The possible causes of pain in the pelvic region are numerous and range in severity from harmless to potentially life-threatening. Conditions affecting the digestive, reproductive and urinary systems are often the culprits. Problems affecting the muscle, nerves or blood vessels are also possibilities. The nature and duration of the pelvic pain, and accompanying symptoms are important factors in narrowing the list of possible causes.
Disorders affecting portions of the intestine that occupy the pelvic region commonly cause pain in this area. Mild pelvic pain may simply be due to constipation, whereas sudden, severe pain could indicate a bowel blockage. Diverticulitis -- a condition in which outpouchings in the colon wall become inflammed -- is a common culprit, especially in older adults. Irritable bowel syndrome, colon infections, appendicitis and inflammatory bowel diseases, including Crohn disease and ulcerative colitis, are also possibilities. Cancer of the colon or rectum is another important consideration.
Female Reproductive System
Cramping pain in the pelvic region commonly accompanies menstruation. Women with endometriosis, in which tissue lining the uterus implants outside the uterus, often experience more severe, cyclic pelvic pain Brief pain may occur with ovulation at mid-cycle. Noncancerous uterine growths known as fibroids, and ovarian cysts or tumors can also cause pelvic discomfort. Infection of the female reproductive organs, known as pelvic inflammatory disease or PID, is another possibility in sexually-active women. Ectopic pregnancy -- wherein the fertilized egg implants outside of the uterus -- is important cause of pelvic pain as this condition can be life-threatening.
Urinary System and Prostate
Pain in the pelvic region may be a symptom of a bladder infection. Interstitial cystitis -- painful bladder syndrome -- can also cause pelvic pain, along with frequency and urgency of urination in men and women. In some cases, a kidney infection or a stone in the urinary system provokes pelvic-region pain. In men, bacterial inflammation of the prostate, or prostatitis, can cause sudden, severe or chronic, intermittent pelvic pain.
Spasms of the muscles that make up the pelvic floor can lead to recurring pelvic pain and pressure. Hernias in the groin region may cause vague, aching pelvic pain, which is typically relieved while lying down. Scarring in the lower abdominal or pelvic region due to previous surgery or infection is another possibility. Irritation of one of the nerves that runs in the pelvic region -- a condition called pudendal neuralgia -- is an uncommon cause of pelvic pain. Other possibilities include ballooning, rupture or development of a blood clot in one of the arteries in the pelvic region.
Warning Signs and Symptoms
While pelvic pain related to the menstrual cycle or constipation is generally not cause for concern, pain in this region may indicate a serious underlying disorder. See your doctor for a thorough medical evaluation for any lasting, recurring or worsening pelvic pain, especially if accompanied by a fever, urinary symptoms, weight loss, diarrhea or constipation. Seek immediate medical attention for any sudden, severe pelvic pain -- particularly if accompanied by vaginal bleeding, bloody stools, an inability to pass gas, dizziness or fainting.
- Bonica's Management of Pain, 4th Edition; Scott Fishman, M.D., et al.
- American Family Phyician: Chronic Pelvic Pain in Women
- Clinical Obstetrics and Gynecology: Pathogenesis, Diagnosis and Management of Severe Pelvic Inflammatory Disease and Tuboovarian Abscess
- American Family Physician: Diagnosis and Management of Ectopic Pregnancy
- Family Practice Notebook: Chronic Pelvic Pain Causes
- The Merck Manual Professional Edition: Appendicitis
- American Family Physician: Prostatitis: Diagnosis and Treatment
- Urology Care Foundation: Interstitial Cystitis (Painful Bladder Syndrome)
- The Merck Manual Professional Edition: Levator Syndrome
- Clinical Gynecology, First Edition; Eric J. Bieber, M.D., et al.