Pelvic Pain

Pelvic pain can happen in both men and women and might stem from infections, abnormalities in internal organs, or pain from the pelvic bones. In women, pelvic pain might be related to the reproductive system. Treatment depends upon the cause.

OVERVIEW

Pelvic pain can be a sign that there might be a problem with one of the reproductive organs in a woman’s pelvic area.

Although pelvic pain often refers to pain in the region of women's internal reproductive organs, pelvic pain can be present in either sex and can stem from other causes. Pelvic pain might be a symptom of infection or might arise from pain in the pelvis bone or in non-reproductive internal organs. In women, however, pelvic pain can very well be an indication that there might be a problem with one of the reproductive organs in the pelvic area (uterus, ovaries, fallopian tubes, cervix, and vagina).

Causes

Several types of diseases and conditions can cause pelvic pain. Chronic pelvic pain can result from more than one condition.

Pelvic pain can arise from your digestive, reproductive or urinary system. Recently, doctors have recognized that some pelvic pain, particularly chronic pelvic pain, can also arise from muscles and connective tissue (ligaments) in the structures of the pelvic floor.

Pelvic pain might also be caused by irritation of nerves in the pelvis.

Female reproductive system

Pelvic pain arising from the female reproductive system might be caused by conditions such as:

• Adenomyosis
• Ectopic pregnancy (or other pregnancy-related conditions)
• Endometriosis
• Menstrual cramps (dysmenorrhea)
• Miscarriage (before the 20th week) or intrauterine fetal death
• Mittelschmerz (ovulation pain)
• Ovarian cancer
• Ovarian cysts
• Pelvic inflammatory disease (PID)
• Uterine fibroids
• Vulvodynia
• Other causes in women or men

Examples of other possible causes of pelvic pain — in women or men — include:

• Appendicitis
• Colon cancer
• Constipation
• Crohn's disease (a type of inflammatory bowel disease)
• Diverticulitis
• Fibromyalgia
• Inguinal hernia
• Interstitial cystitis (also called painful bladder syndrome)
• Intestinal obstruction
• Irritable bowel syndrome
• Kidney stones
• Past physical or sexual abuse
• Pelvic floor muscle spasms
• Prostatitis (infection or inflammation of the prostate)
• Ulcerative colitis (a type of inflammatory bowel disease)
• Urinary tract infection (UTI)

Symptoms

When asked to locate your pain, you might sweep your hand over your entire pelvic area rather than point to a single spot. You might describe your chronic pelvic pain in one or more of the following ways:

• Severe and steady pain
• Pain that comes and goes (intermittent)
• Dull aching
• Sharp pains or cramping
• Pressure or heaviness deep within your pelvis

In addition, you may experience:

• Pain during intercourse
• Pain while having a bowel movement or urinating
• Pain when you sit for long periods of time

Your discomfort may intensify after standing for long periods and may be relieved when you lie down. The pain may be mild and annoying, or it may be so severe that you miss work, can't sleep and can't exercise.

When to see a doctor

With any chronic pain problem, it can be difficult to know when you should go to the doctor. In general, make an appointment with your doctor if your pelvic pain disrupts your daily life or if your symptoms seem to be getting worse.

Diagnosis

To help your healthcare provider accurately diagnose the cause of your pelvic pain, try to record information like when the pain occurs, what you are doing when it strikes, and what helps alleviate it.

In the end, creating a symptom/pain journal is an excellent method of tracking your pain and can make the first step of the diagnostic process (your medical history) that much more efficient.

Medical History

When you do see a healthcare provider about your pelvic pain, be prepared to answer questions about when the pain occurs, what triggers it, what relieves it, and how long you've been experiencing it. In addition, during your medical history, your healthcare provider may ask you questions about your family, like whether you have a family history of fibroids or cancer.

Your healthcare provider will also take a sexual history, inquiring about the number of sexual partners you have and if you have ever had a sexually transmitted infection.

Physical Examination

When evaluating pelvic pain, a key part of the physical exam is the pelvic exam, whereby your healthcare provider will check for any abnormalities (for example, tenderness or masses) within your reproductive system.23

Due to the fact that pelvic pain may be related to other organs besides the reproductive system, your healthcare provider will also likely perform an abdominal and lower back exam to evaluate for an intestinal or kidney source of your pain.

Treatment

There are numerous therapies for pelvic pain, and the precise treatment needed depends on the underlying cause. For example, urinary tract infections are treated with antibiotics, while surgery is needed to treat emergent causes like ectopic pregnancy, ovarian torsion, or appendicitis.

Surgery is also often the first-line therapy for some cancers and is used to treat severe cases of endometriosis and fibroids.

A Word From Verywell

Experiencing pelvic pain is physically and emotionally distressing, and with all the potential causes, you may worry that it's something serious. See your healthcare provider, provide them with as much information about your pain as possible, and expect them to run a battery of tests to figure out what's causing it. And remember that sudden, severe pelvic pain warrants a trip to the emergency room.