PVD can result from hormonal changes, inflammation, neurological factors, and hypertonic pelvic floor muscles. Deficiency in testosterone is especially common, mostly in younger women receiving oral contraceptives and in menopausal women. Pelvic muscle health is also a big factor. When pelvic floor muscles are tight and overactive, pain can be referred to the vestibule, and this can mimic bladder pain symptoms, she said.
"The pelvis is a bowl of muscles holding the bladder up. If it's irritated, it causes the bladder 'next door' to sense pain," she said. "But it's not actually the bladder that has problem; it's the tissue around and nearby the bladder that's the problem."