Why Pelvic Nerve Disorders Are the Hidden Epidemic Nobody Talks About.

mpossover
Dec 4, 2025
7 min read

A story about pain, silence, and a part of the body medicine has overlooked for far too long.

Millions of women live with pelvic pain, bladder problems, sexual discomfort, or sciatic-like leg pain - yet the real cause is often overlooked. Pelvic nerve disorders are a hidden epidemic, affecting daily life in ways most people never talk about. Many women spend years going from one specialist to another, receiving different diagnoses, normal scans, and treatments that don’t help, simply because the true source - the pelvic nerves - is not recognized.

Pelvic neuropathy can affect sitting, walking, intimacy, bladder and bowel control, and emotional well-being. It steals quality of life, confidence, relationships, and sometimes even the ability to work. Yet most women are told their symptoms are “gynecological,” “urological,” “orthopedic,” or “stress-related,” when in fact the nerves deep in the pelvis are suffering.

Neuropelveology finally brings clarity. It is the first medical discipline dedicated to understanding and treating pelvic nerve disorders - offering answers, proper diagnosis, and new hope.

The European Neuropathy Foundation is raising awareness so that no woman or man has to suffer in silence. Pelvic nerve disorders may be unseen, but the people who live with them should not be.

Most women know what it means to have pelvic pain, bladder problems, sexual discomfort, or unexplained sensations in the lower body. What almost nobody knows is that many of these symptoms come from the nerves deep inside the pelvis - nerves that control our bladder, our bowel, our sexual organs, and even the way we walk or sit. When these nerves suffer, life changes dramatically.

Yet pelvic nerve disorders remain one of the least recognized medical problems of our time.Millions of women - and men - live with symptoms that are misinterpreted, misunderstood, or dismissed. They are sent from one specialist to another, collecting different diagnoses, different medications, different explanations, but rarely an answer that truly helps.

In reality, pelvic neuropathy is a hidden epidemic. It is everywhere, and yet almost no one talks about it.

A Problem Far More Common Than People Realize

No global statistics exist yet, because medicine has never looked at pelvic nerves as a group of conditions that deserve attention. But experience from clinics around the world shows a clear pattern: millions of women live with nerve-related pelvic pain or dysfunction, often for years before anyone identifies the real cause. These women are told that their symptoms belong to different areas: the bladder is “urology,” genital pain is “gynecology,” bowel symptoms are “gastroenterology,” and leg or buttock pain must be “orthopedics.” Because the symptoms fall into so many categories, no single doctor has the full picture. The patient is left to connect the dots herself - which is almost impossible without help. This is why pelvic nerve disorders stay invisible.

Why So Many Women Are Misdiagnosed

One of the main reasons is that pelvic nerves are rarely considered as the source of symptoms. When a woman says she has burning, stabbing, pulling, or pressure-like pain in the pelvis, doctors often suspect infections, endometriosis, inflammation, hormonal problems, or psychological stress. Pelvic nerves are not part of the routine thinking - even though they are responsible for some of the most important functions in the body.

Many patients undergo multiple surgeries, take medications for years, get simply the diagnosis “endometriosis”or are told that everything looks “normal” on their scans. This is especially painful for women who know something is wrong but are made to feel unheard or misunderstood. Some are even told, “You just have to live with it.”

Most pelvic nerve disorders are invisible on MRI or CT scans. A normal imaging report does not mean the nerves are healthy. It simply means that the cause of the pain is hidden in a place that current technology cannot easily show.

Imagine living with pain for years, being told again and again that “everything is fine,” while your daily life becomes smaller and smaller. This is the reality for many women with pelvic nerve disorders.

The Real-Life Impact: Far Beyond Physical Pain

Pelvic nerve problems change a woman’s life in ways that go far beyond the body. They affect how she moves, how she sits, how she sleeps, and how she feels about herself. They influence intimacy, relationships, confidence, work, and emotional well-being. Many women with pelvic neuropathy describe:

• struggling to sit even for a short time• avoiding sexual contact because of pain• always needing to know where the next toilet is• feeling embarrassed to speak about symptoms• losing jobs because they cannot sit or walk without pain• withdrawing from social life out of fear of judgment• and sometimes falling into depression or hopelessness

Pelvic nerve pain is not just a physical condition, it is a life condition, and because society rarely talks about pelvic nerves, many women think they are alone. But they are not. They are part of a growing group of patients whose suffering has simply not yet been recognized.

A Problem That Affects Both Women and Men

Although women are affected more often, men also suffer, often silently. Many men with chronic pelvic pain are told they have “chronic prostatitis,” even when no infection is present. Others develop severe pain after hernia or prostate surgery, but the nerve injury behind these symptoms is overlooked. Just like women, men need proper recognition and diagnosis. Pelvic nerves do not care about gender; they care only about function.

Why This Epidemic Remains Invisible

Pelvic nerve disorders are hidden not because they are rare, but because no medical field has traditionally taken responsibility for them. The pelvis belongs to several specialties, and so the nerves that cross these territories were never truly studied as a group. Patients suffer in the space between medical disciplines.

Another reason is silence. Many people, especially women, feel too embarrassed to speak about bladder problems, bowel issues, or sexual pain. They carry these symptoms alone, believing no one else experiences the same. This silence protects the problem instead of the patient.

And finally, medical education has simply not caught up. Doctors receive very little training in pelvic nerve anatomy and almost none in pelvic nerve pathology. They cannot diagnose what they have never been taught to look for. Even in gynecology - the specialty where the field of Neuropelveology was born - pelvic nerves were traditionally not part of standard training. This creates an important but often misunderstood situation.

Many doctors, including excellent gynecologists and surgeons, understandably assume that “neuropelveology” refers only to advanced laparoscopic nerve surgery or nerve-sparing techniques. Because imaging such as MRI often fails to show pelvic nerve problems, it is easy to believe that “if the scan is normal, the nerves must be normal too.” And without formal education in this field, one cannot know how much remains hidden beyond the reach of standard diagnostic tools.

The difficulty is this: a neuropelveological diagnosis is not a gynecological diagnosis - it is a neurological diagnosis adapted to the pelvic nerves and pelvic organs.Without specific training, even the most experienced gynecologist cannot recognize what lies outside the framework of gynecology. And neurologists face similar limitations: the pelvic nerves lie deep inside the pelvic bones, a region they cannot physically examine. Vaginal or rectal assessment of the pelvic nerves - a fundamental part of neuropelveological evaluation - is not part of neurological examination and can easily be misunderstood.

This is why a typical neuropelveological patient, when seen without this perspective, often receives a diagnosis within minutes such as “endometriosis,” followed by hormonal therapy or an exploratory laparoscopy. These recommendations are given with the best intentions, but without understanding that the symptoms may originate from the nerves, not from the reproductive organs.

None of this is a failure of individual doctors. It is simply the natural consequence of a new discipline that was not part of medical education until very recently. Neuropelveology is like a new language: until one has learned it, the brain does not recognize the meaning of the signs and symptoms. One cannot taste a new cuisine without trying it; one cannot master a new field without studying it. The intention is not to judge, but to build, - not to divide, but to unite,- not to criticize, but to elevate the standard of care for all people suffering from pelvic nerve disorders.

This is why education and certifications are essential.

A Turning Point: The Birth of Neuropelveology

Neuropelveology, founded by Prof. Possover in 2005, is the first medical discipline dedicated to understanding and treating pelvic nerve disorders. It brings the entire pelvis - and all of its nerves - into a single framework.Instead of splitting symptoms between different specialties, neuropelveology looks at the whole system: the nerves, their functions, how they interact with pelvic organs, and how they cause pain or dysfunction.

This allows for diagnoses that were previously impossible and treatments that address the real cause instead of the symptoms. For many patients, it is the first time someone listens long enough, understands deeply enough, and explains clearly enough what is happening to their body.

Neuropelveology gives patients something they often lose along the way: hope.

The European Neuropathy Foundation (ENF) places great importance on proper, structured education in Neuropelveology - not to exclude colleagues, but to support them, to empower them, and ultimately to protect patients. The goal is transparency, clarity, and trust: patients have the right to know who has been trained in this field, and doctors deserve the opportunity to learn it in a respectful, structured, and scientifically grounded way.

For this reason, the ENF works closely with the International Society of Neuropelveology (ISON) to promote a certification pathway that recognizes real expertise. This process supports committed colleagues who want to master the field, and it helps patients identify qualified specialists who can provide accurate diagnosis and appropriate care.

Pelvic neuropathy is a growing public health challenge. Neuropelveology provides the tools to understand it. And with proper education, collaboration, and certification, we can ensure that no patient is left with unexplained pain, unnecessary surgeries, or a life lived in silence.

Why Awareness Matters Now More Than Ever

Every year that pelvic nerve disorders remain invisible, millions continue to suffer unnecessarily. Early diagnosis can prevent long-term nerve damage. Correct treatment can return dignity, independence, and quality of life.Raising awareness is not a luxury, it is a responsibility.To ensure no woman or man has to live in silence, shame, or despair because their nerves are suffering in a way medicine has overlooked.

Pelvic nerve disorders may be hidden, but the people who live with them should not be.

This is the mission of the ENF:

- to illuminate what has long been hidden,

- to support both patients and clinicians,

- to ensure that this new discipline grows with integrity, compassion, and excellence.