Pelvic pain management

Having pain in your pelvis can have a negative impact on your life. Pelvic pain can be chronic (lasting for more than six months) or acute (coming on suddenly). Seeking help from your primary care physician can put you on the path to less pelvic pain and better quality of life.

What causes pelvic pain?

Finding the source of pelvic discomfort can be tricky because there are many potential causes and it may come from more than one part of your body.

Sources of pelvic pain

Sources related to the reproductive system:

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

Sources related to the urinary tract:

• Cystitis: Bladder inflammation caused by bacteria
• Interstitial cystitis: Bladder inflammation with no known cause
• Urinary tract infection
• Urinary stones: Particles made of built-up salts and minerals found in the urinary system (kidneys, ureters, bladder, urethra)

Sources related to other conditions:

• Irritable bowel syndrome (IBS)
• Appendicitis: Infection or inflammation of the appendix
• Pelvic adhesions: Internal scarring that causes two tissues to bind together
• Cancerous tumor
• Hernias
• Pelvic organ prolapse: As you age, your bladder or uterus may drop into a lower position
• Pelvic floor dysfunction: Muscles of the pelvic floor are weak or don’t work correctly

If your pain is mild, you may be able to soothe it with ice, a heating pad, rest or over-the-counter medications. Be sure to mention any recurring pain to your doctor at your annual exam. They may ask you how long the pain lasts, what it feels like or what you think caused it.

Use our pelvic health assessment to help you decide if you need to see a doctor about your pelvic pain. Seek medical help promptly if you:

• Have a known painful condition and your pain changes suddenly
• Have blood in urine
• Have fever, nausea or vomiting along with pain
• Have pain that comes on quickly or is severe
• Have unexpected vaginal bleeding along with severe pain
• Think you have an infection

Pelvic pain during pregnancy

A certain amount of pelvic pain during pregnancy may be normal. As the fetus grows throughout your pregnancy, it puts pressure on other organs, the nerves in your pelvis and the pelvic girdle (bones of the pelvis). Pelvic girdle pain during pregnancy may be worse when you’re climbing stairs or taking a long walk.

Pelvic pain may also be associated with labor. Keep your doctor informed about your pain level. Contact them immediately if you have any of the following along with pelvic pain during pregnancy:

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

Your doctor can help you decide if you need to be seen right away.

Symptoms of pelvic pain

Each source of pelvic pain has some symptoms that are different and some that are similar. When you have pelvic pain that’s connected to any condition of the urinary tract you may also experience frequent urination, low back pain or pain while urinating.

Pain related to the reproductive system may feel like cramps, pressure, bloating or low back pain. You may also have pain during sex, abnormal vaginal discharge or unexpected vaginal bleeding.

Any kind of pelvic pain may make you feel generally sick. You may also have pressure, swelling, bloating, constipation or diarrhea. Infections of any kind may also cause fever, dizziness or nausea.

Treatments for pelvic pain

There are some self-care things you can do for some kinds of pelvic pain. Some conditions may get better with diet changes, drinking more water, stress management, increased physical activity or use of over-the-counter medications.

When you see a doctor for pelvic pain, they’ll want to know if the pain is sharp, stabbing, dull or achy. They’ll also ask if it’s mostly in one spot or if it’s spread over a large area. You’ll have a physical exam and they may order imaging, blood tests, urine tests or other testing to pinpoint the cause or causes of your pain.

Some causes of pelvic pain will get better with antibiotics or other prescription drugs. Some may need surgery. Others may get better with physical therapy. Your provider will work with you to make a treatment plan to lessen your pain and address any underlying conditions.