Pelvic Pain in Women and Men

Pelvic pain is often described as a dull ache, pain, or pressure in the abdomen below the navel. The pain may be constant, or it may come and go. It can also include other symptoms, such as abnormal vaginal bleeding and lower back pain. Because pelvic pain can have so many causes, treatments vary.

Both men and women can experience pelvic pain related to the urinary or gastrointestinal tracts. In females, pelvic pain is often due to conditions that affect the reproductive system, such as endometriosis, fibroids, or an ectopic pregnancy.

It’s important to see your healthcare provider if you have any type of pelvic pain that does not resolve on its own.

This article discusses pelvic pain in men and women. It explores possible causes of pelvic pain and symptoms that help differentiate between pelvic conditions. It also explains potential treatments for pelvic pain and when to seek urgent medical care.

Where Is Pelvic Pain Located?

Pelvic pain is located in the lower torso. The pelvic cavity is the bowl-like structure that starts at the top of your hip bone (about level with your navel) and ends at the groin.

The base of the pelvis is made up of a network of muscles and ligaments known as the pelvic floor. This structure supports the bladder, rectum, descending colon, and reproductive organs. Problems with any of these organs or muscles can result in pelvic pain.

Causes in All Sexes

Some causes of pelvic pain can occur regardless of sex. Structures that are common to both men and women can be a source of pelvic pain. Some common causes are listed below.

Irritable Bowel Syndrome 

Irritable bowel syndrome is a functional gastrointestinal disorder. Common symptoms include:

• Abdominal pain (may be worse with stress or eating)
• Changes to bowel movement patterns
• Diarrhea
• Constipation
• Bloating
• Incomplete emptying (feeling like you did not get all the poop out)
• Mucous in the stool
  

Urinary Tract Infection

A urinary tract infection (UTI) is typically a bacterial infection of the urethra, bladder, or kidneys. Symptoms of a UTI may include:

• Pain over the bladder (low in the pelvis)
• Having to urinate often (called frequency)
• Burning pain with urination
• An urge to urinate, even if you just went to the bathroom (urgency)
• Blood in the urine

Kidney Stones

Kidney stones are caused by a build-up of minerals in the urine. The minerals bind together in crystals that result in kidney stones. If a stone is large enough to get stuck in the urinary tract, it can cause severe symptoms, including:

• Pain, especially with urination
• A strong desire to urinate
• Blood in the urine
• Nausea
• Vomiting
  

Sexually Transmitted Infections

Sexually transmitted infections (STIs) include many different diseases that can be spread through sexual contact. There are many different kinds of STIs, and symptoms vary depending on the specific infection. Potential symptoms may include:

• Discharge from your genitals (vagina, penis, anus)
• Pain when urinating
• Lumps, blisters, sores, rashes, or warts
• Vaginal bleeding
• Itching genitals
  

Appendicitis

Appendicitis is an acute and severe inflammation of part of the intestines called the appendix. It requires immediate medical attention. Signs of appendicitis include:

• Sudden pain in the abdomen
• Loss of appetite
• Fever
• Vomiting
• Constipation
• Diarrhea
  

Cystitis

Cystitis is the urinary bladder inflammation usually caused by an infection. This is sometimes called a bladder infection. In addition to pelvic pain, symptoms may include:

• Cloudy urine
• Bloody urine
• Urine with a bad or strong odor
• Pain or burning with urination
• Low-grade fever
• Need to urinate, even if you just used the bathroom
  

Pelvic Pain in Females

The female reproductive system may be the cause of pelvic pain for women. Almost any structure in the abdomen can be a potential source of pain, so see your healthcare provider if you have new or worsening pain. Some causes of pelvic pain in females include:

Ectopic Pregnancy

In an ectopic pregnancy, an embryo (fertilized egg) implants outside of the uterus, most often in the fallopian tube. At the start, it may feel like a normal pregnancy. Other symptoms may include:

• Abnormal vaginal bleeding
• Pain in the lower back
• Cramping
• Sudden or severe abdominal pain
• Pain in the shoulder (referred from the abdomen)
• Weakness
• Fainting

If the fallopian tube ruptures, it can be a life-threatening emergency. Symptoms of a rupture may include severe pain, bleeding, a drop in blood pressure, fainting, and shock. A ruptured ectopic pregnancy requires immediate medical care.

Pregnancy

Mild pelvic and lower back pain and cramping are normal in a healthy pregnancy. More severe pelvic pain, known as pregnancy-related pelvic girdle pain, occurs in one-quarter to two-thirds of pregnancies.

Pregnancy-related pelvic girdle pain typically begins in the second or third trimester. The pain is due to a combination of weight gain and hormones. One hormone in particular, relaxin, relaxes the ligaments, muscles, and joints in the pelvis in preparation for childbirth.

Types of pelvic girdle pain in pregnancy include symphysis pubis dysfunction or round ligament pain. Both can cause sharp shooting pain, pressure, or discomfort that may spread over your:

• Groin
• Lower abdomen
• Lower back
  
• Perineum
• Thighs

Symphysis pubis dysfunction can also cause clicking, grinding, or snapping sensations or sounds.

If you experience pelvic pain during pregnancy, tell your ob-gyn, who may recommend pelvic floor therapy. Other treatments may include wearing a pelvic support band, hydrotherapy, chiropractic treatment, and massage.

At the end of pregnancy, pelvic pain or pressure accompanied by low back and abdominal pain may be a sign of labor.

Pelvic Inflammatory Disease

Pelvic inflammatory disease (PID) is due to an infection of the uterus, ovaries, fallopian tubes, and/or vagina. It is typically caused by sexually transmitted infections like gonorrhea or chlamydia. Pelvic pain may worsen during sex. If an abscess (an infected lump) develops, severe pelvic pain and fever may result.

Symptoms of PID may include:

• Fever
• Abnormal vaginal discharge (may have a bad odor)
• Pain or bleeding during sex
• Burning when you urinate
• Unusual bleeding between menstrual periods
  

Endometriosis

Endometriosis causes tissue that’s normally found in the lining of the uterus to grow on the ovaries, fallopian tubes, or intestines. Symptoms of endometriosis may include pain during:

• Menstruation
• Sex
• Urination
• Bowel movements

Fibroids

Uterine fibroids are benign (noncancerous) tumors in the uterus. They may cause symptoms including:

• Heavy bleeding during your period
• Lower abdomen feeling full
• Frequent urination
• Pain during sex
• Lower abdomen becoming larger
  

Cancers of the Reproductive Tract

Pelvic pain can be a symptom of one of the gynecologic cancers, but pain is more likely when the cancer has progressed. While the general symptoms may be similar, the various types do have some key differences. These include:

• Ovarian cancer: Cancer can start and grow in the ovaries. Unlike other gynecologic cancers, pelvic pain can be an early sign of ovarian cancer, along with symptoms including bloating, lower back pain, and gastrointestinal changes like constipation.
• Endometrial cancer: Endometrial cancer is cancer of the lining of the uterus that can cause pelvic pain once cancer has progressed. This cancer is also associated with abnormal vaginal bleeding, such as bleeding after menopause or spotting between periods.
• Cervical cancer: This is cancer of the cervix, the lower end of the uterus. Abnormal vaginal bleeding, including bleeding after sex, may be a symptom of cervical cancer, with pelvic pain beginning later on.

Pelvic Pain in Males

Pelvic pain in men is also related to their anatomy and reproductive organs. Some common causes of pain are discussed below.

Prostatitis

Prostatitis is inflammation of the prostate gland. Once irritated, the prostate swells. Prostatitis can also cause swelling in the areas around the prostate, leading to pelvic pain and painful urination. Other symptoms of prostatitis include:

• Trouble urinating
• Fever
• Chills
• Pain or difficulty ejaculating

Benign Prostatic Hyperplasia

Benign prostatic hyperplasia (BPH) is an enlarged prostate. It is more common as men get older. Symptoms of BPH may include:

• Weak stream of urine
• Difficulty emptying the bladder
• Urgent need to urinate
• Urinating often (frequency)
• Having to urinate during the night (nocturia)
  

Urethral Stricture

Urethral stricture is the medical term for a narrowed urethra—the tube where urine exits the body. Symptoms of this condition may include:

• Discharge from the urethra
• Blood in the semen
• Bloody or dark-colored urine
• Urgent need to urinate
• Urinating often (frequency)
• Inability to empty the bladder
• Loss of bladder control (incontinence)
• Swelling of the penis
• Slow stream of urine
• Scattered spray of urine
  

Post-Vasectomy Pain Syndrome

A vasectomy is a surgical procedure to stop sperm from exiting the penis and is used as a type of permanent birth control. Sometimes, people develop chronic pain after a vasectomy, called post-vasectomy pain syndrome. Symptoms may include:

• Persistent pain (at least three months)
• Pain with erection
• Pain with sex
• Pain with ejaculation
• Genitals that are tender to the touch
  

When to See a Healthcare Provider

If you experience sudden, severe pelvic pain, seek medical care immediately. Appendicitis and ectopic pregnancy are some life-threatening emergencies that may require immediate surgery.

If you experience pain that isn’t going away or getting worse, you should be evaluated by a healthcare provider to receive a diagnosis and proper treatment. Many causes of pelvic pain can become serious over time if left untreated.

If you are menstruating, it’s important to note that mild cramping and pain associated with your period are normal and don’t require medical attention unless you have high pain levels (a condition called dysmenorrhea).

How Pelvic Pain Is Treated

Because pelvic pain has so many potential causes, its treatment is highly variable. Conditions caused by bacterial infection, such as UTIs and certain STIs, can be treated with antibiotics. Other conditions, such as cancer or fibroids, may be treated with medication, surgery, or both. Conditions such as appendicitis and ectopic pregnancy require emergency surgery.

Depending on the cause, chronic pelvic pain may also respond to physical therapy and pelvic floor exercises. If you have chronic pelvic pain, you may also benefit from speaking to a psychologist or psychiatrist.

Treating Pelvic Pain at Home

Many causes of pelvic pain are best treated under the guidance of a healthcare provider. This is why it’s important to see your healthcare provider if you have unresolved pelvic pain of any kind.

There are things you can also do at home to help relieve chronic pelvic pain. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen) can help reduce inflammation and ease pain. Heating pads can be effective at relieving pain as well.

Exercising or practicing yoga can also increase blood flow and help manage the stress and tension that could be contributing to your pain.

Summary

Pelvic pain is often caused by conditions that affect the female reproductive system, but not always. Both men and women can experience pelvic pain due to a urinary tract infection, appendicitis, or other problems. Diagnosing the source of pelvic pain requires a physical examination and may also need imaging and other types of diagnostic procedures.

A Word From Verywell

Pelvic pain can be due to a variety of causes. Work with your healthcare team to determine what is causing your pain and how it can best be treated. If you are experiencing pelvic pain with no known cause, call your healthcare provider. If your pain is sudden or severe, you should go to the emergency room.