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Our Approach to Relieving Pelvic Pain

Pelvic pain can range from being mildly uncomfortable to tremendously debilitating. No matter what level of pain you are experiencing, we care deeply about resolving it at Honu Women’s Health. As our patient, you will have our board-certified OB/GYN, Dr. Aya Sultan, applying her more than 20 years of experience in medicine and research to uncovering the cause of your pelvic pain. Additionally, Dr. Sultan is compassionate, patient and thinks outside-the-box to solve your health-related conundrums and help you achieve your best health.

pelvic pain Honu Women's Health OB / GYN & Aesthetics Physician - Honolulu Hawaii

Potential Causes of Pelvic Pain

There are countless reasons why you could be experiencing pelvic pain and diagnosing the cause may not be immediately identifiable. Therefore, we take the time to obtain a thorough history and perform a comprehensive evaluation to uncover the potential cause(s) of your pelvic pain and thereby offer solutions, when available, rather than prescribing pain medication to just treat the symptom of pain. This means that even when the cause of pelvic pain is determined to not be from a gynecological issue, we will direct you to the appropriate specialty for treatment and care.

Gynecological Causes for Pelvic Pain


Endometriosis and Adenomyosis

These conditions involve an overgrowth of the lining of the uterus, outside the uterus (endometriosis), or an overgrowth of glands and increased bleeding inside the uterine muscle (adenomyosis). Endometriosis is a primary research interest of Dr. Sultan, who uses her expert knowledge to help patients reverse its symptoms.

Menstrual cramps

These throbbing or cramping pains can be severe enough to interfere with everyday activities and can be exacerbated by underlying conditions such as endometriosis or uterine fibroids.

Uterine Adhesions

Can occur after surgery or infections in the uterine cavity. Uterine adhesions can form when scar tissue builds up between the inner walls of the uterus, leading to the walls binding together.

Uterine Fibroids and Polyps

These growths of the uterus almost never develop into cancer and can often present without symptoms, but their size and location can also lead to pelvic pressure or pain and even painful periods.

Ovarian cysts

These fluid-filled sacs in the ovaries usually form during ovulation. Although they are common, sometimes they can cause intense levels of pain when they rupture.

Pelvic Inflammatory Disease (PID)

This is a type of infection of the female reproductive organs that usually occurs when sexually transmitted bacteria spread from the vagina. While it can occur with no signs or symptoms, it can also present with symptoms of fever, pelvic and/or abdominal pain, painful urination, painful sex, and other pain-related symptoms.

Fallopian or Ovarian Torsion

Sometimes the fallopian tubes or ovaries can become twisted and result in pain. Many times, these organs will untwist on their own, but other times, they require surgical intervention.


This term refers to pain affecting the vulva, which is the external female genitalia area. Symptoms last for three months or longer and are not caused by infection, skin disorder, or other medical conditions.


Painful sex, can be deep or superficial and may result from a range of factors including insufficient lubrication to uterine position, current or past infection, congenital problem or previous surgery, to name a few.

Psychological Problems

Stress, anxiety, depression, or even a history of abuse, can all contribute to the manifestation of pelvic pain.


Cancer of the ovaries, fallopian tubes, and/or uterus can present as pain. Therefore, evaluation will depend on not just your past medical history, but also a careful determination of your family history and risk factors and a thorough evaluation.

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Non-Gynecologic Causes for Pelvic Pain

Gastrointestinal Issues

  • Constipation
  • Irritable bowel syndrome (IBS) and
  • Inflammatory bowel disease (IBD)
  • Crohn’s disease
  • Cancer

Genitourinary Issues

  • Urinary tract infection (UTIs)
  • Kidney stones
  • Kidney infections

Diagnosing the Cause of Pelvic Pain

If you are living with pelvic pain, Dr. Sultan will begin the evaluation process by conducting a thorough history and pelvic exam. During the exam, your comfort is a priority and the exam will not be rushed. Next, lab tests will be conducted to assess blood cell counts and identify any potential infections. These results may uncover the cause of your pelvic pain and guide your course of treatment.

If the cause of your pelvic pain is still unclear, Dr. Sultan may order an ultrasound to be completed in the convenience and comfort of our office. Other imaging tests, such as abdominal x-rays, CT scans or MRIs may also be needed to help detect abnormal structures or growths that could be causing your pelvic pain.

If these efforts are unsuccessful, the next step in diagnosing the cause of your pelvic pain is a diagnostic laparoscopy. This procedure allows Dr. Sultan to view pelvic organs and is especially useful in detecting and treating endometriosis, chronic PID, and adhesions. Discovering the reason for your pelvic pain is paramount to the success of your personalized treatment plan developed by Dr. Sultan. Your pain relief and safety are her top priorities.

Types of Therapies for Pelvic Pain

The cause of your pelvic pain will dictate the type of treatment you receive in order to achieve the best results. Depending on your unique situation, you could be prescribed any of the following pelvic pain treatments:

Pain Relievers

While in some instances a prescription pain reliever may be necessary, women with pelvic pain often benefit from over-the-counter pain remedies such as ibuprofen or acetaminophen.

Lifestyle Remedies

During your examination, Dr. Sultan will ask questions about your lifestyle, including your nutrition intake, stress levels and more. By learning more about your daily routine, Dr. Sultan may be able to make recommendations on how you can reduce your pelvic pain naturally by making lifestyle adjustments.

Hormone Therapy

Hormone therapy is prescription medication that contains female hormones (estrogen and progesterone) or general hormones (thyroid and melatonin) to replace the ones that your body lacks. A simple blood test will reveal the levels of your hormones and provide a glimpse into why you may be experiencing certain health issues.


If your pelvic pain is caused by infection, antibiotics can eliminate the infection and in turn, your pelvic pain.

Select Trigger Point Injections

Trigger point injections consisting of a steroid and local anesthetic can offer immediate pelvic pain relief. This is a nonsurgical, minimally invasive technique geared to women who experience pelvic pain that is resistant to other therapies.

Antidepressants or Psychotherapy

At Honu Women’s Health, we believe mental health is among the most important aspects of total body health. Even for women who do not have depression or other mental illnesses, antidepressants can be helpful in treating chronic pelvic pain. Psychotherapy can help develop women develop strategies for coping with pain, including cognitive-behavioral therapy and biofeedback.

Physical Therapy

Certain stretching exercises, massage, and relaxation techniques can reduce pelvic pain by loosening tight muscles.


Endometriosis can often be treated through laparoscopic surgery, where a slender viewing instrument (laparoscope) is inserted through a small incision near your navel. If tissue overgrowths need removal, additional instruments are inserted through one or more small incisions. For intra-uterine pathology, a simple hysteroscopic surgery, where a camera is inserted through the cervix into the uterine cavity, may be performed in the office to treat conditions such as uterine adhesions, polyps, or fibroids. For more complicated issues that are causing pelvic pain, Dr. Sultan may recommend more complex surgery as a last resort.

Start Optimizing Your Health Now

Honu Women’s Health is committed to looking at every patient’s total body health, encompassing mind, body and spirit. Even if pelvic pain is one of many issues you are experiencing, Dr. Sultan will apply her unique expertise to solving your personal health quandaries. Here, we embrace the fact that every woman has uniqueness and that a personalized health care plan is the ideal way to improve health and experience a renewed quality of life.

Contact us today to take the first step toward feeling better!