Pelvic pain management

Having pelvic pain can have a negative impact on your life. Pelvic pain in women 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 low abdominal pain 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
• Polycystic ovary syndrome (PCOS)
• 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)
• Inflammatory bowel disease (IBD)
• 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 girdle 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.

When is pelvic pain serious?

Pelvic pain can be concerning, and it's important to know when to seek medical attention. In some cases, you don’t need to see your doctor for pelvic pain, especially if your lower abdominal pain can be eased with over-the-counter pain medication, rest, ice or using a heating pad. Be sure to tell your doctor of any pain in your pelvis at your annual exam.

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

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

Pelvic pain during pregnancy

A certain amount of pelvic girdle 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 below the belly button 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 lower abdominal 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.

What does pelvic pain feel like?

Each source of female abdominal pain has some symptoms that are different and some that are similar. If your chronic pelvic pain is related to the urinary tract, you may also experience:

• Frequent urination
• Sharp pain in the lower left abdomen
• Low back pain
• Pain while urinating

Pain related to the reproductive system may feel like:

• Cramping
• Pressure
• Bloating
• Low back pain
• Pain during sex
• Abnormal vaginal discharge
• Unexpected vaginal bleeding

Any type of low abdominal pain may make you feel generally sick. You may also experience pressure, swelling, bloating, constipation, or diarrhea. Infections of any kind may 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 lower abdominal 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 underlying cause 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 variety of conditions.