Pelvic pain is one of the most common reasons women visit a gynecologist, yet it is often minimized or endured in silence. While mild pelvic discomfort can be normal during menstruation or ovulation, persistent or severe pelvic pain may signal a serious underlying condition that requires medical attention.
Understanding when pelvic pain is a warning sign empowers you to seek timely care and protect your reproductive health.
Understanding Pelvic Pain
Pelvic pain refers to discomfort felt:
- Below the belly button
- Between the hip bones
- In the lower abdomen or pelvic region
Pelvic pain may be:
- Acute – sudden and severe
- Chronic – lasting 6 months or longer
Women describe pelvic pain as:
- Sharp or stabbing pain
- Dull, constant aching
- Cramping similar to menstrual cramps
- Pelvic pressure or heaviness
- Pain radiating to the lower back or thighs
Because the pelvis contains reproductive organs, the bladder, intestines, and muscles, identifying the cause often requires evaluation by a women’s health specialist.
Common Causes of Pelvic Pain
Normal Pelvic Pain vs. Concerning Symptoms
Some pelvic pain is common and usually not serious, such as:
- Mild menstrual cramps
- Ovulation pain (mittelschmerz)
- Temporary discomfort after intercourse
Pelvic pain may be concerning if it:
- Interferes with daily activities
- Worsens over time
- Occurs outside of your menstrual cycle
- Is accompanied by other symptoms
Serious Conditions That Cause Pelvic Pain
Endometriosis: When Tissue Grows Outside of the Uterus
Endometriosis affects 1 in 10 women of reproductive age.
Common symptoms include:
- Severe menstrual cramps that worsen over time
- Chronic pelvic pain throughout the month
- Painful intercourse (dyspareunia)
- Pain with bowel movements or urination
- Heavy or irregular periods
- Infertility or difficulty conceiving
Endometriosis is often underdiagnosed. If pelvic pain disrupts your life or progressively worsens, ask your gynecologist about endometriosis evaluation.
Ovarian Cysts: When to Worry
Ovarian cysts are fluid-filled sacs on the ovaries. Many resolve on their own, but some cause serious complications.
Warning signs include:
- Sudden, severe pelvic pain on one side
- Pain with fever, nausea, or vomiting
- Abdominal bloating or fullness
- Painful periods or irregular bleeding
Medical emergencies include:
- Ruptured ovarian cyst
- Ovarian torsion (twisting of the ovary)
Pelvic Inflammatory Disease (PID)
PID is a serious infection often caused by STIs like chlamydia or gonorrhea.
Symptoms may include:
- Lower abdominal or pelvic pain
- Abnormal vaginal discharge with odor
- Painful urination
- Irregular bleeding
- Fever and chills
- Pain during intercourse
Untreated PID can lead to infertility, ectopic pregnancy, and chronic pelvic pain. Prompt antibiotic treatment is essential.
Uterine Fibroids
Fibroids are noncancerous growths in the uterus.
Symptoms may include:
- Heavy menstrual bleeding with clots
- Periods lasting longer than 7 days
- Pelvic pressure or pain
- Frequent urination
- Constipation
- Back or leg pain
Treatment depends on fibroid size, location, and symptoms.
Adenomyosis
Adenomyosis occurs when uterine lining tissue grows into the uterine muscle.
Common symptoms:
- Severe menstrual cramps
- Chronic pelvic pain
- Heavy or prolonged periods
- Pain during intercourse
- Enlarged, tender uterus
It most often affects women in their 40s and 50s who have had children.
Ectopic Pregnancy (Medical Emergency)
An ectopic pregnancy occurs when a fertilized egg implants outside the uterus.
Emergency symptoms include:
- Sharp, one-sided pelvic pain
- Vaginal bleeding or spotting
- Shoulder pain
- Dizziness or fainting
- Nausea or vomiting
Seek emergency care immediately if pregnancy is possible.
Ovarian Torsion
Ovarian torsion occurs when the ovary twists and cuts off blood flow.
Symptoms include:
- Sudden, severe pelvic pain
- Nausea and vomiting
- Sometimes fever
This is a surgical emergency.
Interstitial Cystitis (Chronic Bladder Pain)
Symptoms include:
- Persistent pelvic or bladder pain
- Frequent urination (up to 60 times/day)
- Urgency to urinate
- Pain relieved after bladder emptying
- Painful intercourse
While not life-threatening, it significantly affects quality of life.
Red Flags: When to Seek Immediate Medical Attention
Seek urgent care if pelvic pain is accompanied by:
- Sudden, severe pain
- Fever over 101°F
- Heavy vaginal bleeding
- Signs of shock (dizziness, rapid heartbeat)
- Pain during pregnancy
- Persistent vomiting
- Inability to pass stool with abdominal pain
These symptoms may indicate life-threatening conditions.
Chronic Pelvic Pain (Lasting Over 6 Months)
Chronic pelvic pain may result from:
- Endometriosis
- Adenomyosis
- Pelvic adhesions
- IBS
- Pelvic floor dysfunction
- Nerve damage
Treatment often requires a multidisciplinary approach.
How Doctors Diagnose Pelvic Pain
Evaluation may include:
- Detailed medical and menstrual history
- Pelvic exam
- Pregnancy testing
- STI screening
- Urinalysis and blood work
- Pelvic ultrasound, CT scan, or MRI
- Laparoscopy (in some cases)
Accurate diagnosis is essential for effective treatment.
Treatment Options for Pelvic Pain
Treatment depends on the cause and may include:
- NSAIDs or prescription pain medication
- Hormonal therapy (birth control, IUDs, GnRH agonists)
- Antibiotics for infections
- Pelvic floor physical therapy
- Minimally invasive surgery
- Hysterectomy (in severe cases)
Many women benefit from combination therapy.
Lifestyle Modifications That Help Manage Pelvic Pain
Support medical treatment with:
- Heat therapy
- Gentle exercise (yoga, walking, swimming)
- Stress management techniques
- Anti-inflammatory diet changes
- Keeping a pain and symptom diary
Why You Shouldn’t Ignore Pelvic Pain
Ignoring pelvic pain can lead to:
- Delayed diagnosis
- Fertility complications
- Chronic pain
- Mental health strain
- Reduced quality of life
Your pain is valid—and treatable.
Questions to Ask Your Gynecologist
Consider asking:
- What could be causing my pelvic pain?
- What tests do I need?
- Will this affect my fertility?
- What treatments are available?
- What can I do at home?
- When should I seek emergency care?
Taking Control of Your Pelvic Health
Pelvic pain is your body’s signal that something needs attention. While not all pain is serious, persistent or severe pelvic pain should never be ignored.
With early diagnosis and proper care, most causes of pelvic pain can be effectively treated—allowing you to protect your reproductive health and reclaim your quality of life.
Schedule your women’s health appointment with IVANA MD in Missouri City, TX.
Call: 346-585-4077
4220 Cartwright Road, Suite 201
Missouri City, Texas 77459
