Pelvic Pain

Medically Reviewed By William C. Lloyd III, MD, FACS
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What is pelvic pain?

Pelvic pain is pain or discomfort in the pelvic region, the area below your belly button. It can affect both men and women. Some women describe the pain as a stabbing, burning or heavy feeling. The pain may be constant or variable and may range in intensity from mild to severe. Pain due to an injury often has a sudden onset, while pelvic pain resulting from an infectious or disease process may develop slowly and persist or worsen over time.

Pelvic pain in women is often experienced as cramping during a normal menstrual cycle. Pelvic pain may also be caused by reproductive, digestive, or urinary system diseases and disorders. This pain may occur during sexual intercourse, menstruation, bowel movements, or urination. Symptoms of pelvic pain can result from damage or injury to any of the structures within the female reproductive system, including the outer genitalia, clitoris, vagina, uterus, ovaries, or fallopian tubes.

Pain in the pelvis may be associated with cancer or disease in the bladder or colon. Sometimes perceived pelvic pain is actually a psychological symptom following sexual abuse, rape, or trauma.

Pain and discomfort in the vulva (vulvodynia) is often linked to pelvic pain. Other causes include pelvic inflammatory disease, polycystic ovary syndrome, sexually transmitted infections, and cancers. Further, pelvic pain may be related to a chronic underlying disease that affects other regions of the body.

Pelvic pain alone is rarely a serious medical condition; however, it may be associated with symptoms of a serious or life-threatening condition. Seek immediate medical care (call 911) if you have high fever (higher than 101°F), severe pain, chills, severe or uncontrollable vaginal bleeding, or rapid heart rate (tachycardia).

If your pelvic pain is persistent or causes you concern, seek prompt medical care.

What other symptoms might occur with pelvic pain?

Pelvic pain may accompany other symptoms that vary depending on the underlying disease, disorder or condition. Symptoms that frequently affect the pelvic region may also involve other body systems.

Reproductive system symptoms that may occur along with pelvic pain

Pelvic pain may accompany other symptoms affecting the reproductive system including:

Other symptoms that may occur along with pelvic pain

Pelvic pain may accompany symptoms related to other body systems including:

Symptoms that might indicate a serious condition

In some cases, pelvic pain may indicate a serious condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) for pelvic pain along with other serious symptoms including:

  • Abdominal, pelvic, or lower back pain that can be severe

  • Chills

  • High fever (higher than 101°F)

  • Rapid heart rate (tachycardia)

  • Severe or uncontrollable vaginal bleeding

What causes pelvic pain?

Pelvic pain may accompany other symptoms that vary depending on the underlying disease, disorder or condition. Symptoms that frequently affect the pelvic region may also involve other body systems.

Female reproductive organ causes of pelvic pain

Pelvic pain may be caused by reproductive organ disorders including:

Other causes of pelvic pain in men or women

Pelvic pain can also be caused by disorders or conditions involving systems other than the reproductive system including:

Serious or life-threatening causes of pelvic pain

In some cases, pelvic pain may be a symptom of a serious or life-threatening condition that should be immediately evaluated by a healthcare provider. These include:

When should you see a doctor for pelvic pain?

Sudden, severe, or rapidly worsening pelvic pain could be a sign of a serious or life-threatening medical problem. Seek emergency medical care for this type of pelvic pain.

Also, call 911 or go to your nearest emergency room for pelvic pain when:

  • You also have a fever, chills, nausea or vomiting.

  • You have blood in your urine or stool.

  • You have foul-smelling or cloudy urine.

  • You have pelvic pain during pregnancy.

  • You have pelvic pain in the lower right side or pain that starts behind the navel and moves to the lower right side.

See a doctor promptly when:

  • Pelvic pain changes, intensifies, or becomes frequent or chronic.

  • Pelvic pain is new or interrupts your daily activities or sleep.

  • Pelvic pain persists or recurs.

  • There is no obvious cause of pelvic pain, such as constipation.

How do doctors diagnose the cause of pelvic pain?

To diagnose the cause of pelvic pain, your doctor will take a medical history, perform an exam, and possibly order testing. Questions your doctor may ask about pelvic pain include:

  • Where exactly is the pain?

  • When do you feel pelvic pain?

  • How long have you felt pain in your pelvis?

  • Did it start suddenly or come on gradually?

  • What does the pain feel like, such as sharp, dull, crampy or achy?

  • On a scale of 1 to 10 with 10 being the worst pain ever, how would you rate the pain?

  • Do you have any other symptoms?

  • What medications are you taking?

  • When was your last menstrual period?

  • Are you experiencing abnormal bleeding?

  • Could you be pregnant?

During the physical exam, your doctor will feel your abdomen. It will be important to note any areas of tenderness or pain. The exam may also involve a digital rectal exam (DRE). For women, the exam will likely include a pelvic exam. Using the results of the exam, your doctor may order testing including:

  • Blood tests to check blood cell counts for signs of infection

  • Urine tests to check for infection, the presence of blood or other abnormalities, and pregnancy in females

  • Genital swabs to culture for sexually transmitted infections, or STDs

  • Stool tests to check for the presence of blood

  • Imaging exams of the abdomen and pelvis, including X-rays, ultrasounds, CT (computed tomography) exams, and MRIs (magnetic resonance imaging)

  • Endoscopy exams, including colonoscopy (to look inside the large intestine and rectum), cystoscopy (to look inside the bladder and urethra), and hysteroscopy (to look inside the uterus) in females

  • Diagnostic laparoscopy to explore the abdomen and pelvis

It is not always possible to diagnose an underlying cause or condition. If pelvic pain persists and your provider is unable to determine a cause, seeking a second opinion may give you more information and answers.

How do you treat pelvic pain?

Treating pelvic pain depends on the underlying cause. Doctors may recommend the following treatment options:

  • Medications, including antibiotics, anti-inflammatory drugs, muscle relaxants, and pain medicines, which may include antidepressants or anti-seizure medicines. In females, birth control pills and other hormonal treatments may also be options.

  • Physical therapy, including massage, stretching, strengthening, and exercises to control abdominal and pelvic floor muscles to help muscular and connective tissue disorders

  • Surgery, which will vary depending on the underlying issue

  • Counseling, including talk therapy and cognitive behavioral therapy to help deal with the stress and learn to cope with pelvic pain that becomes chronic or that occurs for no apparent physical reason

Sometimes, a combination of these approaches is most effective in treating pelvic pain.

Home remedies for pelvic pain

There are several self-care strategies you can try at home unless your doctor tells you to avoid them. Home treatments for pelvic pain include:

  • Heat therapy, including heating pads and hot water bottles, especially for menstrual pain

  • Over-the-counter (OTC) pain relievers, including acetaminophen (Tylenol) and ibuprofen (Advil, Motrin)

  • Posture improvement

  • Regular exercise, increased fluid intake, and a high-fiber diet to combat constipation. Ask your doctor about fiber supplements, stool softeners, or laxatives.

  • Stress relief and relaxation techniques, including meditation and mind-body activities

Alternative treatments for pelvic pain

In general, there is usually limited evidence for the effectiveness of alternative treatments. However, they may help some people in some cases. Pelvic pain, especially menstrual pain, may respond to the following:

  • Acupuncture or acupressure

  • Magnesium supplements

  • Nerve stimulation therapy, such as TENS (transcutaneous electrical nerve stimulation)

  • Vitamin B1 (thiamin) supplements

Talk with your doctor before trying alternative treatments for pelvic pain. It is important to make sure the treatment is safe for you and will not interact with traditional treatments.

What are the potential complications of pelvic pain?

The potential complications of pelvic pain depend on their cause. Pelvic pain associated with serious medical conditions may have long-term and even potentially life-threatening complications. Getting prompt treatment of injuries or infections can help you avoid serious complications, such as deformity or widespread infection.

Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your healthcare professional design specifically for you to reduce the risk of potential problems. Left untreated, conditions that cause pelvic pain may lead to the following complications:

  • Abscess

  • Adverse effects of treatment

  • Infertility

  • Sepsis (life-threatening to infection)

  • Sexual dysfunction

  • Spread of cancer

  • Spread of infection

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Aug 19
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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