What Does Pelvic Pain Feel Like? Gynecologic and Non-Gynecologic Causes

According to statistics, 15% of women in the US experience chronic pelvic pain.

The pain is felt just below the bellybutton, and it can come on suddenly and severely, or be mild and last for months [1].

There are different conditions and diseases that can cause pelvic pain.

Therefore, the key is to get a proper diagnosis, so you can treat the problem accordingly.

Wrong treatment and the condition can be worsen [2].

To be considered chronic, the pain has to last for at least six months period and severe enough to demand treatment and affect the quality of life.

As soon as you start experiencing pelvic pain, you should consult with your GP.

Men are rarely affected by pelvic pain.

What is the pelvic?

Before we get to the causes and treatments of pelvic pain, let’s explain the pelvis.

It is the lowest part of your abdomen, and the organs in the pelvis include the bladder, the bowel, the womb, and the ovaries.

The pain starts in one of these organs, and in some cases it might come from the pelvic bones that are located just next to the organs [3].

The pain can be acute and chronic, as we mentioned it before [4].

Acute means that it is your first time experiencing that type of pain.

Chronic means it lasts for a long time, usually more than six months.

Gynecologic causes of chronic pelvic main

Every fifth pelvic pain is caused by some gynecologic cause.

There are a number of causes that qualify in this category.

Here are all of them:

  • Pelvic inflammatory disease, an infection of the tubes, ovaries, and uterus. PID is caused by an untreated sexually transmitted disease, and more than 30% of women with PID will develop chronic pelvic pain
  • Endometriosis is the most common gynecologic cause of pelvic pain affecting more than 70% with chronic pain. The condition can affect ovaries, fallopian tubes and the tissue lining the pelvis. The condition causes lines inside of your uterus, the endometrium, to grow outside of the uterus
  • Pelvic congestion syndrome is a controversial cause, as it has not been proven as a cause of pelvic pain. However, some women with the syndrome have experienced pain. It can be detected only through a pelvic ultrasound, and it refers to dilated uterine and ovarian veins
  • Pelvic adhesions, or scar tissue is a dense adhesions from infection, endometriosis, or prior surgery. Laparoscopy can identify mild adhesions, but they might not be the cause of the pain. Adhesions in the bowel cause abdominal bloating, constipation, and pain. Patients with multiple cesarean deliveries usually have adhesions involving the uterus
  • Ovarian tumor or pelvic mass is an abnormal growth on the ovary or in the pelvis
  • Fibroids can cause pressure symptoms, and acute pain occurs with degeneration or expulsion of the fibroid through the cervix
  • Adenomyosis is a condition causing heavy bleeding and pain with menstruation due to swelling of the endometrial glands in the uterine muscle

Pregnancy-related pelvic pain

  • Miscarriage or loss of pregnancy at any time up to the 24th week causes pelvic pain, accompanied with vaginal bleeding and lower abdominal cramps. In most cases, miscarriage happens before 13 weeks of pregnancy [5]
  • Ectopic pregnancy, or a pregnancy that tries to develop outside of the womb [6]. The condition is rare, and happens only in one out of 100 pregnancies. Symptoms include pain in one side of the pelvis or the abdomen. It develops sharply, but it can also occur slowly and become worse over several days. In some cases, the pain is accompanied by vaginal bleeding which is darker-colored than period bleeding
  • Premature labour, which is a childbirth before 37 completed weeks. If you experience pelvic pain that come and go in a regular pattern, contact your GP [7]
  • Rupture of corpus luteum cyst. The corpus luteum produces hormone that help you during pregnancy, until the placenta takes over. They are found during ultrasound scan, and usually cause no problems at all and clear up without treatment [8]. However, sometimes they can become swollen and burst, causing sharp pain on one side of the pelvis
  • Placental abruption, which happens very rarely, 6 times in 1,000 deliveries is when the placenta detaches form the wall of the womb. If this happens before 24 weeks of pregnancy, it is considered a miscarriage. However, if it happens after 24 weeks, it is called an abruption, and it is an emergency situation. Without a working placenta, the baby cannot get oxygen and food, and might die. The staff in the emergency department will try to quickly deliver the baby with an emergency cesarean section

Other causes of chronic pelvic pain

  • Irritable bowel syndrome, characterized by chronic abdominal pain associated with bowel function or dysfunction [9]. Some 10% of the general population experiences symptoms compatible with irritable bowel syndrome, and women are diagnosed twice as often as men
  • Inflammatory bowel disease, causing fatigue, diarrhea, weight loss, fever, rectal bleeding, and cramps and abdominal pain. It can be caused by ulcerative colitis or Crohn’s disease, but both are chronic and debilitating diseases requiring medical attention
  • Fibromyalgia, a disorder in which the patient reports pain in four quadrants of the body, and 11 are tender to touch. It is a common musculoskeletal condition that can cause chronic pelvic pain
  • Urinary tract infection, causing pain and/or burning sensation while urinating
  • Peritonitis, inflammation of the thin layer of tissue lining the inside of the abdomen. The pain gradually becomes worse and more severe
  • Constipation or bowel spasm, usually caused by changes in the diet and medication

What to do if you have pelvic pain?

As we saw by now, there are many different causes of pelvic pain [10].

Therefore, a proper diagnosis is the key to treatment.

Never take painkillers or any other medications without confirming the cause of the pelvic pain.

See a doctor if you are not sure about the cause of the pain, and whether the pain is severe or not.

In some cases, the pain might be a reason for a medical emergency, like in ectopic pregnancy.


  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1550236/
  2. https://www.ncbi.nlm.nih.gov/pubmed/24658485
  3. http://www.msdmanuals.com/professional/gynecology-and-obstetrics/symptoms-of-gynecologic-disorders/pelvic-pain
  4. http://obgyn.mhmedical.com/content.aspx?bookid=1813&sectionid=126253075
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3050758/
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4834745/
  7. https://www.ncbi.nlm.nih.gov/pubmed/7777823
  8. http://onlinelibrary.wiley.com/doi/10.1080/00016340600626982/abstract
  9. https://medicine.uiowa.edu/urology/research/chronic-pelvic-pain-study
  10. https://www.aafp.org/afp/2010/0715/p141.html

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