Pelvic pain management

Pelvic pain is pain that occurs below your belly button and above your legs. Whether it’s mild or severe, it can have a big impact on your quality of life.

Pelvic pain can be chronic or acute. Chronic pelvic pain is pain that lasts for more than six months. Acute pelvic pain comes on quickly and may be intense. Either kind of pain can benefit from treatment, so consult your primary care physician or a women’s health specialist for guidance about what to do.

When is pelvic pain serious?

You may not need to see your doctor in some cases. Low abdominal pain that you’re able to ease with over-the-counter medications, ice, rest or a heating pad doesn’t require a visit to your doctor. However, you should tell your doctor about pain like that at your annual physical checkup.

You should see a doctor promptly if you also experience any of the following:

• Blood in urine
• Pain accompanied by fever, nausea or vomiting
• Pain from a known condition that changes suddenly
• Sudden or severe pain
• Unexpected vaginal bleeding with severe pain
• You believe you have an infection of some kind

Your doctor may ask about how long you’ve had the pain and what it feels like (sharp, stabbing, achy or dull pain in lower left abdomen). They may also want to know whether you think it’s related to an injury or another underlying cause.

Use our pelvic floor self-assessment to help decide if you need to see your doctor because of your pelvic discomfort.

What causes pelvic pain?

Pelvic pain can come from a variety of conditions, and more than one condition may contribute to your pain. Potential causes of female abdominal pain can be categorized based on the part of the body that they affect.

Sources of pelvic pain

Causes of pelvic pain associated with the urinary tract:

• Cystitis: Bladder inflammation caused by bacterial infection
• Interstitial cystitis: Bladder inflammation with no known cause
• Urinary stones
• Urinary tract infection

Causes of pelvic pain associated with the reproductive system:

• Ectopic pregnancy: Embryo implants and develops outside the uterus
• Endometriosis: Abnormal growth of tissue outside the uterus that’s like endometrium (tissue that lines the uterus).
• Menstrual pain and cramps
• Ovarian cyst: Cyst that grows on an ovary
• Ovulation: Pain from an egg being released from an ovary
• Pelvic inflammatory disease: Infection in the uterus
• Sexually transmitted infections
• Polycystic ovary syndrome (PCOS)
• Uterine fibroids

Causes of pelvic pain associated with other conditions:

• Appendicitis: Infection or inflammation of the appendix
• Cancerous tumor
• Hernias
• Irritable bowel syndrome (IBS)
• Inflammatory bowel disease (IBD)
• Pelvic adhesions: Internal scarring that binds two tissues that shouldn’t be joined
• Pelvic floor dysfunction: Pelvic floor muscles become weak or don’t work right
• Pelvic organ prolapse: Bladder, uterus or both organs may drop into a lower position as you get older 

Pelvic pain during pregnancy

Some pelvic pain in women during pregnancy may be normal. As the fetus grows during your pregnancy, it puts pressure on the nerves in your pelvis, other organs and the pelvic girdle (the bones of the pelvis). You may notice more pelvic girdle pain when you’re walking a lot or climbing stairs.

Labor pain may be felt in the pelvis, although it may spread to higher in your abdomen, too. Keep your doctor informed about pain in the pelvis during pregnancy. Contact them immediately if you have any of the following symptoms along with low abdominal pain:

• Fainting, feeling light-headed or having a rapid heartbeat
• Fever or chills
• Severe or sudden pain
• Vaginal bleeding or discharge

Your doctor may recommend you be seen right away.

What does pelvic pain feel like?

There are as many symptoms of pelvic pain in women as there are causes. The pain itself may be sharp, stabbing, dull or achy. If you have an infection, you may also have nausea, dizziness and fever.

Symptoms related to pelvic pain

When pelvic pain is connected to a urinary tract condition, you may also experience frequent urination, pain while urinating or low back pain.

Pain related to parts of the reproductive system may feel like cramps, pressure or bloating. You may also have unexpected vaginal bleeding, abnormal vaginal discharge, heavy periods, pain during sex or pain in the pelvis that extends to your lower back.

Pain from these or other sources may come with pressure, swelling, bloating, diarrhea, constipation and a general feeling of being unwell.

Treatment for pelvic pain

Treatment for your pelvic pain will depend on its causes. Your doctor will order testing depending on your group of symptoms and things they observe during your physical exam. They may recommend an MRI or other imaging. Or they may draw blood or take a urine sample to test for infections or other conditions.

Pelvic floor physical therapy or medications may be prescribed for some conditions, while surgery may be necessary for others. Your provider will work with you to develop a plan that treats your pelvic pain and any underlying conditions.