Overview

Pelvic pain is a blanket term describing any pain occurring below the belly button, in the lowest part of the abdomen and pelvis. Pain can affect the reproductive, digestive, musculoskeletal, urinary, or gastrointestinal symptoms. Pelvic pain may indicate the presence of an infection, such as a urinary tract infection.  

The majority of causes of pelvic pain are benign but can become serious if left untreated. The most common causes of pelvic pain in women are related to their menstrual cycle. Menstruation, ovulation, and pregnancy are three of the most common causes of pelvic pain in women. 

Treatment options 

The treatment of pelvic pain depends on the cause, but common treatment options include:

• Lifestyle changes:
  • Some conditions that cause pelvic pain require special diets, such as gluten-free or low FOD map diets. Reducing your intake of sugary, greasy, and processed foods can help alleviate some pelvic pain. 
  • Drink more water. 
  • Eat slowly and smaller portions. 
  • Avoid foods you are allergic to or have an intolerance for. 
• Heat therapy
• Over-the-counter medication for pain, bloating, or gas relief
• Prescription medication for pain or to treat a specific disease
  • Birth control for those with a uterus 
• Physical therapy
• Surgery: In some cases, you will need surgery to treat your symptoms. Cancer and appendicitis are two common causes of pelvic pain that may require surgery. 

For those whose pelvic pain is directly related to their pregnancy, birthing the baby may reduce their pelvic pain. Some women may experience an increase in pain while giving birth and shortly thereafter before the pain dissipates. 

Symptoms

• Pain occurring in the lowest part of the abdomen, lower back, buttocks, or thighs
• Vaginal bleeding, spotting, or discharge
• Pain during intercourse or while urinating or defecating 
• Bloating or gas
• Blood present in your urine or stool
• Difficulties with or inability to control urinating or defecating

The pain may range from mild to severe in intensity and can be constant or intermittent. 

Seek immediate medical attention if your sudden, intense abdominal pain is solely on the right side of your abdomen and is accompanied by:

• Nausea and vomiting
• Loss of appetite
• Low-grade fever
• Constipation or diarrhea
• Bloating and flatulence

These can be symptoms of appendicitis, which may be caused by a ruptured appendix or a pus pocket in your abdomen. 

Diagnostic tests

If your pelvic pain lasts more than several weeks or progressively worsens, you should seek medical attention. Your healthcare professional will inquire about your symptoms’ frequency, location, severity, and duration. They will inquire about your sexual activities, complete medical history, and familial history related to pelvic pain before conducting a physical exam. 

For those living with a uterus, you may not know when to seek medical attention. Pelvic pain is a common experience during menstruation. Documenting the severity of any cramps, nausea, and bloating, along with any other symptoms you experience while menstruating over the course of several months, can help you determine when you should visit your general practitioner or gynecologist. 

Following a physical exam, your doctor may order diagnostic testing such as:

• Blood, stool, or urine analysis
• X-rays
• MRI
• Laparoscopy
• Ultrasound 
• Vaginal or penile cultures to check for STI
• Pap smear
• Pregnancy test
• Colonoscopy or sigmoidoscopy 

Causes

Causes of pelvic pain include, but are not limited to:

• Appendicitis
• Cancer 
• Constipation 
• Crohn’s disease
• Cystitis or interstitial cystitis 
• Diseases affecting reproductive organs
• Fibromyalgia 
• Irritable Bowel Syndrome
• Lactose intolerance 
• Pancreatitis 
• Pelvic adhesions
• Sexually transmitted illness
• Sore or tight pelvic muscles 
• Testicular or ovarian torsion
• Trauma or injury 
• Tumor 
• Urinary or kidney stones
• Urinary tract infections

Causes specific to those with uteruses:

• Adenomyosis
• Ectopic pregnancy: occurs when embryo implants itself anywhere outside of the uterus 
• Endometriosis
• Menstrual cramps
• Mittelschmerz: painful ovulation
• Ovarian cysts or cancer
• Ovulations
• Polycystic ovary syndrome (PCOS) 
• Pelvic Inflammatory Disease
• Pelvic organ prolapse
• Pregnancy
• Uterine fibroids
• Yeast infection

Facts 

• Women are more likely to experience pelvic pain than men.