12106 Pelvic Pain

Overview

Pelvic pain is pain you feel in the lower part of your belly, between your hip bones. It can be a dull ache that lingers or a sharp pain that comes and goes. The pelvis is the bony bowl at the base of your body. It holds your bladder, bowel, and reproductive organs, and it has many muscles, nerves, and joints. Pain can come from any of these, so pelvic pain has lots of possible causes. It can affect women, men, and children.

Yes, pelvic pain is very common. It is one of the most frequent reasons people visit their doctor or a sexual health clinic. Long-lasting pelvic pain affects roughly one in six women and is also seen in men and children.

Anyone can get pelvic pain. It is reported most often by women of childbearing age, but it also affects men (for example, from prostate or testicle problems) and children (often from constipation or urine infections). Older adults may have pain linked to joints, muscles, or bowel and bladder changes.

Symptoms

Common symptoms

• A dull ache or heaviness low down in the belly
• Sharp or stabbing pain, sometimes on one side
• Pain that comes and goes, or that gets worse over time
• Pain during sex
• Pain when passing urine, or needing to go more often
• Pain or straining when passing stools
• Period pain that is much worse than usual or lasts longer
• Pain spreading to the lower back, bottom, or tops of the thighs
• Bloating or a feeling of fullness in the lower belly
• Pain that changes with your posture, movement, or how tired you are

Symptoms in children

• Tummy ache that keeps coming back, or pain a child cannot point to clearly
• Crying or holding the tummy, or not wanting to play
• Pain or stinging when weeing
• Hard, painful poos or holding poo in on purpose
• Pain after sport or a fall
• Being clingy, off food, or sleeping badly

Symptoms in older adults

• Pain that is hard to describe or feels like pressure rather than sharp pain
• Pain linked to constipation or changes in bowel habits
• Urine infections that cause discomfort low down
• In men, pain with urination or a feeling of not emptying the bladder fully
• Pelvic floor weakness, leaking urine, or a feeling of dragging
• Hip or lower back joint pain that spreads into the pelvis
• Confusion or tiredness can sometimes be the main sign of infection, so watch for changes from usual

Causes

Main causes

• Urine infections (cystitis) — burning and frequent trips to the toilet
• Constipation or irritable bowel syndrome (IBS) — pain linked to bowel habits
• Period pain and conditions such as endometriosis (where tissue like the womb lining grows elsewhere)
• Pelvic inflammatory disease — an infection of the reproductive organs, often spread through sex
• Ovarian cysts, fibroids (non-cancer growths in the womb), or other growths
• Prostate problems or testicle problems in men
• Pelvic floor muscle tightness or weakness, often after childbirth or from strain
• Nerve pain, scar tissue, or pain after pelvic surgery
• Hernia (a bulge where tissue pushes through muscle), or appendicitis in the lower right side
• Pregnancy-related causes, including a pregnancy outside the womb
• Joint problems in the hips or lower back that spread pain into the pelvis

Risk factors

• Being of childbearing age and having periods
• A recent sexually transmitted infection or a history of one
• Pregnancy, childbirth, or recent pelvic surgery
• Long-term constipation or straining on the toilet
• Heavy lifting, prolonged sitting, or low levels of physical activity
• Stress, poor sleep, and a history of pain elsewhere in the body
• Smoking and a weaker immune system, which raise the risk of some infections

When to see a doctor

See a doctor urgently if:

• Severe pain that starts suddenly or keeps getting worse
• Fever with pelvic pain, or feeling very unwell
• Bleeding between periods, after sex, or after the menopause
• Pain when passing urine that does not settle in a couple of days
• Vomiting, or not being able to keep fluids down
• A new lump or swelling in the pelvis or groin

Book a routine appointment if:

• Pain that has lasted more than a few weeks or keeps coming back
• Pain that affects sleep, work, exercise, or sex
• Pain with changes in your periods or bowel habits
• Pain that started after a new sexual partner
• Pain that has not improved after trying self-care for a few weeks

Diagnosis

Your doctor will start by asking about your pain — where it is, what it feels like, when it started, and what makes it better or worse. They will ask about your periods, bowels, bladder, sex life, and past surgeries. Then they may examine your tummy and, if you are comfortable, your pelvis. In men, they may check the testicles or prostate. You can ask for a chaperone (a staff member who stays with you) at any time, and you can pause or stop the examination.

Tests that may be done

• A urine sample to look for infection
• A pregnancy test where relevant
• Blood tests to check for infection, inflammation, or hormone changes
• Swabs to check for sexually transmitted infections
• An ultrasound scan of the pelvis
• Stool tests if bowel problems are suspected
• Sometimes a CT or MRI scan for a clearer picture
• Sometimes a thin camera test (laparoscopy) under anaesthetic to look inside the pelvis

What to expect at your appointment

Tests are usually done step by step. Your doctor may start with simple tests and only arrange scans if needed. Results can take a few days to a couple of weeks. Keep a simple diary of your pain, periods, and bowel and bladder habits before your appointment. It helps your doctor a lot, and it helps you remember what you want to ask.

Treatment

Treatment depends on the cause. Many people improve with a mix of self-care, physiotherapy, and treating the underlying problem, such as an infection or constipation. If no clear cause is found, the focus shifts to managing the pain itself and helping you live well. Your doctor will talk through options with you and review how things are going.

Self-care at home

• Use a warm pack or warm bath to relax tight muscles
• Try gentle stretching, walking, or pelvic floor exercises taught by a physiotherapist
• Keep bowels regular with fibre, fluids, and a routine toilet habit — don't strain
• Pace activity: short bursts with rests rather than long stretches of strain
• Try relaxation, breathing exercises, or a pain management app to calm the nervous system
• Keep a symptom diary so you can see patterns and track what helps
• Avoid heavy lifting until the pain settles, and check your sitting posture

Medical treatments

Your doctor may suggest simple pain relief available from a pharmacy, always following the packet and asking a pharmacist if unsure. Other options depend on the cause: antibiotics for infection, treatments to soften stools for constipation, hormonal treatments for period-related pain, physiotherapy for pelvic floor problems, or support from a pain clinic for long-lasting pain. Talking therapies such as cognitive behavioural therapy can help with ongoing pain. No single treatment works for everyone, so your doctor will help you find a plan that suits you.

When is surgery considered?

Surgery is only considered for specific causes, such as removing a growth, treating a hernia, or dealing with a pregnancy outside the womb. It is not a routine treatment for pelvic pain and is usually offered only after other options have been tried or when there is a clear problem to fix.

Living with this condition

Long-lasting pelvic pain can be tiring and can affect work, sleep, relationships, and mood. Plan your week with a mix of activity and rest, and be kind to yourself on harder days. Small, steady routines often help more than trying to do everything at once. Tell people close to you what helps and what doesn't.

Lifestyle tips

• Build gentle movement into each day, such as walking or swimming
• Aim for regular sleep and cut back on caffeine and alcohol if they make symptoms worse
• Manage stress with breathing, mindfulness, or a hobby you enjoy
• Take breaks from long sitting and adjust your chair and screen
• Talk to your partner about pain and sex, and agree on what feels comfortable
• Keep up with routine health checks and go back to your doctor if things change

Diet and exercise

Eat regular meals with plenty of fibre — fruit, vegetables, wholegrains, beans — and drink enough water to keep stools soft. Some people find that fizzy drinks, very spicy food, or caffeine make symptoms worse; a short food diary can help you spot your own triggers. Gentle exercise such as walking, swimming, yoga, or cycling helps blood flow and eases muscle tension. A pelvic health physiotherapist can teach you safe exercises for your pelvic floor.

Mental health and emotional wellbeing

Ongoing pain can cause worry, low mood, frustration, or problems in relationships and at work. This is very common and not a sign of weakness. Pain and emotions affect each other, so looking after your mental health is part of managing pain. If you ever feel you cannot cope or have thoughts of harming yourself, contact your local emergency number or a crisis support line in your country straight away, and tell someone you trust.

Prevention

Not all pelvic pain can be prevented, but you can lower your risk of some causes. Treat urine infections early, avoid long-term constipation, use condoms to reduce the risk of sexually transmitted infections, and get pain checked rather than pushing through it. Pelvic floor exercises and good lifting technique help protect the muscles and joints of the pelvis.

Vaccines

Vaccines can prevent some infections linked to pelvic problems. The HPV vaccine helps protect against viruses that cause genital warts and some cancers, and is offered to young people in many countries. Ask your doctor or pharmacist which vaccines are recommended for you.

Screening programmes

Regular sexual health checks and cervical screening (smear tests) help find problems early. If you are sexually active, testing for sexually transmitted infections is quick and usually free at sexual health clinics in many countries. Ask your local health service what screening you are due for.

Complications

If left untreated

• An infection that spreads and makes you very unwell
• Long-lasting pain that affects sleep, mood, work, and relationships
• Scarring or lasting damage to the reproductive organs after an untreated infection
• Bowel problems such as ongoing constipation or piles from straining
• Bladder problems, including leaking or difficulty passing urine
• Avoiding sex, exercise, or social activities because of pain

Long-term outlook

Most people with pelvic pain get better or find a way to manage it well. Finding the cause early makes a difference, and even long-lasting pain often improves with the right mix of self-care, physiotherapy, and support. Many people go back to the activities they enjoy. Keep talking to your doctor if things are not improving — there is usually something else to try.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.