Pelvic pain is discomfort in the area of the pelvis, including the lower abdomen, vagina, low back, and upper thighs. Pelvic pain may result from gynecological issues or bladder and bowel issues. Talk to your health care provider about pelvic pain to rule out a serious issue.
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Doctors define pelvic pain as pain in your pelvic area. You may have pelvic pain in your abdomen (lower belly), but it can also spread to your vagina, lower back, and upper thighs.
Pelvic pain doesn’t always involve the female reproductive organs, and it isn't always connected to gynecological issues. Both men and women can have pelvic pain, but it's more common in people with female reproductive organs. The bladder and bowels are also located in the pelvis, so if you have pelvic pain, it’s important to talk to your provider about the possible causes. Because it has many causes, pinpointing the actual cause can be a long and complex process.
Pelvic pain can happen to people at different times and ages, range from mild to severe, and vary. Doctors define chronic pelvic pain as pain that lasts for more than six months without getting better.
Because chronic pelvic pain is often linked to other disorders, such as endometriosis, researchers aren't sure exactly how many U.S. women live with it.
One study showed that about 15% of U.S. women of childbearing age reported pelvic pain that lasted at least six months. Worldwide rates of chronic pelvic pain for this demographic range from 14% to 32% — with between 13% and 32% having pain so severe that they miss work or school.
Often, pelvic pain stems from an underlying issue in your pelvic muscles or your urinary, digestive, or reproductive system.
Causes of pelvic pain include:
Several things can contribute at once to make pelvic pain worse. For example, a person may have a gynecological issue, like endometriosis, and a digestive issue, like irritable bowel syndrome (IBS).
The biggest risk factor for pelvic pain is gender. People designated female at birth are most at risk of lower abdominal pain.
Having sacroiliac (SI) joint pain also puts people at risk for pelvic pain because the two often occur together. This is especially true in pregnancy.
Other risk factors include:
Some causes of female lower abdominal pain can lead to long-term issues. One such issue is pelvic inflammatory disease (PID), an infection of the female reproductive organs that can cause infertility and ectopic pregnancy.
Many people don't know they have PID until they have pelvic pain. This is why you should see your health care provider if you have pelvic pain that doesn't go away.
Another complication of pelvic pain is worsening mental health. Left undiagnosed or untreated, chronic pelvic pain can cause depression and may lead to relationship stress and problems with sleep, sex, and work.
Pelvic pain can be hard to prevent since many factors that cause it are out of your control. Researchers have looked at whether exercise can help, especially with pregnancy-related pelvic pain. But the evidence isn't clear that it can prevent pelvic pain — although exercise can help with things like anxiety and mood, so it may help in ways we don't yet know.
One of the most important steps you can take to catch pelvic pain early is to see your provider for your regular appointments. Tell them about any pain you have and can't explain in your abdomen or low back. You may be able to treat an underlying cause before it turns into chronic pelvic pain.
Symptoms of pelvic pain can include:
Pelvic pain can come on suddenly and feel sharp and stabbing. Or, it can be dull and more spread out. People often describe pelvic pain with words like aching, cramping, stabbing, tender, sickening, or hot and burning.
Some people also have sacroiliac (SI) joint pain. SI joint pain is pain occurring in the very low back or butt. It can be hard to tell the two apart since they can exist together.
To diagnose your pelvic pain, your doctor will take your medical history and perform a physical exam.
Your doctor may order imaging and other tests to find or rule out gynecologic, bowel, or bladder issues. They can then look for muscle or joint problems since some types of pelvic pain are myofascial — or pain in the tissues that support your muscles.
Tests to find the root of pelvic pain may include:
Not everyone will need testing, so talk to your provider about if any testing is indicated for you.
Once your provider learns the cause of your pain, they'll work with you to manage your specific type of pain.
Doctors prescribe drugs to help manage pelvic pain symptoms or treat the underlying causes. These can include vaginal medications, muscle relaxers, antidepressants, pain injections, and hormone-related medicine.
In addition, nerve blocks target specific nerves and pathways involved in pain transmission to interrupt these nerve pathways. They may be performed for diagnosis, pain relief, or both.
Your pelvic floor includes the muscles and nerves that support your pelvic organs. These muscles and nerves are also near your lower back and abdomen. A pelvic floor physical therapy program can treat pain with techniques like deep tissue massage and exercises to tighten and relax certain muscles, depending on your needs.
We have physical therapists specially trained in pelvic floor physical therapy.
Surgery may be the recommended treatment for an underlying cause of pelvic pain, like endometriosis.
Talk therapy can help improve pain, especially when it's combined with other therapies.
Last reviewed by Lauren Giugale, MD on 2024-09-05.
