Pelvic pain most often occurs in the lower abdomen area. Considered chronic if the pain lasts six months or more, the source of pelvic pain is often difficult to diagnose. While underlying infection may be the cause of some cases of pelvic pain, Dr. McDonald has found the vast majority of cases of pelvic pain are not organ-based, but neuropathic.

Perineal pain problems may be due to surgical diseases such as hemorrhoids, rectal fissures or abscesses. These are not difficult to distinguish from the gynecologic problems of Bartholin's gland infection and an abscess, and skene's glands urthritis. Pain, tenderness, and dyspareunia are the common symptoms. Diagnosis must be made by a careful digital physical examination and culture of the affected area.

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