In such instances of chronic pelvic pain, we may need to get a pelvic examination by the Gynecologist, a high vaginal swab for gm stain and culture and a pelvic ultrasound (also to look at the post void residual urinary volume). The therapeutic options for whatever is detected can be limited to: (Pasted from http://www.upointmd.com/therapic_page.php )

Antibiotics

May be helpful for patients with the Infection domain. Should only be used to treat positive cultures.

Pelvic Physical Therapy

May be helpful for patients with the Tenderness of Skeletal Muscles domain

Pelvic floor physical therapy is the best technique to treat pelvic floor spasm. Therapy may include myofascial release, stretching and paradoxical relaxation.

Dietary Modifications

May be helpful for patients with Urinary or Organ Specific domains

Some people find certain food triggers that worsen symptoms. They are not the same for everybody, but common ones include caffeine, spicy foods, alcohol and wheat products. Try eliminating from the diet and see the impact on symptoms. If elimination doesn't help at all, you don't need to keep avoiding them.

Psychologic support

May be helpful for patients with the Psychosocial domain

Pelvic pain is not "all in your head" but having chronic pain can increase stress, cause depression and make other stressful events in life more difficult to handle. Depression can be treated with counseling and medication. Cognitive behavioral therapy and stress reduction can greatly reduce the impact of symptoms. Short term therapy with anti-anxiety medications may be used with caution during a symptom flare.

best wishes,
ArogyaUDHC team

PS: Rakesh Biswas is morally and legally responsible for this suggestion and ArogyaUDHC team is working under the hypothesis that informational support (such as this) for the patient and local physician is likely to be beneficial toward achieving better health outcomes."