Pelvic pain management

Pelvic pain occurs below your belly button and above your legs. Typically, this pain stems from your urinary tract, reproductive system or another organ or area in your abdomen such as your appendix or colon. Whether it’s mild or severe, pelvic pain can have a big impact on your quality of life.

What does pelvic pain feel like?

Pelvic pain can feel different depending on the problem or affected area. It can be sharp, stabbing, dull or achy. If you have an infection, you may also have nausea, dizziness and fever.

It’s also important to note how long you’ve had pelvic pain. Chronic pelvic pain lasts for more than six months and can be attributed to diseases like endometriosis or interstitial cystitis (bladder inflammation). Acute pelvic pain comes on quickly and may be intense, such as when an ovarian cyst ruptures or when the urinary tract gets infected.

Either kind can benefit from pelvic pain management, so consult your primary care physician or a women’s health specialist for guidance about how to treat it.

What are the types of pelvic pain?

Pelvic pain can come from a variety of conditions, and more than one condition may contribute to your pain. Potential causes of female abdominal pain can be categorized based on the part of the body that they affect.

Sources of pelvic pain

Causes of pelvic pain associated with the urinary tract:

• Cystitis: Bladder inflammation caused by bacterial infection
• Interstitial cystitis: Bladder inflammation with no known cause
• Urinary stones: Crystalized material that can get stuck in your urinary tract
• Urinary tract infection: Bacterial infection, typically in the bladder and urethra

Causes of pelvic pain associated with the reproductive system:

• Ectopic pregnancy: Embryo implants and develops outside the uterus
• Endometriosis: Abnormal growth of tissue outside the uterus that’s like endometrium (tissue that lines the uterus)
• Menstrual pain and cramps: Pain from shedding the uterine lining before or during menstruation
• Ovarian cyst: Cyst that grows on an ovary
• Ovulation: Pain from an egg being released from an ovary
• Pelvic inflammatory disease: Infection in the uterus
• Sexually transmitted infections: Infections spread from sexual contact
• Polycystic ovary syndrome (PCOS): Hormonal disorder that affects ovulation and menstruation
• Uterine fibroids: Noncancerous growths found in the uterus

Causes of pelvic pain associated with other conditions:

• Appendicitis: Infection or inflammation of the appendix
• Cancerous tumor: An abnormal mass of cells that can invade other tissue and organs, which can be life-threatening
• Hernias: Weak spots or openings in abdominal muscle or tissue that allow organs to push through
• Irritable bowel syndrome (IBS): Gastrointestinal disorder that affects bowel function
• Inflammatory bowel disease (IBD): Chronic conditions that cause the gastrointestinal tract to become inflamed
• Pelvic adhesions: Internal scarring that binds two tissues that shouldn’t be joined
• Pelvic floor dysfunction: Pelvic floor muscles become weak or don’t work right
• Pelvic organ prolapse: Bladder, uterus or both organs may drop into a lower position as you get older

Symptoms related to pelvic pain

When pelvic pain is connected to a urinary tract condition, you may also experience frequent urination, pain while urinating or low back pain.

Pain related to parts of the reproductive system may feel like cramps, pressure or bloating. You may also have unexpected vaginal bleeding, abnormal vaginal discharge, heavy periods, pain during sex or pain in the pelvis that extends to your lower back.

Pain from these or other sources may come with pressure, swelling, bloating, diarrhea, constipation and a general feeling of being unwell.

Pelvic pain during pregnancy

Some pelvic pain in women during pregnancy may be normal. As the fetus grows during your pregnancy, it puts pressure on the nerves in your pelvis, other organs and the pelvic girdle (the bones of the pelvis). You may notice more pelvic girdle pain when you’re walking a lot or climbing stairs.

Labor pain may be felt in the pelvis, although it may spread to higher in your abdomen, too. Your OB-GYN can advise how to manage pelvic pain during pregnancy. Contact them immediately if you have any of the following symptoms along with low abdominal pain as they may want you to be seen right away:

• Fainting, feeling light-headed or having a rapid heartbeat
• Fever or chills
• Severe or sudden pain
• Vaginal bleeding or discharge

When should I see a specialist for pelvic pain management?

You may not need to see your doctor in some cases. Low abdominal pain that you’re able to ease with over-the-counter medications, ice, rest or a heating pad doesn’t require a visit to your doctor. However, you should tell your doctor about pain like that at your annual physical checkup.

You should see a doctor promptly if you also experience any of the following:

• Blood in urine
• Pain accompanied by fever, nausea or vomiting
• Pain from a known condition that changes suddenly
• Sudden or severe pain
• Unexpected vaginal bleeding with severe pain
• You believe you have an infection of some kind

Your doctor may ask about how long you’ve had the pain and what it feels like (sharp, stabbing, achy or dull pain in lower left abdomen). They may also want to know whether you think it’s related to an injury or another underlying cause.

Take our pelvic floor quiz to help you decide

Our pelvic floor self-assessment can help you determine if you need to see your doctor because of your pelvic discomfort.

What are the medical and interventional treatments for pelvic pain management?

Treatment for your pelvic pain will depend on its causes. Your doctor will order testing depending on your group of symptoms and things they observe during your physical exam. They may recommend an ultrasound, MRI or other imaging. Or they may draw blood or take a urine sample to test for infections or other conditions.

Pelvic floor physical therapy is almost always beneficial for pelvic pain management. If you need additional help alleviating discomfort and treating underlying causes, your doctor can help decide the best path forward. Other treatments may include:

Medications for pelvic pain management:

• Antibiotic medication for infections like UTIs or pelvic inflammatory disease
• Hormonal medication for gynecologic concerns like endometriosis, ovarian cysts or fibroids
• Muscle relaxers (oral or vaginal) for tense or overactive pelvic floor muscles
• Pain relievers for conditions like menstrual cramps or gastrointestinal pain

Interventional treatments, which are targeted, minimally invasive procedures:

• Nerve block injections, which can numb specific nerves to minimize pain
• Trigger point injections, which can numb specific muscles to minimize pain
• Neuromodulation, or stimulating devices that block nerve pain signals to the brain

Surgical procedures – often minimally invasive laparoscopic or robotic surgery – can be used to address serious conditions and chronic pelvic pain:

• Remove things such as ectopic pregnancies, endometriosis tissue or urinary stones
• Repair issues such as pelvic adhesions or hernias