Secondary dysmenorrhea is frequently associated with dyspareunia. When the diagnostic workup is negative, its clinical management might result unspecific and frustrating for the patient. We reported a case of a young woman who suffered from dyspareunia, dysmenorrhea and chronic pelvic pain. After symptoms progression and pharmacological therapy unresponsiveness, the gynaecologist referred the patient to an osteopath for the functional evaluation of the pelvic girdle. The examination revealed the presence of pelvic, lumbosacral and sacrococcygeal dysfunctions that, once treated, significatively reduced the severity of dysmenorrhea and dyspareunia. A multidisciplinary approach might be considered in case of suspected functional impairment. This should be carefully diagnosed by exclusion, with the support of past trauma history and pelvic girdle dysfunction signs.