A pathway through persistent pelvic pain 

How a new multidisciplinary clinic is helping people with persistent pelvic pain improve their quality of life. 

According to healthdirect Australia, persistent pelvic pain is pain in the abdomen, below the belly button, that lasts for six months or more. It can take years to develop and is often due to a combination of physical, psychological and social factors. 

This debilitating condition affects one in four Australian girls, women and people assigned female at birth, and impacts all aspects of a person’s life. Managing it effectively requires a team of health professionals and a holistic approach. 

Thanks to Australian Government funding to Family Planning Tasmania through Primary Health Tasmania, a new multidisciplinary pathway is helping Tasmanians improve their quality of life by providing wraparound support. 

The model brings together GPs, pelvic floor physiotherapists, psychologists, nurses and – just recently – dietitians. This team meets regularly to develop treatment plans for complex cases tailored to each patient’s needs. 

Family Planning Tasmania project manager Amanda Duncan says it’s a reflection of the complexity of endometriosis and pelvic pain that a range of input and skills is needed in the care team.  

“We try and connect that person to all those disciplines so they get the better outcomes,” Amanda says. “It’s an umbrella of care approach.” 

Patients can self-refer, or be referred by their GP. 

Clinical services manager Karen Brooks says new patients start by seeing a GP at a Family Planning Tasmania clinic in Hobart (Glenorchy), Launceston or Burnie.  

“From that point, the GP assesses if they would benefit from participating in the pathway,” Karen says.  

“They fill in a pre-questionnaire, then work with the GP to put together a treatment plan. If they need pelvic floor physiotherapy or psychology, they are then referred to the next stage of the pathway.” 

A pathway nurse supports each patient throughout their journey and follows up after the program ends. Six months after completing the pathway, patients fill in a follow-up survey to assess outcomes. 

Each health professional brings a different lens to the patient’s experience, and psychology is a key part of the model. 

“Talking about psychology is a very sensitive conversation,” Amanda says.  

“Historically, a lot of people with endometriosis have experienced gaslighting in the health profession around their pain. But I always like to highlight the fact that hunger is also in our heads, and it’s very valid. 

“The importance of psychology is that it’s part of that holistic model (which might include eating disorders, sexual challenges, mental health) looking at the person as a whole and not just siloing on the pain aspect.” 

Karen says the collaborative nature of the clinic means patients benefit from more than just formal referrals. 

“The physios, GPs, nurses, dietitian—everyone involved in care—come together to talk about more complex cases and put together a plan,” she says.  

Amanda agrees. “It’s rare to have multidisciplinary staff having these open conversations. I have a background in sexology and lived experience of endometriosis, so I’ve been transparent about my experiences and treatments I’ve tried.” 

Holistic care for patients also includes accessible education-in addition to clinical care- to help people maintain self-determination navigating pelvic pain.  

The pathway includes free online workshops for people with pelvic pain so they can gain in-depth knowledge from a psychologist, physiotherapist, dietitian and psychologist.  

The sessions include a group discussion to empower people to feel validated, informed and connected.  

One participant shared feedback from a workshop, saying: “That was amazing information! Getting to know all the different parts of persistent pelvic pain. I wish all people had access to this information.” 

Suzette, a patient under the pathway, says pelvic floor physiotherapy was a turning point. 

“Janet, the physio, was really good,” she says. “She helped me understand what was happening to my muscles, and gave me stretches I could do to alleviate pain.  

“It was really informative to be able to chat with her about how relaxing too much could affect my prolapse.” 

Suzette says the pathway helped her prepare for surgery with better understanding and confidence. 

“Being able to access people with expertise to help me understand what was actually happening and why—it helped me balance the restrictions I’ve got with the pain I manage.” 

Maggie Jefferies, another patient, says the affordability of the service made it accessible for her. 

“If it was going to cost a lot, I probably wouldn’t have done it,” she says.  

Maggie also praised the sensitivity and care she received, which was tailored to her particular needs related to a past experience of trauma. 

“Janet, the physio, was incredibly patient,” she says.   

“The first examination was beautifully done—slow, gentle, and always checking my consent.  

“I’ve never had an experience like that before. There were tears, and she handled that really well.” 

Throughout her appointments, Maggie received education and support tailored to her needs. 

“Janet showed me diagrams of pelvic nerves and muscles and explained why I felt pain in my hips,” she says.  

“It helped me understand the rest of my body.  

“She sent me lots of links and stayed in contact with my psychologist. They even asked for consent to communicate directly, which I really appreciated—it felt like support from all directions.” 

Maggie says she left the program with a personal plan and a new sense of empowerment. 

“It was validation across the whole program. I didn’t know that it wasn’t normal to feel that much pain, and Janet said, ‘You don’t have to just live with this’. That was so good to hear.” 

Dr Jenny Davidson, a GP involved in the program, says the results are tangible. 

“There are multiple things we treat, and the team approach works really well,” she says.  

“You see the relief in patients when their problems are validated. There’s light at the end of the tunnel.” 

For both clinicians and patients, the message is clear: no one should have to live with persistent pelvic pain without support. 

“There’s a lot we can do,” Dr Jenny says.  

“GPs often send patients here because they know it’s hard to manage solo. We are the most experienced health service in terms of sexual and reproductive health.” 

Both Suzette and Maggie say the pathway hasn’t just helped them, it’s helped to lift the health literacy of the people around them.  

“Janet explained it to me in a very real-life sort of way so that I could then pass that on to other people experiencing pelvic pain,” Maggie says.  

“I’ve really been very grateful for being able to be a part of it,” Suzette says.  

Click here to find out more about the pathway.

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This story features in Issue 20 of our Primary Health Matters magazine. Click here to read the rest of the issue

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