Pain in Your Pelvis? Here's What Your Body's Trying to Tell You

Your pelvis is the meeting point between your lower and upper body, and it's home to many vital organs and tissues that make up your reproductive, nervous and digestive systems.

Pain in your pelvis, whether it's sudden or chronic, could be linked to a number of health conditions. In other words, it's not likely you have pelvic pain for no reason.

"Neuromuscular causes of pelvic pain are very common," says Allyson Shrikhande, MD, a board-certified physical medicine and rehabilitation specialist and the Chief Medical Officer of Pelvic Rehabilitation Medicine.

"Other common causes of chronic pelvic pain in women include underlying gynecological issues such as endometriosis, adenomyosis, fibroids and PCOS," she adds. "Chronic prostatitis, hip impingement and hernias are prevalent in men with pelvic pain. Bladder pain syndrome and interstitial cystitis are also common underlying causes of chronic pelvic pain."

Many of these conditions cause your pelvic muscles to spasm and your pelvic nerves to be irritated and inflamed, Dr. Shrikhande explains.

Below, we'll dig deeper into what it means when your pelvis hurts and how to get relief.

Endometriosis is a condition in which tissue similar to the tissue that lines your uterus grows outside of this organ, according to the Mayo Clinic.

Endometriosis typically affects the ovaries, fallopian tubes and the tissue lining your pelvis, but in rare cases, it can spread to other areas.

Because your body isn't able to shed the tissue, it becomes trapped and can cause the surrounding areas to become irritated. Scar tissue and adhesions can form, causing pelvic tissues and organs to stick to each other, per the Mayo Clinic.

Endometriosis can cause mild to severe pelvic pain, especially during menstruation.

If you have endometriosis, you may also have:

• Painful periods (dysmenorrhea)
• Pelvic pain and cramping beginning before and extending several days into a menstrual period
• Lower back and abdominal pain
• Pain during or after sex
• Pelvic pain with bowel movements or urination, especially during your period
• Excessive bleeding (heavy menstrual periods or bleeding between periods)
• Infertility
• Fatigue, diarrhea, constipation, bloating or nausea, especially during menstrual periods

Endometriosis can happen in any person who has menstrual periods, but it is more common among those in their 30s and 40s, according to the Office on Women's Health.

You might be more likely to get endometriosis if you have:

• Never had children
• Menstrual periods that last more than seven days
• Short menstrual cycles (27 days or fewer)
• A family member (mother, aunt, sister) with endometriosis
• A health problem that blocks the normal flow of menstrual blood from your body during your period

Uterine fibroids are noncancerous growths that form in or on the wall of your uterus, according to the Cleveland Clinic. Depending on the size and location of these growths, they can cause pelvic pain.

Other symptoms of uterine fibroids include:

• Excessive or painful bleeding during your period
• Bleeding between periods
• Bloating in your lower belly
• Frequent urination
• Pain during sex
• Lower back pain
• Constipation or feeling pressure on your rectum
• Long-term vaginal discharge
• Inability to pee or completely empty your bladder
• Increased abdominal distention (enlargement)

According to the Cleveland Clinic, you may have a higher risk of fibroids if you have:

• Obesity and a higher body mass index (BMI)
• A family history of fibroids
• Have not had children
• An early onset of menstruation (getting your period at a young age)
• A late onset for menopause

Pelvic inflammatory disease (PID) is an infection of one or more of the reproductive organs in the pelvis, such as the uterus, fallopian tubes and/or ovaries, according to the Mayo Clinic.

Not everyone with PID experiences pain, but depending on whether the inflammation is mild or severe, pain in your pelvis can be a symptom. Other symptoms of PID include:

• Unusual or heavy vaginal discharge that may have an unpleasant odor
• Unusual bleeding from the vagina, especially during or after sex or between periods
• Pain during sex
• Fever, sometimes with chills
• Painful, frequent or difficult urination

According to the Mayo Clinic, risk factors for PID are:

• Being sexually active and younger than 25 years old
• Having multiple sexual partners
• Being in a sexual relationship with someone who has more than one sex partner
• Having sex without a condom
• Douching regularly, which changes the bacterial environment in the vagina
• Having a history of PID or a sexually transmitted infection
• Having an IUD (there is a small increased risk, especially during the first three weeks after insertion)

Often mistaken for a urinary tract infection, interstitial cystitis (IC) is a condition marked by inflammation or irritation of the wall of your bladder, according to Johns Hopkins Medicine. It usually comes with chronic pressure, tenderness or pain in the pelvis.

Other symptoms include:

• Frequent urination or urgency to urinate
• Feelings of pressure, pain and tenderness around the bladder, pelvis and the area between the anus and vagina or anus and scrotum (perineum)
• Pain during sex
• Discomfort or pain in the penis and scrotum
• Discomfort or pain that's worse around your period

According to the Mayo Clinic, risk factors for IC include:

• Being 30 or older
• Having a chronic pain disorder, such as irritable bowel syndrome or fibromyalgia

Ovarian cysts are solid or fluid-filled sacs that form within or on the surface of an ovary, according to the Office on Women's Health. Depending on the size or location of ovarian cysts, they can cause pain in your pelvis that's either dull or sharp, or may come and go.

Other symptoms include:

• A dull ache in the lower back and thighs
• Problems emptying the bladder or bowel completely
• Pain during sex
• Unexplained weight gain
• Pain during your period
• Unusual vaginal bleeding
• Breast tenderness
• Needing to urinate more often

Ovarian cysts are common in people who have regular periods and are less common after menopause.

A urinary tract infection (UTI) is when bacteria enters the urethra and infects your urinary tract, according to the CDC. There are different types of UTIs, the most common being a bladder infection. Kidney infection is another less common (but more serious) type.

When you have a UTI, the lining of your bladder and urethra often become irritated and cause pain in the pelvis and lower back. Other symptoms of bladder infection UTI include:

• Pain or burning while urinating
• Frequent urination
• Feeling the need to urinate despite having an empty bladder
• Bloody urine
• Pressure or cramping in the groin or lower abdomen

Symptoms of a kidney infection UTI can include:

• Fever
• Chills
• Lower back pain or pain in the side of your back
• Nausea or vomiting

People with vaginas are more likely to get UTIs because they have shorter urethras, making it easier for bacteria to enter the urinary tract, per the CDC. Other factors that raise your risk of a UTI are:

• A history of UTIs
• Sexual activity
• Changes in the bacteria that live inside the vagina (for example, menopause or the use of spermicides)
• Pregnancy
• Age (older adults and young children are more likely to get UTIs)
• Structural problems in the urinary tract, such as enlarged prostate
• Poor hygiene, for example, in children who are potty-training

Irritable bowel syndrome (IBS) is a chronic condition that affects the stomach and intestines with symptoms like cramping, abdominal pain, bloating, gas and diarrhea or constipation, or both, according to the Mayo Clinic.

Pelvic pain is common in people with IBS because parts of the digestive tract located in or above the pelvis become inflamed. People with IBS may also have an "overactive" pelvic floor, meaning that the muscles are tense and contracted, even at rest, according to the International Pelvic Pain Society.

Other symptoms of IBS include:

• Abdominal pain, cramping or bloating
• Changes in stool appearance
• Changes in how often you are having a bowel movement
• A sensation of incomplete evacuation
• Increased gas or mucus in the stool
• Weight loss
• Diarrhea at night
• Rectal bleeding
• Unexplained vomiting

You may be at a higher risk for IBS if you:

• Are younger than 50
• Are female
• Have a family history of IBS
• Have anxiety, depression or other mental health issues

Menstrual cramps (dysmenorrhea) are cramping pains felt in the lower abdomen or pelvis, and they typically occur just before or during your period, according to the Mayo Clinic.

For some, the discomfort is mild, while for others, it can be severe enough to interfere with everyday activities.

Other symptoms of menstrual cramps include:

• Pain that starts one to three days before your period, peaks 24 hours after the onset of your period and subsides in two to three days
• A dull, continuous ache
• Pain that radiates to your lower back and thighs

Many people also experience these symptoms alongside menstrual cramps:

• Nausea
• Loose stools
• Headache
• Dizziness

According to the Mayo Clinic, you may have a higher risk of menstrual cramps if you:

• Are younger than 30
• Started puberty early, at age 11 or younger
• Bleed heavily during periods
• Have irregular periods
• Have a family history of menstrual cramps
• Smoke

Chronic pelvic pain syndrome (CPPS) is a disorder where ongoing pelvic pain originates in any of the urogynecological, gastrointestinal, pelvic musculoskeletal or nervous systems, according to a May 2022 review in the ‌International Journal of Environmental Research and Public Health‌.

In people assigned male at birth (AMAB), chronic prostatitis (CP) is one type of CPPS characterized by recurring inflammation of the prostate, according to the Mayo Clinic. People with CP/CPPS often have painful or difficult urination and pain in the groin, pelvic area or genitals.

According to St. Luke's KC, other symptoms of CP/CPPS include:

• Trouble urinating
• Pain while urinating
• Pain during or after ejaculation

CP/CPPS tends to occur in young and middle-aged (under 50) adults. Other risk factors include:

• Nerve damage in the urinary tract
• Previous bladder infection
• Psychological stress

Appendicitis is inflammation of the appendix, an organ in your lower-right abdomen. It's considered a medical emergency and should be treated right away.

An inflamed appendix may put pressure on your pelvis and cause pain there. According to Johns Hopkins Medicine, other symptoms of appendicitis include:

• Pain in the abdomen
• Upset stomach and vomiting
• Loss of appetite
• Fever and chills
• Trouble having a bowel movement (constipation)
• Loose stool (diarrhea)
• Trouble passing gas
• Swollen belly

Most people who get appendicitis are between the ages of 10 and 30, according to Johns Hopkins Medicine. Having a family history of appendicitis may raise your risk, especially for people AMAB. Children with cystic fibrosis may also have a higher risk.

Certain sexually-transmitted infections (STIs), like chlamydia and gonorrhea, are linked to pelvic inflammatory disease, according to the CDC.

You may want to talk to your doctor about getting tested if you also notice:

• Abnormal discharge
• A burning sensation when peeing

You have a higher risk of getting an STI if you are sexually active with new or multiple partners, or you have a sex partner who has a sexually transmitted infection.

An ectopic pregnancy is when a fertilized egg implants and grows outside the uterus. One of the first signs of ectopic pregnancy is pelvic pain along with light bleeding, according to the Mayo Clinic.

You may not notice symptoms initially, but over time, you might also feel:

• Shoulder pain
• An urge to have a bowel movement

You're at a higher risk for ectopic pregnancy if you:

• Have had a previous ectopic pregnancy
• Have undergone fertility treatments
• Have had tubal surgery
• Get pregnant while you have an IUD in place
• Smoke

An adhesion is a band of scar tissue that causes organs or other tissues in your body to stick together. Pelvic adhesions most often occur after surgery or as a result of another condition, like endometriosis, according to the UNC School of Medicine.

Not everyone with pelvic adhesions will experience pain, but you may have discomfort if the adhesions are dense and restrict the movement of your organs. Most adhesions don't cause symptoms, and they can't be detected on imaging tests like ultrasound or CT scans, per UNC School of Medicine.

You may be more likely to have adhesions if you have:

• Had surgeries on any of your pelvic organs
• Endometriosis
• IBS

Constipation is when you have infrequent bowel movements and/or your stools are difficult to pass, according to the Cleveland Clinic. Because parts of your digestive tract are located in your pelvis, constipation can be a cause of pelvic pain.

Per the Cleveland Clinic, you may be constipated if:

• You have fewer than three bowel movements a week
• Your stools are dry, hard and/or lumpy
• Your stools are difficult to pass
• You have a stomachache or cramps
• You feel bloated and nauseated

You may have a higher risk of constipation if you:

• Don't eat enough fiber
• Don't drink enough water (dehydration)
• Don't get enough exercise
• Are traveling, or eating and/or going to bed at different times (read: traveler's constipation)
• Are eating a lot of milk and/or cheese
• Are stressed
• Resist the urge to have a bowel movement
• Take certain medications that cause constipation
• Have a health condition that causes constipation

Miscarriage is the loss of a pregnancy before the 20th week of gestation. Between 10 and 20 percent of known pregnancies end in miscarriage, and it can happen before a person knows they're pregnant, according to the Mayo Clinic.

Your reproductive organs are located in your pelvis, so a miscarriage can be a cause of pelvic pain. Other common symptoms of a miscarriage are:

• Bleeding from the vagina with or without pain, including light bleeding (or spotting)
• Fluid or tissue passing from the vagina
• Fast heartbeat

Per the Mayo Clinic, risk factors for miscarriage include:

• Age (being older than 35)
• History of miscarriage(s)
• Chronic health conditions, such as uncontrolled diabetes
• A history of problems with your uterus or cervix
• History of smoking, alcohol use and/or drug use
• Having overweight or underweight
• Certain genetic conditions

Adenomyosis is when the tissue lining your uterus grows into your uterine muscle (this is different from endometriosis, where tissue grows completely outside of the uterus), according to the Cleveland Clinic.

The condition can cause your uterus to double or even triple in size, which may cause you to feel pressure and pain in your pelvis.

Many people with this condition don't experience any symptoms, but in other cases it can cause:

• Painful menstrual cramps
• Heavy menstrual bleeding
• Abnormal menstruation
• Painful sex
• Infertility
• Enlarged uterus
• Bloating or fullness in your belly (adenomyosis belly)

Per the Cleveland Clinic, adenomyosis most often occurs in people assigned female at birth (AFAB) who:

• Are between the ages of 40 and 50
• Have given birth at least once
• Have had prior uterine surgeries, like uterine fibroid removal or dilation and curettage (D&C)
• Have endometriosis

A hernia is when part of an organ or tissue (usually in the stomach or intestine) bulges through an opening or weakness in the muscle or tissue that holds it, according to the Cleveland Clinic.

There are several types of hernias. Inguinal hernias, which are the most common type (especially among people AMAB), may cause pain in your pelvis. These happen when part of your bowel protrudes into a passageway that runs down your groin (your inguinal canal), per the Cleveland Clinic.

According to the Mayo Clinic, other common symptoms of inguinal hernia are:

• A bulge in the area on either side of your pubic bone, which becomes more obvious when you're upright
• A burning or aching sensation at the bulge
• Pain or discomfort in your groin
• A heavy sensation in your groin
• Weakness or pressure in your groin
• Pain and swelling around the testicles

Per the Mayo Clinic, risk factors for inguinal hernia include:

• Being AMAB
• Being older, as your muscles weaken as you age
• Family history of inguinal hernia
• Chronic cough, such as from smoking
• Chronic constipation (which causes straining during bowel movements)
• Pregnancy, which can weaken the abdominal muscles
• In babies, premature birth and low birth weight
• Previous inguinal hernia or hernia repair

Rarely, pelvic pain could be a sign of cancer — specifically, ovarian or colorectal cancer, as these begin in the pelvic area.

Ovarian cancer usually doesn't cause noticeable symptoms early on, but as it progresses, it might trigger pelvic pain along with any of the following symptoms, according to the Memorial Sloan Kettering Cancer Center:

• Abdominal bloating or swelling
• Feeling full quickly
• Lack of appetite
• Urinary urgency and frequency
• Constipation or diarrhea
• Spotting
• Menstrual period changes
• Back pain
• Weight loss or gain

Similarly, colon (aka, colorectal) cancer may not cause symptoms in the early stages. But pelvic pain is a common sign, along with the following, according to the American Cancer Society:

• Diarrhea, constipation, narrower stool or other bowel movement changes
• Feeling like you need to have a bowel movement even after having one
• Blood in the stool (bright red, dark brown or black)
• Abdominal cramping or pain
• Feeling tired or weak
• Weight loss

Pelvic pain isn't normal. If you have pelvic pain that's sharp or severe, talk to your doctor right away, as it could be a sign of a serious health condition. Even if the pain is mild, you should bring it up with your doctor.

If you're pregnant and have pain in your pelvis, see your doctor immediately for testing and treatment.