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Medical News Today: What causes pelvic pain?

The pelvis is the area of the body below the abdomen or belly. There are many different organs and structures in the pelvis, including blood vessels, nerves, reproductive structures, bladder and urinary structures, and the bowel and rectum.

There are many different causes of pain in the pelvis. In this article, we investigate possible causes of pelvic pain in men and women. We also look at the treatment options and when to see a doctor.


Woman holding her pelvis due to pelvic pain
Constipation, endometriosis, fibroids, and STIs can cause pelvic pain.

There are many causes of pelvic pain, including:

1. Constipation

Constipation can cause pelvic pain, especially if it affects the lower colon. This type of pain tends to go away once a person has a bowel movement.

2. Other intestinal problems

A variety of other intestinal conditions can cause pain in the lower abdomen or pelvis. These include:

3. Endometriosis

Endometriosis is when tissue similar to the uterine lining grows outside of the uterus. This tissue can bleed during a person’s menstrual cycle, as well as stick to other organs, causing pain and other symptoms.

The location of the pain depends on where the tissue implants. While some people experience symptoms just during menstruation, others have pain at other times during their cycle.

4. Fibroids

Fibroids are benign (non-cancerous) growths in the uterus. They can cause pain throughout the pelvis and lower back.

Fibroids can also cause rectal or bladder pressure and the feeling of needing to go to the bathroom more often.

5. Pelvic inflammatory disease (PID)

PID is an infection that occurs in the female reproductive structures. It is usually due to a sexually transmitted infection (STI).

PID causes pelvic or low back pain, menstrual period changes, and unusual vaginal discharge.

6. Ovulation pain

Ovulation pain or “mittelschmerz,” is slight to moderate discomfort during the middle part of a menstrual cycle.

Ovulation pain can last for a few minutes or up to a few days. The pain may feel like a cramp or be sharp and sudden. It is not indicative of any underlying problem.

7. Scar tissue or adhesions

Previous infections or surgical procedures can cause the formation of scar tissue or adhesions in the pelvis. This type of scar tissue can cause chronic pelvic pain.

8. Adenomyosis

Adenomyosis is when endometrial tissue grows deep into the uterine muscle. Women with this condition tend to have very heavy periods with severe pelvic pain.

9. Sexually transmitted infections (STIs)

Most STIs do not cause any symptoms, but a few can cause pelvic cramping or pain. These include chlamydia and gonorrhea.

Without treatment, some STIs can lead to PID, which can also cause pelvic pain.

10. Menstrual cramps

woman sitting on sofa holding small hot water bottle on her stomach
Menstrual cramps can cause pelvic pain.

Menstrual cramps occur in the lower part of the pelvis and tend to start just before a person’s period and may continue for a few days.

Particularly painful cramps could be a sign of an underlying condition, such as endometriosis or adenomyosis, so a person may wish to speak to a doctor about testing.

11. Ectopic pregnancy

An ectopic pregnancy is a life-threatening event that requires immediate medical care.

An ectopic pregnancy is when a fertilized egg implants into the pelvis or abdomen outside of the uterus.

In most cases, an ectopic pregnancy occurs in the fallopian tubes, but it can happen anywhere in the abdomen or pelvis. Pain and cramping occur as it grows, pressing on nearby organs or nerves.

12. Pregnancy loss

A pregnancy loss can also cause cramping or pelvic pain. Though some cramping in early pregnancy is normal as the fetus grows, people should report severe or long-lasting pain to a doctor.

13. Appendicitis

The appendix is located in the lower abdomen and can cause pelvic or low back pain if it becomes inflamed and presses against the colon.

14. Hernia

A hernia is an opening where the internal organs can pass through. If the hernia occurs in a muscle in the lower pelvis, it can lead to pelvic pain. Other symptoms may include a visible bulge at the location of the pain.

15. Muscle spasms in the pelvic floor

The pelvis is made up of several muscles that support the bladder, reproductive structures, and bowel.

Like other muscles, the pelvic floor muscles can spasm, causing pain and discomfort.

16. Prostate problems

A man’s prostate sits low in the pelvis. Inflammation or infection of the prostate can cause pelvic pain.

A growth on the prostate, whether benign or cancerous, may also cause pelvic pain or discomfort.

17. Urinary tract infection (UTI)

The typical symptoms of a UTI are burning pain during urination and more frequent urges to urinate. Some people also present with pelvic pain or cramping, especially for severe or long-lasting infections.

18. Interstitial cystitis

Interstitial cystitis is a chronic bladder problem that causes pain in the lower pelvis, especially when delaying urination.

People with interstitial cystitis usually experience frequent and urgent needs to go to the bathroom to urinate.

19. Kidney stones

Stones formed in the kidney usually begin to make their way out of the body through the ureters and bladder, which can cause pain in the lower pelvis. This pain can be severe.

20. Ovarian mass

A growth on the ovary can cause pelvic pain especially if it is pressing on the local nerves or nearby organs.

Possible masses include an ovarian cyst, benign ovarian tumor, or ovarian cancer.

Managing pelvic pain

Doctor speaking to his patient and writing a prescription
Consult a doctor if pelvic pain is severe.

It is possible to manage the pain and discomfort once a person knows what is causing it. If a person is not sure of the cause or the pain is severe or does not improve, it is best to see a doctor.

In many cases, simple home remedies can help relieve some of the pain. Home remedies to get relief include:

  • taking over-the-counter pain relievers, such as ibuprofen
  • placing a heating pad on the pelvis
  • doing light and gentle exercise or stretching
  • resting with the legs elevated, which promotes blood flow to the pelvis

When to see a doctor

While pelvic pain is a widespread problem, people should report it to a doctor, particularly if it does not respond to home remedies or is happening regularly.

A person should seek medical help immediately if the pain is severe or they experience nausea or vomiting, fever, or loss of consciousness.

It is best to contact a doctor with any questions or concerns about new or chronic pelvic pain.