Common Reasons for Pelvic Pain: When Should You See a Healthcare Provider?
Pelvic pain can be uncomfortable, frustrating, and sometimes difficult to describe. It may feel like a dull ache, pressure, cramping, heaviness, or a sharp pain that comes and goes. For some people, it appears suddenly. For others, pelvic discomfort may continue for weeks or months.
Because many different organs and structures are located in the pelvis, there isn’t one single cause of pelvic pain. The reproductive organs, bladder, urinary tract, intestines, muscles, and joints can all contribute to discomfort in this area.
Fortunately, many causes of pelvic pain are treatable. Understanding some of the common possibilities can help you recognize when it’s time to talk with a healthcare provider.
1. Menstrual Cramps
Menstrual cramps are one of the most common causes of pelvic pain. During menstruation, the uterus contracts to help shed its lining. These contractions can cause cramping or aching in the lower abdomen and pelvis.
Mild to moderate cramping is common. However, periods that cause severe pain, interfere with normal activities, suddenly become much more painful, or progressively worsen deserve further evaluation.
2. Ovulation Pain
Some people experience pelvic discomfort around the time an ovary releases an egg. This is sometimes called mittelschmerz, or ovulation pain.
The discomfort often occurs on one side of the lower abdomen and may last anywhere from a few minutes to a day or two. It is usually harmless, but recurring or severe pain should still be discussed with a healthcare provider.
3. Urinary Tract Infections
A urinary tract infection (UTI) can cause pain or pressure in the lower abdomen or pelvis. Other symptoms may include:
- Burning or pain with urination
- Frequent or urgent urination
- Feeling like you still need to urinate after emptying your bladder
- Cloudy, bloody, or unusually strong-smelling urine
UTIs are generally treatable, but they can become more serious if the infection spreads to the kidneys.
4. Ovarian Cysts
Ovarian cysts are fluid-filled sacs that can develop on or within an ovary. Many cysts are small, cause no symptoms, and disappear on their own.
However, some ovarian cysts can cause pelvic pressure, bloating, discomfort during certain activities, or pain on one side of the pelvis. Rarely, a cyst can rupture or cause the ovary to twist, resulting in sudden and severe pain that requires prompt medical attention.
5. Endometriosis
Endometriosis occurs when tissue similar to the lining of the uterus grows outside the uterus. It can cause significant pelvic pain, particularly around menstruation.
Other possible symptoms include painful periods, pain during or after sex, pain with bowel movements or urination during a period, and difficulty becoming pregnant.
Severe period pain shouldn’t simply be dismissed as something you have to live with.
6. Uterine Fibroids
Fibroids are noncancerous growths that develop in or around the uterus. Some people have fibroids without experiencing any symptoms.
When symptoms do occur, they may include pelvic pressure or pain, heavy or prolonged menstrual bleeding, frequent urination, constipation, or a feeling of fullness in the lower abdomen.
7. Pelvic Inflammatory Disease
Pelvic inflammatory disease (PID) is an infection involving the female reproductive organs. It can sometimes develop as a complication of sexually transmitted infections such as chlamydia or gonorrhea, although other bacteria can also cause PID.
Symptoms may include pelvic or lower abdominal pain, unusual vaginal discharge, pain during sex, bleeding between periods, fever, or pain with urination.
Early treatment is important because untreated PID can lead to complications, including chronic pelvic pain and fertility problems.
8. Digestive Problems
Not all pelvic pain comes from the reproductive system. The intestines also pass through the pelvic area.
Constipation, gas, irritable bowel syndrome (IBS), intestinal infections, and other digestive problems can cause pain, pressure, cramping, or bloating that may feel like pelvic pain.
Keeping track of whether your symptoms change after eating or having a bowel movement can provide useful information for your healthcare provider.
9. Muscle and Pelvic Floor Problems
The muscles that support the pelvis can also become tight, strained, irritated, or weak. Pelvic floor problems may cause chronic pelvic discomfort, pain during sex, urinary symptoms, bowel difficulties, or pressure in the pelvis.
In some cases, treatment may include pelvic floor physical therapy or other therapies directed at the underlying problem.
10. Pregnancy-Related Causes
Pelvic discomfort can occur during pregnancy for many reasons, including normal changes as the uterus grows. However, pelvic pain can sometimes signal a more serious pregnancy-related problem.
If you are pregnant—or there is a possibility you could be pregnant—and you develop significant pelvic pain, especially with vaginal bleeding, dizziness, fainting, or shoulder pain, seek medical attention promptly. These symptoms can occur with an ectopic pregnancy, which requires urgent medical care.
When Should You See a Healthcare Provider?
Consider making an appointment if pelvic pain is persistent, keeps returning, is getting worse, interferes with normal activities, or occurs with symptoms such as abnormal bleeding, unusual discharge, painful urination, pain during sex, or changes in bowel habits.
Seek urgent medical care for severe or rapidly worsening pelvic pain, particularly when it occurs with heavy bleeding, fever, persistent vomiting, fainting or severe dizziness, or possible pregnancy.
Don’t Ignore Persistent Pelvic Pain
Pelvic pain is a symptom—not a diagnosis. Sometimes the cause is relatively simple, while other times it takes a little investigation to understand what is happening.
That is why you don’t need to figure out the cause on your own.
At Aslan Health, our providers can listen to your concerns, review your symptoms and medical history, perform an appropriate examination or testing when needed, and help determine the next step. If additional testing or specialty care is necessary, we can also help you understand your options and navigate where to go next.
If pelvic pain has been bothering you, has changed recently, or simply doesn’t feel right, consider talking with a healthcare provider.
Aslan Health — Caring for Our Neighbors.