When Should You Worry About Pelvic Pain?

The pelvis houses parts of your urinary, reproductive, and digestive systems. You should worry about pelvic pain when symptoms are severe and point to a potentially urgent underlying condition.

You feel pelvic pain below the belly button and above your thighs. This part of your body houses parts of your urinary, reproductive, and digestive systems. A disease of any of these could cause you pain. 

Disorders of the bones, joints, muscles, and other tissues in the pelvis can also cause pelvic pain. It's essential to know when to worry about pelvic pain and talk to your doctor.

Pelvic pain occasionally occurs in men but is most common in women. Several diseases give rise to pain in the pelvic area. Some of them can be dangerous and need early recognition and treatment.

Appendicitis

Appendicitis is an inflammation of the appendix, a part of your gut. It causes severe pain, which may start around the middle of your tummy. Later it moves to the right pelvic area. You may also have fever and vomiting. 

Irritable bowel syndrome (IBS)

Also called spastic colon, IBS is a disease of unknown origin. If you have cramps, pelvic pain, and diarrhea off and on, your doctor may consider this possibility. Stress and certain foods make irritable bowel syndrome worse.

Premenstrual syndrome (PMS)

PMS usually causes pelvic pain for a few days before and during your period. The timing lets you know the cause of the pain, so you needn't rush to your doctor every time. You can ask your doctor for medicine you can use each month.

Ectopic pregnancy

Once an egg is fertilized, it travels to the uterus to implant. If it settles in any other place other than the uterus, it's called an ectopic pregnancy. Most often, this happens in one of the fallopian tubes. There's severe pelvic pain on one side, internal bleeding or bleeding from the vagina, nausea, and weakness. 

Sexually transmitted diseases (STD)

These diseases are usually not painful, but chlamydia and gonorrhea can cause pelvic pain and vaginal bleeding.

Ovarian cysts

Ovarian cysts are fluid-filled sacs in your ovaries. They're common and usually give you no trouble. Ovarian cysts cause pelvic pain if they burst open. Sometimes, they cause the ovary to twist, blocking its blood supply.

Pelvic inflammatory disease (PID)

Some STDs like chlamydia and gonorrhea cause infections in the reproductive organs. Other infections that aren't sexually transmitted can also cause PID. Douching, intrauterine devices, and age under 25 increase the likelihood. You may have pain, fever, and a vaginal discharge.

Uterine fibroids

Fibroids are growths in the muscle of your uterus. They are not cancerous but can grow to large sizes. Fibroids can cause pain in the lower belly or back, heavy periods, and difficulty getting pregnant.

Endometriosis

A very troublesome condition in which uterine lining tissue (endometrium) grows outside the uterus. This out-of-place tissue responds to the hormones of your menstrual cycle, and you have period-related pain in the pelvis and abdomen.

Urinary tract infection (UTI)

Infections of the urinary bladder (cystitis) are more common in women. Your bladder may cause pain when full, when urinating, and after urinating. UTIs also cause fever, chills, shivering, nausea, and vomiting. 

Interstitial cystitis

This is a long-lasting inflammation of the bladder without any infection. You'll have pain in the pelvic area and need to pee frequently. Passing urine relieves the pain for a while.

Kidney and ureter stones

These small stones can cause significant pain, but kidney pain is mostly in your flanks. If a stone gets stuck in a ureter (one of the tubes carrying urine from your kidneys to the urinary bladder), you might have pelvic pain.

Musculoskeletal pain

The muscles, tendons, and ligaments of the pelvis can be stretched, sprained, and injured. This can happen during childbirth, surgery, or regular activities. The muscles of the pelvic floor sometimes spasm, creating pain.

Scar formation

Scars form in your pelvis because of earlier surgery, endometriosis, or other inflammation. They form adhesions between the organs in your pelvis and tether your organs to the pelvis wall. These scars can cause pain when they restrict the normal movements of the gut and other organs.

Cancer

Cancer of the uterus or ovaries can cause long-lasting pelvic pain.

Some of the same disorders as in women, including acute appendicitis, IBS, UTI, urinary system stones, and interstitial cystitis. Other disorders seen in men:

Prostatitis

The prostate is a gland that lies at the outlet of the bladder. Inflammation of the prostate (prostatitis) can cause pelvic pain.

Bacteria often cause prostatitis. These bacteria can form pus, creating an abscess in the prostate. The bacteria can also spread into the blood. Increasing swelling of the prostate can make it difficult to pass urine.

Benign prostatic hyperplasia (BPH)

BPH is an enlargement of the prostate gland. It is not cancer but can cause pelvic pain and difficulty emptying the bladder.

Hernia

Hernias are much more common in men than in women. Some organs push through a weakness or opening in the abdominal wall, creating a bulge you can see and feel. Pain happens at the site of the hernia when you are straining or exercising.

Some situations with pelvic pain are urgent. If you have these symptoms, you might be in danger. 

Pregnancy. Any pelvic pain in pregnancy could be an impending miscarriage. Don't wait at all. Call your physician and follow their instructions. 

Pregnancy and severe pain and bleeding. You might have pregnancy symptoms, including delayed periods and a positive urine test. However, abdominal pain can also indicate an ectopic pregnancy during your fertile years. The pain is often severe, and you could be bleeding from the vagina. Ectopic pregnancy can be life-threatening because of blood loss and shock. You should reach a hospital or emergency room quickly.

Shifting pain. Pain that starts around the belly button and shifts to the right side of the pelvis could be appendicitis. If you also have fever and vomiting, seek medical help quickly. Untreated appendicitis can rupture, leading to peritonitis, a widespread infection involving the whole abdomen, and is a dangerous condition.

Pain on passing urine and after. This could be a UTI. Bladder infections can spread to the kidneys, damaging them by creating scars. You need early diagnosis and treatment to prevent permanent harm and kidney failure.

Sudden, severe pain. Ovarian torsion is a condition where an ovary twists around, shutting off the blood supply. If not treated, the ovary could become non-functional. A ruptured ovarian cyst also causes sudden, intolerable pelvic pain.

Severe hernia pain. If you can't push your hernia back and have severe pain, it is dangerous. The hernia could be incarcerated or strangulated, and you should go to an emergency room quickly.

Some pelvic pain is not severe enough to bother you a lot. However, such pain may be caused by progressive diseases. These diseases may not put you in danger immediately but can affect your future health, fertility, and longevity.

Endometriosis causes pain a few days a month and may not be severe. But untreated endometriosis causes infertility. It can also be hard to diagnose and treat. 

Pelvic pain with a bad-smelling discharge from your vagina could be a pelvic inflammatory disease. The symptoms are often mild, but the inflammation can cause permanent damage to the ovaries, fallopian tubes, and uterus. PID is the most frequent cause of infertility in women.

When you're over 50, long-lasting pelvic pain might be cancer. Let your doctor know if you feel bloated and have lost weight without trying to. Ovarian cancer is more treatable if diagnosed early.

Pelvic pain is common in women and men because many organs exist in the pelvis. Some pain is not dangerous (period pain and PMS, for example). However, certain diseases that cause pelvic pain can be immediately dangerous. You should get medical care urgently. Other diseases are slowly progressive but reduce your quality of life, longevity, or fertility. Don't ignore pelvic pain. Talk to your physician about it if you have any worrying signs.