces the answer and it cannot be rushed.
- Your previous reportsBring all of them, including the normal ones. A series of normal scans over three years tells us something a single scan cannot, and a treatment that briefly helped is diagnostic information.
- ExaminationIncluding assessment of the pelvic floor muscles and of specific tender points, which is the step most often left out. Explained beforehand, and you may decline any part of it.
- UltrasoundPerformed by Dr. Kunda herself, so the scan is guided by your symptoms rather than done to a standard protocol and reported by someone who has not met you.
- Tests where indicatedSwabs where infection is possible, blood tests, and urine testing where the bladder is implicated.
- A plan with a next stepIncluding what to do if the first treatment does not work. That second branch is the part usually missing, and its absence is why women end up starting again with a new doctor.
Treatment
Treating a cause that is found
Endometriosis, adenomyosis, fibroids, ovarian cysts and infection each have their own treatment, medical or surgical. Where laparoscopic surgery is needed, Dr. Kunda performs it herself at a hospital in Dhantoli where she is attached.
Suppressing the cycle
Where the pain clearly varies with your cycle, hormonal treatment — the combined pill, progestins, or a hormonal intrauterine system — often reduces it substantially, and the response is itself informative about the cause.
Treating the pain itself
Pain relief is prescribed and reviewed rather than repeated indefinitely, and it is treatment in its own right while the cause is being worked out. Sleep and exhaustion are addressed too, because long-term pain and poor sleep worsen each other.
Pelvic floor physiotherapy
Where examination points to muscle spasm, referral to a physiotherapist trained in pelvic health is arranged. This treats something no medicine and no operation will fix, and it is frequently the missing piece in women who have had normal investigations for years.
Referral, with the plan retained
Where the cause lies with the bowel, the bladder or the musculoskeletal system, Dr. Kunda refers to the appropriate specialist and keeps the follow-up herself, so you are not handed over and left to coordinate your own care between three departments.
Worth doing
- Bring every previous report and scan, including the normal ones
- Keep a short diary for two or three weeks before the visit — when the pain comes, what you were doing, where you were in your cycle
- Mention pain during intercourse, bowel and bladder symptoms, even though they feel like a different doctor’s problem
- Say what you have already tried and whether it helped, even briefly
- Expect more than one visit, and ask what the next step is if this one does not work
Not worth doing
- Concluding that a normal scan means there is nothing to find
- Starting again with a new doctor every time one treatment fails
- Taking painkillers indefinitely without anyone reviewing why they are still needed
- Leaving out bowel, bladder or sexual symptoms because they feel unrelated
- Accepting that the pain is imagined because the tests were normal
Which page do you need?
Three related questions bring women in with pelvic pain. This page is for pain that is not tied to your cycle and has no diagnosis yet. If your question is whether your period pain is normal, start with painful periods. If you have been given the word endometriosis, or you suspect it from what you have read, read endometriosis.
Who looks after you afterwards
The doctor who takes the history performs the scan, interprets it as the clinician who examined you, prescribes the treatment and reviews whether it worked. In chronic pelvic pain that continuity is not a comfort, it is the method — the diagnosis often emerges from what happens over two or three visits, and that thread is lost every time care passes to someone new. Where a referral is needed, the plan stays here.
What it costs
| Consultation | ₹500 |
|---|---|
| Follow-up visit | ₹500 |
| Ultrasound, tests and medicines | Charged separately, depending on what is indicated |
| Laparoscopy, if needed | Billed by the hospital, not by the clinic — discussed in advance |
The consultation is charged in addition to any scan performed on the same visit. Charges can change at any time without prior notice — please confirm with clinic reception before your visit. See the full fee list.
Questions women ask
What counts as chronic pelvic pain?
Pain in the lower abdomen or pelvis lasting six months or longer, which may be constant or come and go, and which is not confined to your periods. It is a description rather than a diagnosis — the point of a consultation is to work out what is causing it.
Why has nobody been able to find the cause?
Because the pelvis contains the reproductive organs, the bowel, the bladder, muscles, ligaments and nerves, and all of them can produce pain that feels identical. A gynaecologist who looks only at the uterus and ovaries will miss a bladder or bowel cause, and a physician who looks only at the bowel will miss endometriosis. The answer is usually found by assessing all of them in one consultation rather than in sequence over years.
Does a normal ultrasound mean nothing is wrong?
No, and this is one of the most common reasons women give up seeking help. Ultrasound shows fibroids, ovarian cysts, endometriomas and signs of adenomyosis very well. It does not show superficial endometriosis, adhesions, nerve pain or pelvic floor muscle pain at all. A normal scan narrows the list; it does not close the question.
Could it be something other than a gynaecological problem?
Frequently, yes. Irritable bowel syndrome, bladder pain syndrome, pelvic floor muscle spasm and nerve-related pain are all common causes of pain that women reasonably assume is gynaecological. Dr. Kunda assesses for these too, and refers to the right specialist when the cause lies outside her field — while keeping the follow-up plan rather than handing you over.
Is the pain in my head if the tests are normal?
No. Pain that has been present for a long time changes how the nervous system processes signals, so the pain becomes real and self-sustaining even when the original trigger has settled. That is a recognised physical process, not an imagined one. It also responds to treatment, but to different treatment than a cyst or an infection would.
What will happen at the first consultation?
A long history — where the pain is, what makes it better or worse, how it relates to your cycle, bowels, bladder and intercourse, and what you have already tried. Then an examination, and an ultrasound performed by Dr. Kunda herself. Bring every previous report and scan you have, even the ones you were told were normal, because the pattern across them is often more useful than any single result.
Will I need a laparoscopy?
Not usually at the first step. It is considered where endometriosis or adhesions are strongly suspected and treatment has not worked, or where the diagnosis remains unclear after thorough assessment. Dr. Kunda performs both diagnostic and therapeutic laparoscopy herself at a hospital in Dhantoli where she is attached. It is a decision made together, not a routine next step.
What is pelvic floor physiotherapy and why would I need it?
The muscles of the pelvic floor can go into a sustained spasm, in the same way a shoulder or jaw can, and that spasm causes genuine pain including pain during intercourse. It is commonly missed because no scan shows it. A physiotherapist trained in pelvic health treats it directly, and Dr. Kunda arranges the referral where the examination points that way.
Can it be treated if no cause is found?
Yes. This is important, because being told nothing is wrong often ends the conversation when it should start a different one. Pain itself can be treated — with medication, with physiotherapy, by managing the cycle if the pain varies with it, and by addressing sleep and the exhaustion that long-term pain causes. Not finding a lesion is not the same as having nothing to offer.
What symptoms mean I should be seen sooner?
New pain that is severe or came on suddenly; pain with fever; bleeding after intercourse or between periods; any bleeding after the menopause; unexplained weight loss; a change in bowel habit that has lasted several weeks; or difficulty passing urine. These need assessing promptly rather than being added to a long-standing problem.
How long does it take to get an answer?
Often more than one visit, and it is fairer to say so than to promise otherwise. Some causes are clear at the first consultation. Others become clear only by seeing whether a treatment works, which is itself diagnostic information. What should not happen is being sent away with painkillers and no plan for what happens if they do not work.
What does it cost?
The consultation is ₹500 and a follow-up visit is ₹500. Scans, tests and medicines are charged separately, depending on what is indicated. Charges can change at any time without prior notice — please confirm with clinic reception on 0712 6692706.
Finding the exact cause of pelvic pain can be difficult because no single test shows everything. You may have already visited several doctors, but let's start fresh from the basics. By carefully piecing together your symptoms, previous reports, and a detailed ultrasound, we will create a clear, step-by-step medical plan.Dr. Kunda Shahane MBBS · MS (Obs & Gynae) · FIFM · FMF (London)
Written and medically reviewed by Dr. Kunda Shahane, MBBS · MS (Obs & Gynae) · FIFM · FMF (London) · Last reviewed: 4 September 2026
Related pages
Speak to Dr. Kunda Shahane about pelvic pain
Bring your previous reports, including the normal ones. Consultations in English, Hindi and Marathi.
Mayflower Clinic, Surdham Complex, Behind Silver Palace Building, 2nd Lane from Panchsheel Square, Opp. Yashwant Stadium, Dhantoli, Nagpur – 440012 · Monday–Saturday, 10:00 AM – 6:00 PM · Sunday closed
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