Pelvic Pain: 12 Causes & What to Do

Updated in April 2022

Pelvic pain is typically felt below the abdomen, and is usually a sign of a gynecological, urological or intestinal problem. It can also be related to pregnancy. 

This symptoms is more common in women due to the reproductive organs that are found in this area. Men who experience pelvic pain are more likely to have intestinal problems, or issues with their prostate. 

To correctly diagnose the cause of the pain, you should go to a family doctor for assessment and to order testing, like urine tests, ultrasound or CT. Depending on the cause, treatment may include the use of analgesics, anti-inflammatories, or antibiotics. Surgery may be an option for some causes. 

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The main causes of pelvic pain that can affect both men and women are: 

1. Urinary tract infection (UTI) 

A urinary tract infection is the most frequent cause of pelvic pain in both men and women. Pain usually appears like a heavy sensation in the lower abdomen and is accompanied by other symptoms like urinary frequency, pain or burning with urination, low-grade fever and changes to urine characteristics (like darker urine or foul odor). 

What to do: If you suspect a UTI, you should see your doctor to confirm whether bacteria is present in your urine. In most cases, UTIs are treated with antibiotics like fosfomycin and nitrofurantoin. Analgesics and antispasmodics may also be prescribed to relieve discomfort. It is important to ensure adequate hydration during treatment. Learn about the other prescription medication that the doctor may advise, as well as natural option you can take to complement your treatment. 

2. Appendicitis

Another relatively common cause of pelvic pain is inflammation of the appendix. The appendix is a small structure connected to the intestine that is located in the lower right abdomen. Normally, appendix pain is diffuse and is felt around the bellybutton, but it can gradually radiate to the lower abdomen or top of the pelvic area, on the right side. 

In addition to pain, appendicitis can cause fever, a feeling of bloating, nausea, changes to intestinal flow and decreased appetite. Check out other symptoms that are commonly associated with appendicitis. 

What to do: Appendicitis is considered to be a medical emergency that should be assessed in the hospital. You should proceed immediately to an emergency room to confirm a diagnosis and initiate treatment, which is normally done with surgical removal of the appendix. 

3. Diverticulitis

Diverticulitis is an inflammation of the diverticuli, the small sacs found along the intestinal lining, especially in the colon. This type of inflammation generally causes a persistent pain in the left pelvic region and is accompanied by other symptoms like diarrhea, constipation, sensitivity to the left belly, fever, and loss of appetite. 

This type of problem is more common in older age, but it can also affect young adults who eat a fiber-rich diet or have constipation. 

What to do: If you suspect an intestinal problem, you should see a doctor for assessment to identify the correct cause. Most times, diverticulitis can be treated with just medication, like anti-inflammatories and antibiotics, but diet changes are also often recommended. 

4. Inguinal hernia

The presence of an inguinal hernia in the pelvic region can cause pain in this area, as well as groin swelling and a feeling of heaviness. Inguinal hernias are more common in people who are overweight or who have recently completed an abdominal surgery. Learn more about the causes of inguinal hernias and the associated symptoms. 

What to do: It is important to consult a family doctor to confirm diagnosis and initiate appropriate treatment. In most cases, surgery is advised to correct the hernia, especially if it is causing pain and other symptoms. 

5. Sexually-transmitted infections (STIs) 

STIs are infections that can be transmitted with sexual contact. They generally affect the reproductive organs, which is why STIs can cause pelvic pain. They can also appear with other symptoms like foul odor, intense gentical itching, lesions or pain with urination. 

What to do: If you suspect an STI, you should consult your doctor for assessment and diagnosis to confirm an infection. In most cases, STIs that cause pelvic pain can be treated with an antibiotic if found early. There are also infections, like HIV and herpes, that are chronic and do not have a specific treatment that cures the infection.

6. Nerve compression 

Although this is a less frequent situation, nerve compression in the spine can also cause pelvic pain. This type of condition is more common in older adults or in people with spinal problems, like a herniated disc. 

In addition to pelvic pain, some people may feel tingling in the legs, incontinence, or difficulty walking. Pain can also worsen with certain movements. 

What to do: You should consult a doctor to confirm diagnosis and start approproiate treatment, which usually involves the use of analgesics and anti-inflammatories. Depending on the severity of the compression, physiotherapy or surgery may be indicated. 

Causes of pelvic pain in women 

Because the reproductive system is mostly found in the pelvic region, pelvic pain can have causes that do not occur in men, like:

1. Menstrual cramps

Menstrual cramps are most common in adolescent girls and are caused by involuntary contraction of the uterus during menstruation. This pain usually improves with age and after pregnancy. 

Menstrual cramps that appear later in life, worsen over a few months or last outside of a period can indicate other symptoms like endometriosis. These symptoms warrant assessment by a gynecologist.  

What to do: Many times, menstrual cramps can be relieved with home remedies like applying a hot water bottle over the pelvic region or by drinking ginger tea. If pain is very intense, you should see your doctor to rule out other causes of pain, but to evaluate the need for medications like antispasmodics. 

2. Pregnancy

Pelvic pain is very common during pregnancy, and usually occurs due to the production of the relaxin hormone. This hormone makes ligaments more elastic, allowing the junctions of the pelvis to become looser for delivery. In addition, the baby’s weight can also cause pressure within the pelvic organs, causing pain. 

Pelvic pain that occurs during pregnancy is usually not intense, but it can be uncomfortable. It can occur in the first trimester or occur only a few days before delivery. Learn about other symptoms usually associated with the beginning of pregnancy. 

What to do: When pain is not too intense, you can relieve it at home by resting and avoiding strenuous activities. If pain is very intense, however, if it increases over time, or if it appears with other symptoms like bleeding, it can be a sign of a more serious complication and requires assessment. 

3. Endometriosis

Endometriosis is a condition that is characterized by the growth of endometrial tissue outside of the uterus. It causes pelvic pain and inflammation that worsens during menstruation. Endometriosis can also cause increase menstrual flow, pain with sexual contact and difficulty getting pregnant. Learn about other symptoms that can occur with endometriosis.

What to do: You are advised to consult a gynecologist for diagnosis and to initiate appropriate treatment. When symptoms are mild, treatment can be cone with just pain-relieving medication, like ibuprofen. More serious cases require hormonal medication or surgery to remove migrated endometrial tissue. 

4. Uterine myoma 

Uterine myomas are benign tumors that grow on the muscular layer of the uterus. although they usually do not cause symptoms, they can cause pelvic pain, bleeding outside of menstruation, constipation and difficulty getting pregnant. 

What to do: If you suspect a myoma, then you should see your doctor for assessment and to start appropriat treatment. Treatment is indicated when the myoma causes symptoms or discomfort, and usually involves the use of  hormonal medications like birth control to reduce its size. In other cases, the doctor may prescribe analgesics or anti-inflammatories. In more serious cases, surgery may be advised. 

5. Ovarian disease

The presence of cysts, tumours or ovarian infection can also cause intense pelvic pain. In addition to pain, other symptoms like bleeding outside of menstruation, pain with sex, a feeling of bloating, frequent fatigue and general malaise. 

Another common cause of pelvic pain related to the ovaries is pain that emerges with ovulation. Pain occurs with the release of the egg, and is usually mild and lasts for 1 or 2 days. 

What to do: Ovarian problems should always be evaluated by a gynecologist who can order diagnostic testing, like a pelvic ultrasound, to identify the cause of pain. Treatment depeds on the cause and can involve the use of analgesics, anti-inflammatories or even surgery. 

6. Pelvic inflammatory disease

Pelvic inflammatory disease is a condition that causes swelling of the reproductive organs and can affect the uterus, fallopian tubes and obaries. Generally, it is caused by bacteria that is sexually transmitted, causing an acute  infection or a chronic infection that lasts for months or years. 

What to do: Any suspician of pelvic inflammatory disease should be assessed by the doctor, to confirm diagnosis and start appropriate treatment. Treatment generally involves rest and antibiotics for 14 days. In some cases, surgery may be necessary to treat uterine inflammation or drain an abscess. Sexual partners should also be treated, even if they are asymptomatic, to prevent recontamination.