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10 Pelvic Pain Causes Every Woman Should Know About

Pelvic pain is discomfort felt in the lower abdomen, below the belly button. It can feel stabbing, dull, or burning, and it can be constant or come and go. 

While occasional mild twinges associated with your menstrual cycle are typically nothing to worry about, persistent or severe discomfort is not something you should ignore. Chronic or intense pelvic pain might signal an underlying condition and should be evaluated by a healthcare provider. 

What Causes Pelvic Pain? 

Pelvic pain can have many different causes, since the pelvic area contains organs, muscles, nerves, and other tissues that may all contribute to discomfort. Because of this, the pain may start in one area but be felt more widely across the lower abdomen or pelvis. 

The following are some of the more common pelvic pain causes:

1. Endometriosis

Endometriosis occurs when tissue similar to the endometrium or uterine lining grows outside the uterus. This tissue behaves just like it would inside your womb, thickening, breaking down, and bleeding with every menstrual cycle.

Because this blood has no way to exit your body, it becomes trapped, leading to severe symptoms:

• Debilitating menstrual cramps that worsen over time
• Chronic lower back and pelvic pain that persists outside of your period
• Pain during or after sexual intercourse
• Painful bowel movements or urination, particularly during your cycle

If your period pain routinely forces you to miss work, school, or social activities, you should seek a professional medical evaluation. Your doctor may prescribe medication or other forms of treatment, such as hormone therapy or surgery.

2. Ovarian Cysts

Ovarian cysts are fluid-filled sacs that develop on or inside one of your ovaries. Many women develop these during their childbearing years. While most of these cysts disappear on their own without treatment, some can grow large enough to cause discomfort.

The most common signs include:

• A dull, heavy ache on one side of your lower abdomen
• A feeling of fullness or bloating in your pelvic area
• Sudden, sharp pain if a cyst ruptures or causes the ovary to twist (torsion)

An ovarian cyst becomes a medical emergency if it causes sudden, severe pelvic pain accompanied by fever or vomiting. These symptoms point toward a potential rupture or ovarian torsion, both of which require immediate treatment.

3. Uterine Fibroids

These noncancerous growths can sometimes develop within or on the muscular walls of the uterus. They can vary dramatically in size, ranging from 1 cm to 10 cm or more. Very large masses can distort the shape of the womb. 

Many women have fibroids at some point in their lives, but never realize it because they have no symptoms. When fibroids do cause symptoms, they typically include: 

• Heaviness, pressure, or a frequent dull ache in the pelvic area
• Exceptionally heavy, prolonged, or painful menstrual periods
• An increased frequency of urination or difficulty emptying your bladder fully
• Unexplained lower back pain or constipation

4. Pelvic Inflammatory Disease (PID)

In the United States, approximately one million women are diagnosed with pelvic inflammatory disease (PID) each year. It occurs when bacteria from the vagina or urinary tract move up into the reproductive organs. 

Most cases of PID are caused by sexually transmitted infections (STIs) like chlamydia and gonorrhea. Women who are sexually active and within their childbearing years are most at risk.

Some women with PID experience no symptoms. When they do occur, they may include:

• Pain or tenderness spread across the lower abdomen and pelvis
• An unusual or foul-smelling vaginal discharge
• Irregular bleeding, especially bleeding between periods or after intercourse
• Mild chills or a fever
• Painful and difficult urination

If you are experiencing symptoms or suspect PID, consult your doctor immediately. Prompt antibiotic treatment can help prevent complications like permanent scarring within the fallopian tubes, which can result in chronic pain and difficulty conceiving. 

5. Adenomyosis

A person with adenomyosis has tissue from the lining of the uterus growing into the uterine wall. This can cause the uterus to expand and result in pain and other symptoms. 

Like endometriosis, adenomyosis occurs when tissue from the lining of the uterus grows where it’s not supposed to. However, it is a distinctly different condition because the misplaced tissue stays contained within the uterine muscle rather than spreading outside of it.

Symptoms of adenomyosis include:

• Prolonged, heavy menstrual bleeding that may include large blood clots
• Severe, sharp, or knifelike pelvic cramping during your period
• A constant, low-grade pelvic pressure or abdominal bloating
• Pain during sexual intercourse

Doctors diagnose this condition using advanced pelvic ultrasounds or MRI scans. Treatment approaches range from hormonal therapies like birth control or a progestin-releasing IUD to surgical options. A hysterectomy is considered the definitive cure for adenomyosis in women who do not plan to have children.

6. Urinary Tract Infections (UTIs)

A urinary tract infection occurs when germs, usually bacteria, enter the urinary system and cause an infection. If the bladder is affected, it can cause pain or pressure in the lower part of the belly,

Other symptoms to watch for include:

• A strong, persistent urge to urinate frequently
• A burning or painful sensation whenever you pass urine
• Cloudy, strong-smelling, or pinkish-red blood-tinged urine
• Pressure or discomfort localized directly above your pubic bone

You should contact a doctor as soon as you notice these signs so they can prescribe a targeted course of antibiotics. Ignoring a UTI allows the bacteria to travel higher up into your urinary tract, which can cause a kidney infection.

7. Interstitial Cystitis

Interstitial cystitis, often referred to as painful bladder syndrome, is a chronic condition that results in bladder pressure and pain. Sometimes, it can also cause pelvic discomfort. 

The symptoms of interstitial cystitis are similar to a UTI and include:

• Chronic pelvic pain that intensifies as your bladder fills 
• An urgent need to urinate, often dozens of times a day and night
• Pain between the vagina and anus that fluctuates in intensity

There is no simple cure for interstitial cystitis. Treatment focuses on managing symptoms. 

8. Irritable Bowel Syndrome (IBS)

IBS is a common disorder of the large intestine that can cause abdominal pain and bloating. Because the digestive and reproductive systems are close together in the pelvis and share nearby nerves, pain from the bowel can sometimes be felt in the pelvic region. 

Common triggers that can worsen IBS symptoms include:

• High levels of daily stress or unmanaged anxiety
• Specific foods, particularly dairy, wheat, beans, citrus, or carbonated drinks
• Hormonal fluctuations, with many women noticing flare-ups right before their period

9. Pelvic Floor Dysfunction

The pelvic floor is a hammock-like group of muscles and ligaments that stretches across the base of your pelvis. It supports your bladder, uterus, and bowels, while also helping you control your urinary and bowel functions. When pelvic floor muscles become too tight or weak, or if they don’t coordinate properly, they can cause chronic pain across the pelvic region.

Signs of pelvic floor dysfunction include:

• A constant, aching pain or pressure in your pelvis, lower back, or rectum
• A frequent feeling that you cannot completely empty your bladder or bowels
• Pain or extreme discomfort during pelvic exams or sexual intercourse
• Accidental leaking of urine when coughing, sneezing, or laughing

10. Ovulation or Menstrual Pain

Ovulation and menstrual periods are among the most common pelvic pain causes. Mild discomfort during their monthly cycle is part of life for many women. 

• Pain during the middle of your cycle is called mittelschmerz. When an ovary releases an egg, it can cause a brief twinge or cramp on one side of your lower abdomen. 
• During your period, mild cramping, especially on the first day or two, is normal and is caused by your uterus contracting to shed its lining.

In some cases, cycle-related pain may indicate an underlying medical condition. Consider seeing a doctor if you experience:

• Cramps that get progressively worse every month
• Pain that does not respond to over-the-counter anti-inflammatory medications
• Discomfort that starts several days before your period begins and lasts after it ends
• Bleeding so heavily that you soak through a pad or tampon every hour

Intense menstrual pain is frequently a secondary symptom of conditions like endometriosis or fibroids, both of which require medical management.

When To See a Women’s Health Specialist

Learning to recognize when your symptoms require an expert opinion is crucial for protecting your long-term health and well-being. If you experience the following warning signs, you should schedule an evaluation with a women’s health specialist:

• Sudden or severe pelvic pain 
• Lower abdominal pain that steadily worsens over several days or fails to improve with rest
• Discomfort that interferes with your ability to work or sleep
• Pelvic pain accompanied by an unexplained fever, chills, nausea, or vomiting
• Pain that occurs alongside unusual vaginal bleeding, especially if you are pregnant or past menopause

Persistent or severe pain is not something you have to live with indefinitely. With diagnosis and treatment, you can experience lasting relief from discomfort and improve your quality of life. 

FAQs

How do doctors diagnose the underlying cause of pelvic pain?

Our gynecology services include a comprehensive evaluation to diagnose the underlying cause of pelvic pain. Specialists typically begin with a detailed review of your medical history and a thorough pelvic examination. Depending on your specific symptoms, they may order diagnostic imaging, such as a pelvic ultrasound or an MRI, to view your internal organs. In more complex cases, a minimally invasive surgical procedure called a laparoscopy may be used to inspect the pelvic cavity.

Can lifestyle factors like diet or stress trigger pelvic pain?

Yes, lifestyle factors can affect how your body processes and experiences pain. High levels of chronic stress can cause the muscles of your pelvic floor to involuntarily tense up, creating a cycle of persistent aching and soreness. Additionally, inflammatory foods or gastrointestinal sensitivities can irritate your digestive tract, which can worsen pelvic discomfort.

When should pelvic pain be considered a medical emergency?

Pelvic pain becomes a medical emergency if it is sudden, excruciating, and accompanied by signs of systemic illness or internal distress. Visit your nearest emergency room if your pain is accompanied by:

• A high fever
• Uncontrollable vomiting
• Dizziness or fainting
• Difficulty passing urine or inability to move your bowels
• Sudden, heavy vaginal bleeding

Get Quality, Comprehensive Care for Pelvic Pain

Many women have gotten used to living with pelvic pain. Often, they are told that it’s just part of being a woman. But that’s not how it has to be. If the pain is severe, sudden, or disrupts your activities, seek medical advice immediately. 

The Pearl Women’s Center team is dedicated to providing compassionate, comprehensive care. One of our women’s health specialists will evaluate your symptoms and order tests to determine what causes your pelvic pain. They tailor treatment that addresses any underlying condition and provides lasting relief so that you can return to your normal activities.

Don’t let pelvic pain hold you back from living your life to the fullest. Contact Pearl Women’s Center today to schedule your appointment and take the first step toward finding lasting relief.