You Don't Have to Live With Pelvic Pain: How SoLa Therapy Is Changing the Conversation

Pelvic pain is one of the most common and most dismissed complaints in women's health. 

Women are told it is normal. They are told to take ibuprofen, use a heating pad, and come back if it gets worse. They are handed a referral to a specialist they won't see for three months. And in the meantime, they continue to live with pain that affects their sleep, their relationships, their ability to work, their sense of self. 

At Lamorinda Women's Health, we take pelvic pain seriously. Because it is serious. And because there are now evidence-based, effective treatments available inclusing one you may never heard of that can make a real difference. 

What Is Pelvic Pain?

Pelvic pain refers to any discomfort in the lower abdominal or pelvic region-below the belly button and between the hip bones. It can be sharp or dull, constant or intermittent, mild or debilitating. It may occur during your period, during intercourse, during urination, during bowel movements, or at seemingly random times throughout the day. 

Pelvic pain is considered chronic when it persists for six months or longer. It can be sharp or dull, constant or intermittent, mild or debilitating. It may flare with your period, with intercourse, with urination or bowel movement, with exercise, or after sitting for long periods. 

It is far more common than most people realize. Chronic pelvic pain affects approximately 1 in 7 women in the United States. Yet many women see multiple doctors over several years before getting an answer, because the causes are varied, often overlap, and are easy to miss in a short visit.

Pelvic pian is common. It is not normal. And it is not something you simply have to live with.  

What Causes Pelvic Pain?

Pelvic pain can have many different underlying causes and in many cases more than one factors is involved. At Lamorinda Women's Health, Dr. Hajyan takes a thorough, investigative approach to identifying what is driving your pain rather than simply treating the symptoms. 

Gynecologic Causes

• Endometriosis

One of the most common and commonly missed causes of pelvic pain. Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus, causing inflammation, scarring, and pain that can be severe. It is estimated to affect 1 in 10 women of reproductive age, yet the average time to diagnosis is still 7-10 years. Pain is often cyclical, worsening around menstruation but can also be constant and debilitating.

• Adenomyosis

Similar to endometriosis, adenomyosis involves endometrial tissue growing into the muscular wall of the uterus itself, causing heavy, painful periods, chronic pelvic pressure, cramping, and an enlarged, tender uterus. It is frequently underdiagnosed and often coexists with endometrosis. 

• Uterine Fibroids

Noncancerous growths in or on the uterus that can cause pressure, heaviness, painful periods, pelvic fullness, and chronic pelvic discomfort particularly as they grow in size or number. 

• Ovarian Cysts

Fluid-filled sacs on or within the ovaries that can cause pelvic pain, pressure, or a dull ache particularly when they rupture, bleed, or undergo torsion (twisting), which can cause sudden, sever, pain requiring urgent evaluaiton. 

• Ovarian Torsion 

A gynecologic emergency in which the ovary twists around its supporting ligaments, cutting off blood supply. Presents as sudden, severe, one-sided pelvic pain often accompanied by nausea and vomiting. Requires prompt evaluation. 

• Pelvic Inflammatory Disease

Infection of the reproductive organs often from untreated sexually transfmitted infections such as Chlamydia or Gonorrhea that can cause acute or chronic pelvic pain, fever, discharge, and painful intercourse. If left untreated, PID can lead to scarring and fertility problems. 

• Cervical Stenosis

Narrowing of the cervical canal that can obstruct menstrual flow, causing significant menstrual cramping, pelvic pressure, and pain often underrecognized as a cause of chronic pelvic pain. 

• Adhesions

Adhesions are bands of scar tissue after surgery, infection, or endometriosis. 

• Ectopic Pregnancy

A pregnancy that implants outside the uterus most commonly in the fallopina tube, causing one sided pelvic pain that may be sharp or cramping, with or without vaginal bleeding. A medical emergency requring immediate evaluation. 

• Uterine Polyps

Overgrowths of the uteirne lining that can cause irregular bleeding, spotting, cramping, and pelvic discomfort often identified on ultrasound or hysteroscopy. 

Pelvic Floor & Musculoskeletal Causes

• Pelvic Floor Dysfunction

The muscles, ligaments, and connective tissue of the pelvic floor support the bladder, blowel, and uterus. When these muscles are too tight, too woeak, or in spasm from childbirth, surgery, trauma, or chronic tension, the reuslt can be significant pelvic pain, pressure, and dysfunction. Pelvic floor dysfunction is one of the most common and most underrecognized causes of chronic pelvic pain. 

• Levator Ani Syndrome

Chronic spasm or tension of the Levator Ani, the primary muscle group of the pelvic floor, causing deep pelvic aching, pressure, and pain that worsens with sitting and improves with walking or lying down. 

• Coccydynia 

Pain centered at the coccyx (tailbone) that can radiate into the pelvic floor often following a fall, childbirth, or prolonged sitting. Can significantly contribute to chronic pelvic pain. 

• Pubic Symphysis Dysfunction

Instability or inflammation of the pubic symphysis, the joint connecting the two sides of the pelvis, causing pelvic pain that worsens with walking, climbing stairs, or spreading the legs. 

• Myofacial Pelvic Pain (pelvic floor tension)

Tight, overactive pelvic floor muscles. Common, and frequently overlooked. 

• Abdominal Wall Pain & Trigger Points

Myofascial trigger points localized areas of muscle tension in the abdominal wall or pelvic floor that refer pain into the pelvis and are frequently missed as a source of chronic pelvic pain. 

• Hip and Sacroiliac Joint Problems

These can refer pain into the pelvis. 

Vulvar & Vaginal Causes

• Genitourinary Syndrome of Menopause (GSM)

Declining Estrogen during perimenopause and menopause causes thinning and dryness of the vaginal and vulvar tissues leading ot pain, burning, and discomfort that worsens over time if left untreated. GSM is extremely common and extremely undertreated. 

• Vulvodynia & Vestibulodynia 

Chronic vulvar pain or burining without an identifiable cause often described as stinging, rawness, or irritation that can make sitting, wearing tight clothing, or sexual intercourse extremely painful. Vestibulodynia specifically refers to pain localized to the vaginal opeing (vestibule).

• Vaginismus

Involuvatary tightening or spasm of the vaginal muscles in response to attempted penetration, causing significant pain during intercourse, gynecologic exams, or tampon use. Often related to pelvic floor dysfunction and highly treatable. 

• Lichen Sclerosus

A chronic inflammatory skin condition affecting the vulvar and perianal tissue, causing itching, burning, tearing, pain, skin changes, and sexual discomfort. Often misdiagnosed or undertreated. Early intervention is important to prevent scarring. 

• Lichen Planus

An inflammatory condition affecting the vulvar and vaginal tissue that can cause significant burning, rawness, pain, and discharge. Frequently confused with yeast infection or other conditions. 

Urologic Causes 

• Interstitial Cystitis/Painful Bladder Syndrome

A chronic bladder condition causing pelvic pain, urinary urgency, frequency, and bladder pressure often mistaken for recurring urinary tract infections. The bladder pain typically worsens as the bladder fills and improves with urinartion. 

• Urethral Syndrome

Discomfort, burining, or pressure in the urethra and surrounding pelvic area often is in the bascence of infection that can significantly contribute to chronic pelvic pain and urinary symptoms. 

• Rurcurrent Urinary Tract Infection (UTI)

Frequent or recurrent bladder infecitons can cause ongoing pelvic discomfort, urgency, and pain and should prompt further investigation into underlying causes. 

Gastrointestinal Causes 

• Irritable bowel Syndrome (IBS)

A common functional gastronintestinal disorder causing abdominal cramping, bloating, diarrhea, and constipation with significant overlap with gynecologic pelvic pain condiitons. IBS and endometriosis frequently coexist. 

• Inflammatory Bowel Disease (IBD)

Crohn's disease and ulcerative colitis cause chronic inflammation of the gastrointestinal tract with abdominal and pelvic pain, diarrhea, bleeding, and systemic symptoms. Often requires coordination with gastroenterology. 

• Chronic Constipation

Persistent constipation creates significant pressure, bloating, and pelvic pain and can worsen pelvic floor dysfunction and other underlying pelvic conditions. 

• Appendicitis & Chronic Appendicieal Pain

While acute appendicitis is an emergency, chronic or recurrent low-grade appendiceal inflammation can cause persistent right lowe pelvic pain that is frequently overlooked. 

Neurologic Causes

• Pudendal Neuralgia 

Compression or irritation of the Pudendal nerve, which supplies sensation to the vulva, vagina, perineum, and rectum, causing burning, shooting or electric pain in the pelvis and perineum, often worsened by sitting and relieved by standing. 

• Pelvic Nerve Entrapment

Entrapment of other pelvic nerves, including the ilioinguinal, iliohypogastric, or genitofemoral nerves can cause chronic pelvic pain, burning, or numbness that following a nerve distribuation pattern. 

• Central Sensitization 

In some cases of chronic paelvic pain, the central nervous system becomes sensitized, amplifying pian signals even in the absence of active tissue damage. This is not imaginary pain. It is a real neurological process that requires a specialized, multidisciplinary treatment approach. 

Musculoskeletal & Systemic Causes

• Hip Joint Pathology

Hip labral tears, hip impingement, or hip arthritis can refer pain into the groin and pelvis, and are frequently mistaken for gynecologic causes of pelvic pian. 

• Sacroiliac Joint Dysfunction

Inflammation or instability of the scroiliac joints where the spine meets the pelivs can cause chronic pelvic and lower back pain that worsens with prolonged sitting, standing, or walking. 

• Pelvic adhesions & Scar Tissue

Adhesions from prior surgeries, infections, or endometriosis can tether pelvic structures together, causing chronic pain, pressure, and restricted movement that may require surgical evaluation. 

Why Pelvic Pain Is So Often Dismissed 

The data on this is sobering

Studies show that women wait an average of 4-7 years before receiving a diagnosis for chronic pelivic pain. They see multiple providers. they are told their pian is "in their head," that it is "just part of being a women," or that nothing can be found and therefore, nothing can be dome. 

This is not acceptable. 

Pain is real. Pain has causes. And pain has treatments. At Lamorinda Women's Health, we start from that premise and we do not stop until we understand what is driving yours. 

Common Signs of Tight Pelvic Floor Muscles

• Pain with intercourse, especially deep or at entery
• Pain with sitting, bowel movements, or urination
• Bladder symptoms with negative urine culture
• Aching that spreads to the lower back, hips, or thighs.
• Flares with stress, exercise, infections, or constipation

There is no blood test or scan that shows pelvic floor tension. It is diagnosed with a careful, gentle pelvic exam that checks each muscle for tightness and tender trigger points. This is why Dr. Hajyan examines every pelvic pain patient thoroughly before recommending any treatment. 

Introducing SoLa Therapy-A Breakthrough In Pelvic Pain Treatment

One of the most exciting advances in pelvic pain treatment in recent years is SoLa Therapy.  SoLa is a gentle, in-office treatment that uses near-infrared laser light to relax tight, painful pelvic floor muscles. The technology is called photobiomodulation. SoLa is FDA-cleared, non-invasive, and entirely drug free, and the results for women with pelvic pain have been remarkable. 

How Does It Work?

Photobiomodulation has been used for more than 20 years to treat muscle pain, including low back pain and fibromyalgia. Near-infrared light is absorbed by the mitochondria, the energy centers inside your cells. This boosts cellular energy and releases nitric oxide, a natural muscle relaxant. the result is muscle relaxation, better circulation, and less inflammation. 

The laser is non-ablative. It does not cut, burn, or damage tissue. 

What Does Treatment Feel Like?

Treatment is delivered through a slim vaginal probe with a single-use disposable tip. Each treatment takes only 1 to 4 minutes. Most patients feel a gentle warmth, and the treatment is not painful. There is no anesthesia and no downtime, so you can return to your day right away. 

Before each session, you answer a short symptom quesitonnaire on the device so we can track your progess together. A standard course is about 8 treatments, usually two to three times pre week over three to six weeks. Many patients notice a change after the third treatment. 

Who is a Good Candidate?

SoLa is best suited for women with chronic pelvic pain who have pelvic floor muscle tenderness on exam. This includes many women with painful intercourse, pain with sitting, or pain that persists despite treatment for endometriosis, bladder pain, vulvar pian or IBS. 

SoLa Is Not Appropriate if you:

• Are pregnant
• Have an active vaginal infection or urinary tract infection
• Have unexplained or active vaginal bleeding
• Have cancer of the urogential tract
• Have decreased sensation in the vagina or rectum 
• Take medications that make you sensitive to light or heat

What Does the Research Show?

You deserve honest information, so here it is. In the largest analysis to date, which included women treated at 22 clinics across 16 states, about 8 in 10 women who completed the full course reported a meaningful reduction in pelvic pian. Improvements included pain with sitting, exercise, bowel movements, and intercourse. Follow-up data suggest that for many women the benefit lasts at least six months. No serious side effects were reported. 

These early studies did not include a placebo comparison group, and larger controlled trials are still underway. SoLa is not a cure-all, and not every patient responds. For the right patient, though, it offers a safe, comfortable opiton that does not rely on medications or injections. 

SoLa and Intimacy

For many women, the hardest part of pelvic floor tension is what it does to intimacy. Tight pelvic muscles are one of the most common, and most overlooked, causes of painful intercourse. Many women quietly avoid sex or endur it in silence because they believe nothing can be done. 

In the published data, pain with intercourse was one of the symptoms that improved with treatment. At Lamorinda Women's Health, we talk about sexual health openly and without judgement, because comfortable intimacy is a real part of your wellbeing. 

Does SoLA Work Best on Its Own?

For some patients, SoLa alone brings significant relief. For many others, the best results come from pairing it with pelvic floor physical therapy. 

SoLa relaxes the deep internal pelvic floor muscles. Pelvic floor PT addresses the external muscles, posture, coordination, and the habits that keep muscles tense. If one part is left untreated, symptoms can creep back Dr. Hajyan works with trusted local pelvic floor physical therapists and coordinates care for patients who benefit from both. 

After Treatment

There is no one-size-fits-all plan after a course of SoLa. Some patients stay comfortable by recognizing and avoiding their pain triggers. Others benefit from pelvic floor PT, compounded muscle-relaxing vaginal suppositories, or short maintenance courses of SoLa during flares. 

If pain persists after treatment, Dr. Hajyan re-examines to look for other contributors. Sometimes the muscle tension has resolved and another condition, or a sensitized nervous system, is driving the remaining pain. When that happens, we coordinate with pain specialists, pain psychologist, and other experts so your care stays connected. 

A Comprehensive Approach to Pelvic Pain

SoLa is one tool among many. Your evaluaton and treatment plan at Lamorinda Women's Health may also include: 

• A complete pelvic pain evaulation with detailed history, careful pelvic exam, and in-office ultrasound
• Hormonal evaluation and treatment, including vaginal estrogen and menopausal hormone therapy when appropriate
• Endometriosis, adenomyosis, and fibroids management: medical options and surgical treatment when needed
• Medications: muscle relaxants, nerve pain medications, and compounded vaginal suppositories
• Pelvic floor physical therapy: coordinated with trusted local therapists
• Sexual health evaluation and treatment: addessed openly and without judgment 
• Minimally invaisve surgery: when conservative treatments are not enough

What Makes Lamorinda Women's Health Different

At many practices, pelvic pain gets fifteen minutes and a referral. 

At Lamorinda Women's Health, pelvic pain gets the time, attention, and investigative approach it deserves. Dr. Hajyan takes a thourough, unhurried look at every dimension of your pain, including hormonal, structural, muscular, and neurological, and builds a plan that addresses the root causes not jsut the symptoms. 

Every visit is directly with Dr. Hajyan. And you will never leave this office feeling unheard. 

Ready to Get Relief?

If you ahve been living with pelvic pian, whether for months or for years, we invite you to schedule a consultation with Dr. Hajyan. 

970 Dewing Ave, Suite 301, Lafayette, CA, 94549

(925) 385-7023

Lamorindawomenshealth.com

Call today to schedule your complimentary 15-minute phone consultation. Pelvic pain is not something you have to live with. 

Dr. Karine Hajyan, DO, FACOG, is a board-certified OB/GYN and the founder of Lamorinda Women's Health, a concierge direct-pay gynecology practice in Lafayette, CA. Dr. Hajyan's practice focuses on pelvic pain, menopause, hormonal health, sexual wellness, and comprehensive women's care. 

This article is for general education and is not a subsitute for individual medical advice.