12 Causes Of Pelvic Pain – A Guide to Diagnosis and Treatment

Pelvic pain affects many women, presenting a challenge that demands attention and care. A variety of conditions can cause discomfort in the lower abdomen, ranging from menstrual cramps and ovulation pain to more serious issues like infections and chronic diseases.

This article will introduce you to potential causes, but also provide the proper treatment, along with prevention methods.

1. Menstrual Cramps

Menstrual Cramps

Many women experience discomfort due to menstrual cramps, a condition characterized by aching pains in the lower abdomen. Hormonal changes trigger these cramps, leading to muscle contractions in the uterus. For some women, these pains prove to be a minor inconvenience, yet for others, they significantly impact daily activities. Keep in mind that it may indicate more serious conditions. Therefore, always consult with a doctor when you notice this problem.

“Menstrual cramping will typically occur immediately before a person starts their period, as the uterus contracts and sheds its lining. The pain may feel similar to a muscle spasm or a jabbing pain.”

Jon Johnson, Medical News Today


Hormones known as prostaglandins play a key role, causing the uterus to contract to shed its lining. High levels of these hormones often correlate with more severe pain. Factors such as age, heavy blood flow, and a family history of painful periods can increase the risk of severe cramps.


Options for relief include over-the-counter pain relievers, such as ibuprofen and naproxen. Heat therapy, through warm baths or heating pads, can also alleviate symptoms. For those seeking long-term solutions, hormonal contraceptives offer a way to reduce the severity of pain experienced during each cycle.

2. Ovulation Pain

Ovulation pain, also known as mittelschmerz, occurs midway through the menstrual cycle. It manifests as a sharp or dull ache on one side of the lower abdomen. The duration of this discomfort varies, lasting from a few minutes to several hours.


The pain results from the ovary releasing an egg, which can stretch the ovary’s surface or cause a small, fluid-filled cyst to form. This process can irritate the abdominal lining, leading to discomfort. The side of the pain often corresponds to the ovary that releases the egg.


Typically, this condition requires no medical intervention. Pain management strategies include resting, applying heat, or using over-the-counter pain medication. For recurrent, severe cases, healthcare providers might suggest hormonal contraceptives to prevent ovulation and, consequently, the associated pain.

3. Interstitial Cystitis

A condition known as painful bladder syndrome affects many women, leading to chronic discomfort or pain in the bladder and pelvic region. Unlike typical cystitis, which bacterial infections cause, this syndrome does not stem from a bacterial source and remains poorly understood.


The exact origins of painful bladder syndrome remain elusive, though several theories suggest a combination of factors like a defect in the bladder lining, an autoimmune response, or heredity might contribute. Symptoms often worsen during menstruation or after consuming certain foods and beverages.

David H. Barad from Center for Human Reproduction highlights that proper testing is essential:

Tests depend on which disorders are suspected. Tests may include:

  • Urine tests or testing of samples from the vagina or cervix to check for infections that can cause pelvic pain
  • Ultrasonography, computed tomography (CT), or magnetic resonance imaging (MRI) of the abdomen and pelvis to check for masses and tumors
  • If other tests do not identify the cause of severe or persistent pain and a serious cause (such as a ruptured ectopic pregnancy) is suspected, sometimes laparoscopy or laparotomy


Management strategies focus on symptom relief, as no cure exists. Treatments vary widely, from dietary changes and physical therapy to medications and procedures aimed at relieving bladder pressure and pain. A multi-faceted approach, tailored to each woman’s symptoms and response to treatment, proves most effective.

4. Cystitis


Frequent urination, discomfort during urination, and pelvic pain characterize a common bladder infection known as cystitis. Bacteria typically entering through the urethra and multiplying in the bladder cause most cases.


Escherichia coli, a common bacterium found in the gastrointestinal tract, accounts for most infections. Women are at higher risk due to their shorter urethra, which lies closer to the anus, facilitating bacterial transfer.


Antibiotics represent the primary treatment, effectively clearing the infection in most cases. Preventative measures include practicing good personal hygiene, staying hydrated, and urinating after sexual intercourse to reduce the risk of recurrence. For recurrent cases, long-term antibiotics or other preventive measures may be necessary.

5. Urinary Tract Infections


A common health issue among women involves infections in the urinary tract, characterized by a strong urge to urinate, a burning sensation when urinating, and pelvic pain. These infections usually start in the urethra or bladder and, if left untreated, can progress to more serious kidney infections.


Bacteria, primarily Escherichia coli from the digestive system, are the usual culprits. They enter through the urethra and start to multiply within the bladder. Because of the shorter urethra in women, compared to men, the risk of these infections is higher. Also check out other potential causes.


Antibiotics serve as the primary remedy, with the type and duration depending on the infection’s severity. Drinking plenty of water helps flush out the bacteria, and practicing good hygiene prevents future infections. For women experiencing recurrent infections, additional measures, including longer courses of antibiotics or prophylactic treatment, may be recommended.

6. Gonorrhea


A sexually transmitted infection (STI) that affects both men and women, gonorrhea presents through symptoms like painful urination and pelvic pain. It’s caused by the bacterium Neisseria gonorrhoeae and can lead to severe complications if not treated promptly.


Transmission occurs through sexual contact with an infected partner. The bacterium can infect the urethra, rectum, throat, and cervix. Women often experience more severe complications from gonorrhea, including the risk of pelvic inflammatory disease (PID), which can result in infertility.


Detection through specific tests is necessary for accurate diagnosis. The treatment involves dual antibiotic therapy to eliminate the bacterium, as recommended by health authorities. Preventive strategies include using condoms during sexual activity and regular STI screenings for sexually active individuals.

7. Chlamydia


A prevalent sexually transmitted infection among women, chlamydia often progresses without symptoms, making it a silent threat to reproductive health. When symptoms do manifest, they may include painful urination and abdominal pain. Caused by the bacterium Chlamydia trachomatis, it can lead to serious complications if not addressed.


Transmission of chlamydia occurs through sexual contact with an infected person. The bacterium can affect the cervix, uterus, and fallopian tubes in women, and the urethra in both women and men. Without symptoms, many do not realize they are infected, which underscores the importance of regular screening.


The cornerstone of management is antibiotic therapy, effective in eradicating the infection when taken as prescribed. Preventative measures such as condom use during intercourse and regular sexual health screenings play critical roles in controlling spread and preventing complications.

8. Pelvic Inflammatory Disease

Pelvic Inflammatory Disease

A complication often resulting from untreated sexually transmitted infections, pelvic inflammatory disease (PID) affects numerous women, leading to chronic pelvic pain and fertility issues. This condition involves inflammation of the female reproductive organs, including the uterus, fallopian tubes, and ovaries.


Most cases of PID stem from untreated chlamydia and gonorrhea infections. Bacteria from these STIs ascend from the cervix to the upper genital tract, causing inflammation and scar tissue that can lead to long-term health issues, including ectopic pregnancy and infertility.


Early intervention with antibiotics can effectively treat PID, though treatments cannot reverse any damage already caused to reproductive organs. Hospitalization may be necessary for severe cases. Prevention of PID centers on regular STI testing and prompt treatment of any detected infections.

9. Endometriosis


A condition where tissue resembling the lining inside the uterus grows outside it, endometriosis causes significant discomfort and pelvic pain for many women. The misplaced tissue can lead to scarring, adhesions, and menstrual pain, impacting fertility and quality of life.


The exact cause of endometriosis remains unknown, but several theories include retrograde menstruation, immune system disorders, and surgical scars. Factors increasing risk include family history, menstrual cycle characteristics, and certain health conditions.


Treatment options aim to manage symptoms and may include pain medication, hormone therapy, and surgery. The choice depends on symptom severity, desire for pregnancy, and disease progression. Some women find relief with lifestyle changes and alternative treatments, though these methods require further research for efficacy validation.

10. Irritable Bowel Syndrome

A common disorder affecting the large intestine, irritable bowel syndrome (IBS) presents challenges in daily life through symptoms like abdominal pain, bloating, and changes in bowel habits. IBS impacts women disproportionately, often exacerbating during menstrual cycles.


While the precise causes of IBS remain unclear, factors such as severe infection, changes in gut bacteria, and muscle contractions in the intestine play roles. Stress and food sensitivities can trigger or worsen symptoms, highlighting the need for a holistic management approach.


Managing IBS involves a combination of dietary adjustments, lifestyle changes, and medication. Identifying and avoiding trigger foods, increasing fiber intake, and managing stress contribute to symptom improvement. For persistent cases, healthcare providers may recommend specific medications to address bowel movement irregularities and pain.

11. Appendicitis


A serious medical condition requiring prompt attention, appendicitis involves inflammation of the appendix, leading to severe abdominal pain that typically begins near the navel and shifts to the lower right abdomen. Immediate treatment is crucial to prevent complications, such as rupture, which can lead to widespread infection.


Appendicitis usually results from blockage of the appendix, which can occur due to infection, inflammation, or the presence of a foreign body. This blockage leads to increased pressure, decreased blood flow, and inflammation that can cause the appendix to rupture if not treated.


Surgical removal of the appendix, known as an appendectomy, is the standard treatment for appendicitis. The procedure can be performed laparoscopically or through open surgery, depending on the case’s specifics. Antibiotics are administered before surgery to prevent infection.

12. Ovarian Cysts

Ovarian Cysts

Fluid-filled sacs that develop on or inside an ovary, ovarian cysts are common and often present without symptoms. When symptoms do occur, they can include pelvic pain, bloating, and pressure. Most cysts are benign and resolve on their own, but some may require medical intervention.


The formation of ovarian cysts is typically part of the menstrual cycle’s normal function. Functional cysts, the most common type, include follicular cysts, which form when the ovary does not release an egg, and corpus luteum cysts, which occur when the follicle does not dissolve after releasing an egg. Other types can be indicative of hormonal imbalances or other conditions.


Treatment for ovarian cysts depends on the size, type, and symptoms. Regular monitoring through ultrasound may be recommended for asymptomatic cysts. Hormonal contraceptives can prevent the formation of new cysts. In cases where cysts are large, cause symptoms, or persist, surgical removal might be necessary.


Can pelvic pain be cancerous?

Pelvic pain can sometimes indicate cancer, such as ovarian or uterine cancer. Persistent or worsening pain warrants a medical evaluation.

How long is too long for pelvic pain?

Pelvic pain lasting more than six months, whether constant or intermittent, is considered chronic and should be evaluated by a healthcare provider.

Is it normal to have pelvic pain every day?

Daily pelvic pain is not normal and suggests an underlying condition that requires medical investigation.

How do you know if pelvic pain is serious?

Pelvic pain is serious if it’s severe, sudden, or accompanied by symptoms like fever, vomiting, or bleeding, necessitating immediate medical attention.

Can pelvic pain be psychological?

Yes, psychological factors such as stress and anxiety can manifest as physical symptoms, including pelvic pain.

Can anxiety cause pelvic pain?

Anxiety can contribute to pelvic pain by increasing muscle tension and amplifying the perception of pain signals.


Awareness of the various causes behind pelvic pain and knowing when to consult a healthcare professional stand as essential components for pelvic health management.

Addressing the root cause with suitable treatment options can lead to significant improvements. Persistent or severe pelvic discomfort calls for immediate medical evaluation to secure appropriate care and reassurance.

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