Both men and women experience pelvic pain for a variety of reasons. In many cases, pelvic pain goes away on its own. Sometimes, however, it can be a sign of a serious or chronic condition that needs treatment. Below are some of the most common reasons for pelvic pain as well as signs that it’s time to see a doctor.
What causes pelvic pain?
Because the pelvis is home to a variety of organs, muscles, bones, and connective tissue, several conditions can create pain in this area. Often, a combination of issues can contribute to pelvic pain. Irregularities in the reproductive, digestive, urinary, or musculoskeletal systems as well as psychological factors can lead to pelvic pain. Below are some of the most common culprits.
Digestive and Urinary Causes
In both males and females, digestive conditions like constipation, irritable bowel syndrome, inflammatory bowel disease, and diverticulitis can cause pain in the pelvic region. So can urinary problems like urinary tract infections (UTIs), kidney or bladder stones, and cystitis. While appendicitis typically causes a growing sharp pain in the lower right abdomen, the swollen appendix can also put pressure on the colon, causing pain in the pelvis as well. If you have signs of appendicitis, it’s important to immediately seek emergency care.
Causes in the Male Reproductive System
In males, conditions related to the prostate can cause pain in the pelvic area. Prostatitis, or inflammation of the prostate affects an estimated 16 percent of men at some point in their lives. Prostatitis can also cause urinary symptoms and fever is sometimes, but not always, caused by a bacterial infection, which is treated with antibiotics.
Benign prostatic hyperplasia is even more common, impacting about half of males by age 60 and 90% of them by age 85. Because BPH can block the urethra, it’s important to report symptoms such as difficulty urinating, leaking, frequency, urgency, or pain during urination to your doctor. Left untreated, it can lead to UTI and kidney damage.
Causes in the Female Reproductive System
Most women are familiar with pelvic pain. The American College of Obstetricians and Gynecologists reports that more than half of people who menstruate experience related pain for at least one day each month, and a substantial proportion of these miss work, school, or social functions as a result. While period pain is often a normal part of the monthly cycle, pelvic pain, whether or not it occurs during menstruation, can be a sign of a more serious issue.
Uterine fibroids affect most females at some point in life. It’s estimated that 30% develop fibroids by age 35, and 80% will have them by age 50. They can cause severe cramps and heavy bleeding during periods. In some cases, they can also interfere with pregnancy, labor, and delivery. Fortunately, fibroids typically subside in menopause. Patients who suffer severe symptoms, however, may require treatment. Doctors may prescribe medications or recommend a procedure such as non-invasive focused ultrasound surgery or minimally invasive uterine fibroid embolization (UFE). UFE uses a blocking agent to cut off the blood supply to fibroid tumors and has been found to provide relief for more than 80% of patients who undergo the procedure.
Pelvic Congestion Syndrome
Pelvic congestion syndrome (PCS) results from varicose veins in the pelvis. Experts estimate that 10–30% of women with PCS experience chronic pelvic pain. PCS can also cause increased menstrual bleeding, back and hip pain, and bowel and urinary symptoms. Doctors may prescribe medication to help patients with PCS manage their pain medication and/or recommend vein embolization to treat the underlying condition. The surgery produces successful outcomes in an estimated 85% of patients.
Endometriosis is a condition in which the tissue that forms the uterine lining (the endometrium) begins to grow outside the uterus and on surrounding organs. This can cause pain, inflammation, and the formation of scar tissue. Doctors may prescribe hormones to control tissue growth as well as pain medications, and minimally invasive laparoscopic surgery may be recommended to remove abnormal tissue.
Pelvic Inflammatory Disease
Pelvic inflammatory disease (PID) occurs when bacteria in the vagina migrate to other parts of the reproductive system. Gonorrhea and chlamydia are common PID agents, but the condition can also occur when the cervical barrier is disturbed, such as during menstruation or following childbirth or abortion. Some PID patients experience mild or no symptoms, but it can cause severe pelvic pain as well unusual bleeding or discharge, fever, and urinary difficulties. See a doctor as soon as possible if pelvic pain is severe or you’re experiencing fever, nausea, or vomiting associated with suspected PID. Antibiotics are prescribed to treat the bacterial infection, and surgery is sometimes needed to drain abscesses.
Chronic stress, a history of abuse, and depression can all contribute to pelvic pain. Psychological factors have wide-ranging impacts on the human body. Working with a therapist who you trust and makes you feel understood can sometimes help uncover these hidden causes of physical pain. Remember that having a psychological cause doesn’t mean a condition isn’t “real.” Anytime your body communicates to you with pain, it’s important to listen.
If you experience sudden extreme pain, or if your pelvic pain is accompanied by a fever, nausea, vomiting, cloudy, bloody, or foul-smelling urine, or other severe symptoms, get medical attention immediately. If the pain is new or grows worse over time, make an appointment with your doctor to investigate the cause. They will likely perform a physical exam and may recommend additional testing.
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American College of Obstetricians and Gynecologists. Dysmenorrhea: Painful Periods. https://www.acog.org/womens-health/faqs/dysmenorrhea-painful-periods.
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Mayo Clinic. Uterine Fibroids. Published September 21, 2022. Accessed December 26, 2022. https://www.mayoclinic.org/diseases-conditions/uterine-fibroids/diagnosis-treatment/drc-20354294.