10 Pelvic Pain Causes, Symptoms and Treatment Options

Understand your pelvis pain symptoms, including 10 causes & treatment options for your pelvis pain.

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Contents

  1. Symptoms
  2. Causes
  3. 10 Possible Pelvis Pain Conditions
  4. Treatments and Relief
  5. Questions Your Doctor May Ask
  6. Statistics
  7. Related Articles
  8. References

Pelvis Pain Symptoms

The "pelvis" refers to your hip bones and all of the organs and structures contained within them. This includes your reproductive and urinary tracts; your large and small intestines; and the muscles, tendons, and ligaments inside your pelvis.

Pain and other symptoms can arise from any of those locations, which can make it difficult to pin down exactly what is causing your pelvis pain symptoms [1]. To make the diagnosis, all of your symptoms will be carefully examined and ruled out one at a time to determine the true cause. Pelvis pain is also called pelvic girdle pain.

Common characteristics of pelvis pain

If you're experiencing pelvis pain, it can likely be described by the following.

  • The pain can fit almost any description: Dull, cramping, sharp, on-and-off, constant, mild, or severe
  • Pain location: It may be localized to one spot or seem to exist throughout your pelvis.
  • Genitourinary discharge: There may be a discharge from your urinary tract or your sexual organs.
  • Pain that spreads: The pain may also spread, or radiate, into your back or legs.

Who is most often affected by pelvis pain symptoms?

Women have pelvis pain more often than men. This is because the female pelvis is complex and designed for rapid change during pregnancy [2].

When are pelvis pain symptoms most likely to occur?

Pelvis pain is more likely to occur:

  • During urination
  • During a bowel movement
  • After ejaculation in men
  • During sex in women
  • Before or during menstruation
  • During a pregnancy and in the weeks of recovery that follow: Even with a normal pregnancy, some pelvic pain and discomfort is common due to hormones which relax the ligaments for birth.

Are pelvis pain symptoms serious?

The severity of your pelvis pain symptoms is ultimately dependent on the cause.

  • Not serious: Some pelvis discomfort during pregnancy is quite common and not abnormal.
  • Moderately serious: Any ongoing pain, whether there are other symptoms or not, is something that should be treated by your medical provider.
  • Serious: Any severe pelvis pain symptoms can be a sign of serious illness, especially if there are other symptoms with it.

Pelvis Pain Causes

Most common causes in women

Women may experience pelvis pain due to menstrual processes.

  • Ovulation: Women may experience a mild tearing sensation in the pelvic region around the time of ovulation.
  • Cramping: Cramping ranging from mild to severe, is very common during a menstrual period [3].
  • Abnormalities: Abnormal growth of uterine tissue on other reproductive structures in the abdomen and pelvis can cause pain.
  • Uterine growths: Benign growths lodged within the muscular wall of the uterus cause pain whenever the uterus contracts.
  • Complications of pregnancy: A pregnancy that has begun to grow in a fallopian tube instead of the uterus will cause pelvis pain. Miscarriage is another possible cause, which is labor and delivery of a stillborn infant.

Other inflammatory and infectious causes

Other causes of inflammation of the structures of the pelvis may be related to disease or infection.

  • Infection throughout the female reproductive organs: This is almost always from the bacteria that cause one or more of the sexually transmitted diseases.
  • In men: Sexually transmitted diseases will cause a discharge from the penis as well as pelvis pain symptoms during urination and sexual activity. Inflammation of the prostate gland in men causes pain and burning on urination, along with pain throughout the reproductive organs [4].
  • Bacterial infection of the urethra and bladder: This causes burning pain and cramping in both men and women.
  • Kidney stones: These are crystallized deposits that may travel down from the kidneys in both men and women, causing severe pain while trying to exit the system.

Inflammation of abdominal organs

If the abdominal organs are impaired due to normal processes or illness, this can result in pelvis pain.

  • Infection and inflammation of the appendix
  • Constipation and gas
  • Intestinal contractions: The intestines may be contracting too strongly or too slowly, causing pain and discomfort either way.
  • Inflammation of the large or small intestine [5]
  • A blockage or obstruction within the intestine
  • A protrusion of fatty tissue: Or, a loop of intestine, has been forced out of place within the pelvis

Musculoskeletal pelvis pain causes

Musculoskeletal causes of pelvis pain may include the following.

  • Scar tissue following surgery or disease
  • Injuries: Such as hip fracture, dislocation, or bursitis, as well as muscle or tendon strain, or ligament sprain.
  • Arthritis: Any of several forms of arthritis, which is the wearing away of the cartilage protecting bones.
  • Joint inflammation: Particularly inflammation of the joint at the front of the pelvic girdle. This is usually caused by the stresses of pregnancy and childbirth [6].

Other pelvis pain causes

Other causes of pelvis pay may include the following.

  • Sexual abuse: Anyone, male or female, who has experienced any sort of sexual abuse is more likely to suffer from chronic pelvis pain [7].
  • Tumors: Tumors can grow on almost any of the structures within the pelvis, causing pain.

10 Possible Pelvis Pain Conditions

The list below shows results from the use of our quiz by Buoy users who experienced pelvis pain. This list does not constitute medical advice and may not accurately represent what you have.

Pelvic inflammatory disease

Pelvic inflammatory disease, or PID, is the general term for a bacterial infection of a woman's reproductive organs.

PID is most often a complication of a sexually transmitted disease (STD) such as gonorrhea or chlamydia. However, it is possible to get PID from other causes.

Any woman can be affected. It is most often found in sexually active women under age 25, especially those who have had PID before, have multiple partners, and/or douche frequently.

Symptoms include fever, lower abdominal pain, foul-smelling vaginal discharge, pain and/or bleeding during sex, and pain on urination.

Untreated PID can cause infertility due to damaged tissue in the reproductive tract, as well as chronic pelvic and abdominal pain. Unprotected sex partners will be infected as well.

Diagnosis is made through symptoms, pelvic examination, vaginal and cervical swabs, and urine tests.

Treatment is with a course of antibiotics. Be sure to finish all of the medication as directed, even when you begin feeling better.

To prevent PID, have all partners (male or female) tested for STDs and avoid unprotected sexual contact.

Rarity: Common

Top Symptoms: fever, abdominal pain or unusual vaginal discharge, vaginal discharge, nausea or vomiting, vaginal bleeding, pelvis pain

Symptoms that always occur with pelvic inflammatory disease: fever, abdominal pain or unusual vaginal discharge

Urgency: In-person visit

Endometriosis

Endometriosis is a condition where the tissue that normally forms the lining of the uterus – the endometrium – also begins growing on the outside of the ovaries and fallopian tubes. This out-of-place endometrium still thickens and bleeds each month, causing pain, scar tissue, and adhesions.

Risk factors include short menstrual cycles that begin at a young age, with menopause at an older age; never giving birth; uterine abnormalities; family history; and alcohol use.

Symptoms include severe pelvic pain, cramping, and excessive bleeding during menstruation. There may be pain during sexual intercourse and sometimes during bowel movements and urination. Diarrhea, constipation, nausea, and bloating are also common, as is difficulty becoming pregnant.

Endometriosis can be confused with other conditions, such as pelvic inflammatory disease or irritable bowel syndrome. Permanent infertility can occur with untreated endometriosis.

Diagnosis is made by pelvic examination, ultrasound, and sometimes laparoscopy.

Treatment involves over-the-counter pain relievers and hormone therapy, including contraceptives. Surgery may be done to remove endometriosis tissue. As a last resort, removal of the ovaries and the uterus may be recommended.

Rarity: Uncommon

Top Symptoms: vaginal discharge, abdominal pain (stomach ache), vaginal bleeding, pelvis pain, painful periods

Urgency: Primary care doctor

Ovulation pain (mittelschmerz) or midcycle spotting

Mittelschmerz is a German word that translates as "middle pain." It refers to the normal discomfort sometimes felt by women during ovulation, which is at the midpoint of the menstrual cycle.

Each month, one of the two ovaries forms a follicle that holds an egg cell. The pain occurs when the follicle ruptures and releases the egg.

This is a dull, cramping sensation that may begin suddenly in only one side of the lower abdomen. In a few cases, there may be vaginal spotting. Mittelschmerz occurs about 14 days before the start of the next menstrual period.

Actual Mittelschmerz is not associated with nausea, vomiting, fever, or severe pelvic pain. These symptoms should be evaluated by a medical provider since they can indicate a more serious condition.

Diagnosis is made through patient history.

Treatment requires only over-the-counter, nonsteroidal anti-inflammatory drugs to relieve the pain. An oral contraceptive will stop the symptoms, since it also stops ovulation.

Rarity: Common

Top Symptoms: abdominal pain (stomach ache), last period approximately 2 weeks ago, vaginal bleeding, bloody vaginal discharge, pelvis pain

Symptoms that always occur with ovulation pain (mittelschmerz) or midcycle spotting: last period approximately 2 weeks ago

Urgency: Self-treatment

Normal abdominal pain

The complaint of nonspecific abdominal pain and discomfort, with no apparent cause, is one of the most common in medicine. It is a primary reason for patients to visit a medical provider or the emergency room.

The cause of abdominal pain can be difficult to find, because it can come from many different sources: the digestive tract, the urinary tract, the pancreas, the gall bladder, or the gynecologic organs.

The pain may simply be caused by overly sensitive nerves in the gut. This hypersensitivity can occur after repeated abdominal injury and/or it may have an emotional cause due to fear of the pain itself.

Diagnosis is made through physical examination, patient history, and simply ruling out any other condition. CT scan is often requested, but can rarely find a specific cause. The benefits must be weighed against the risks of radiation.

Treatment first involves making any needed lifestyle improvements regarding diet, exercise, work, and sleep, in order to reduce stress. In some cases, counseling, hypnosis, mild pain relievers, and antidepressants are helpful.

Rarity: Common

Top Symptoms: abdominal pain (stomach ache), vaginal discharge, fever, nausea

Symptoms that always occur with normal abdominal pain: abdominal pain (stomach ache)

Symptoms that never occur with normal abdominal pain: fever, vomiting, diarrhea, nausea, severe abdominal pain, unintentional weight loss, vaginal discharge

Urgency: Self-treatment

Menstrual cramps

Menstrual cramps, also called dysmenorrhea, are actually contractions of the uterus as it expels its lining during a woman's monthly period.

A certain amount of mild cramping is normal, triggered by hormone-like substances called prostaglandins. However, painful cramps may be caused by underlying conditions such as endometriosis, uterine fibroids, high prostaglandin levels, or pelvic inflammatory disease (PID.)

Severe cramping may be present, as well as nausea, headache, and dull pain that radiates to the low back and thighs. It is most common in women under age 30 who smoke, have heavy and irregular periods, and have never given birth.

An obstetrician/gynecologist (women's specialist) can do tests for underlying conditions such as those mentioned above. Women over age 25 who suddenly begin having severe cramps should see a doctor to rule out the sudden onset of a more serious concern.

Treatment of mild cramping can be done with heating pads to the abdomen and with over-the-counter pain relievers such as ibuprofen. Birth control pills, which regulate the menstrual cycle, are often effective in lessening cramps.

Rarity: Common

Top Symptoms: abdominal pain (stomach ache), abdominal cramps (stomach cramps), painful periods, lower back pain, abdominal pain that shoots to the back

Symptoms that always occur with menstrual cramps: abdominal pain (stomach ache)

Symptoms that never occur with menstrual cramps: being severely ill, disapearance of periods for over a year

Urgency: Self-treatment

Pelvis Pain Symptom Checker

Take a quiz to find out what might be causing your pelvis pain

Urinary tract infection

A urinary tract infection is an infection of the urinary tract, which includes the kidneys, bladder, and urethra. Urinary tract infections are usually caused by infections by fecal bacteria.

Symptoms of urinary tract infections include pain with urination (dysuria), ...

Read more

Normal variation of constipation

Constipation means bowel movements which have become infrequent and/or hardened and difficult to pass.

There is wide variation in what is thought "normal" when it comes to frequency of bowel movements. Anywhere from three times a day to three times a week is considered normal.

As long as stools are easy to pass, laxatives should not be used in an effort to force the body to a more frequent schedule.

Constipation is usually caused by lack of fiber in the diet; not drinking enough water; insufficient exercise; and often suppressing the urge to have a bowel movement.

A number of medications and remedies, especially narcotic pain relievers, can cause constipation.

Women are often affected, due to pregnancy and other hormonal changes. Young children who demand low-fiber or "junk food" diets are also susceptible.

Constipation is a condition, not a disease, and most of the time is easily corrected. If simple adjustments in diet, exercise, and bowel habits don't help, a doctor can be consulted to rule out a more serious cause.

Rarity: Common

Top Symptoms: abdominal pain (stomach ache), nausea, stomach bloating, constipation, constipation

Symptoms that always occur with normal variation of constipation: constipation

Symptoms that never occur with normal variation of constipation: vomiting

Urgency: Self-treatment

Polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a hormonal condition very common in women of reproductive age, resulting in menstrual abnormalities as well as an excess of the androgen testosterone. PCOS can affect a woman's overall health and appearance and often has a si...

Read more

Constipation from not eating enough fiber

Constipation is defined as having stools which are large, hard, and difficult to pass. This leaves the person feeling bloated and uncomfortable. Many things can cause constipation, and a common one is lack of fiber in the diet.

To determine whether lack of fiber is causing the constipation, all other causes are first ruled out:

  • Not drinking enough water, sometimes to the point of dehydration.
  • Lack of exercise, which helps increase blood circulation and therefore motility (contraction and movement) of the bowel.
  • A very low or no-fat diet.
  • A need for probiotics, which replenish the "good" bacteria in the gut.
  • Medications, or certain illnesses, which have a constipating effect.
  • Constantly ignoring the feeling of needing to move the bowels, and delaying going to the toilet.

If fiber is needed, the best sources are fresh vegetables; fresh or dried fruits; and whole wheat and brown rice, because those include the fiber-rich bran. Over-the-counter fiber tablets can be tried, though laxatives should only be used if recommended by a medical provider.

Rarity: Common

Top Symptoms: constipation, constipation, pain in the lower left abdomen, pain when passing stools, feeling of needing to constantly pass stool

Symptoms that always occur with constipation from not eating enough fiber: constipation, constipation

Symptoms that never occur with constipation from not eating enough fiber: vomiting

Urgency: Self-treatment

Painful bladder syndrome (interstitial cystitis)

Painful bladder syndrome, also called interstitial cystitis or IC, is a chronic condition of pain and discomfort in the urinary system.

The cause is unknown. It may be an autoimmune disorder and is often found with fibromyalgia, irritable bowel syndrome, chronic fatigue syndrome, or vulvodynia (pain in the outer female organs.) Some researchers feel the condition may be linked to a history of abuse.

Painful bladder syndrome is more common in women than in men, but can happen to anyone.

Symptoms vary and may include pressure and discomfort in the lower abdomen; pain during sexual intercourse; bladder pain; and a frequent urge to urinate.

A medical provider should be seen for these symptoms, because painful bladder syndrome can interfere with quality of life and lead to depression.

Diagnosis is made through patient history; physical examination; blood and urine tests; and sometimes cystoscopy. Women may have a pelvic examination and men may have a digital rectal examination.

There is no cure specifically for painful bladder syndrome, so treatment involves addressing the symptoms and making lifestyle changes.

Rarity: Rare

Top Symptoms: fatigue, abdominal cramps (stomach cramps), depressed mood, pelvis pain, arthralgias or myalgias

Urgency: Primary care doctor

Pelvis Pain Treatments and Relief

When pelvis pain is an emergency

Seek immediate treatment in the emergency room or call 911 for pelvis pain if you are female and you have sudden, severe pelvis pain with dizziness or fainting. This may be an ectopic pregnancy, which is a life-threatening medical emergency.

When to see a doctor for pelvis pain

Schedule an appointment for:

  • Treatment of any signs of infection and/or sexually transmitted disease: As described above.
  • Physical therapy: You can receive a personalized exercise program to address any unstable structures or scar tissue within the pelvis.

At-home treatments for pelvis pain

Pelvis pain remedies that you can try at home:

  • Improving general health: Make improvements to your diet, sleep, and exercise habits.
  • Using over-the-counter pain relievers for minor pain

Questions Your Doctor May Ask About Pelvis Pain

To diagnose this condition, your doctor would likely ask the following questions:

  • Have you experienced any nausea?
  • Any fever today or during the last week?
  • How would you describe the nature of your abdominal pain?
  • Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?

If you've answered yes to one or more of these questions

Please take a quiz to find out what might be causing your pelvis pain. These questions are also covered.

Pelvis Pain Quiz

Pelvis Pain Symptom Checker Statistics

People who have experienced pelvis pain have also experienced:

  • 9% Bloody Vaginal Discharge
  • 7% Vaginal Bleeding
  • 6% Vaginal Discharge

People who have experienced pelvis pain were most often matched with:

  • 55% Pelvic Inflammatory Disease
  • 33% Endometriosis
  • 11% Ovulation Pain (Mittelschmerz) Or Midcycle Spotting

People who have experienced pelvis pain had symptoms persist for:

  • 41% Less than a day
  • 34% Less than a week
  • 11% Over a month

Source: Aggregated and anonymized results from Buoy Assistant (a.k.a. the quiz).

Pelvis Pain Symptom Checker

Take a quiz to find out what might be causing your pelvis pain

References

  1. Pelvic Pain. U.S. National Library of Medicine: MedlinePlus. Updated March 21, 2018. MedlinePlus Link.
  2. Pelvic Pain. NHS. Updated October 30, 2018. NHS Link.
  3. Speer LM, Mushkbar S, Erbele T. Chronic Pelvic Pain in Women. American Family Physician. 2016;93(5):380-387. AAFP Link.
  4. Passavanti MB, Pota V, Pace MC, et al. Chronic Pelvic Pain: Assessment, Evaluation, and Objectivation. Pain Research and Treatment. 2017;2017:9472925. NCBI Link.
  5. Indman PD. Pelvic Pain. ModernMedicine Network. Published October 25, 2011. ModernMedicine Network Link.
  6. Verstraete EH, Vanderstraeten G, Parewijck W. Pelvic Girdle Pain During or After Pregnancy: A Review of Recent Evidence and a Clinical Care Path Proposal. Facts, Views & Vision in ObGyn. 2013;5(1):33-43. NCBI Link.
  7. Lampe A, Solder E, Ennemoser A, Schubert C, Rumpold G, Sollner W. Chronic Pelvic Pain and Previous Sexual Abuse. Obstetrics & Gynecology. 2000;96(6):929-933. NCBI Link.