Pelvic pain in older adults

Overview

Pelvic pain is discomfort or ache in the area between your hip bones. In older adults, it can be caused by problems with the bladder, bowels, reproductive organs, or bones and muscles. This pain may be sharp, dull, constant, or come and go.

Yes. Pelvic pain is a common reason for older adults to visit their doctor. It affects about 1 in 4 older women and many older men, especially those with prostate issues.

It mainly affects adults over 65. Women may have pain from bladder or pelvic floor issues, while men may have pain from the prostate. It can also affect people with chronic conditions like arthritis or diabetes.

Symptoms

Common symptoms

• A dull ache or sharp pain in the lower belly or between the hip bones
• Pain that worsens when sitting, standing, or moving
• Feeling pressure in the pelvic area

Symptoms in older adults

• Pain that spreads to the lower back or thighs
• Pain when urinating, having a bowel movement, or during sex
• Changes in bathroom habits – needing to go more often or having trouble starting
• A feeling that the bladder or bowel isn't empty after going

Causes

Main causes

• Urinary tract infections or bladder stones
• Constipation or fecal impaction (hard stool stuck in the bowel)
• Prostate problems in men, such as an enlarged prostate or prostatitis
• Muscle or joint strain in the lower back, hips, or pelvic floor
• Gynecological issues in women, like uterine fibroids or pelvic organ prolapse
• Bone problems such as osteoarthritis or a stress fracture

Risk factors

• Being over 65
• Having a history of pelvic surgery or radiation therapy
• Taking medications that affect bladder or bowel function
• Being inactive or having poor posture
• Chronic conditions like diabetes, arthritis, or Parkinson’s disease

When to see a doctor

See a doctor urgently if:

• If you have severe pelvic pain that comes on suddenly
• If you have pelvic pain along with a fever, chills, or vomiting
• If you cannot urinate or pass gas
• If you see blood in your urine or stool

Book a routine appointment if:

• If you have pelvic pain that lasts more than a week without a clear cause
• If the pain is mild but bothersome and affects your daily life
• If you have changes in how often you need to go to the bathroom

Diagnosis

Your doctor will start by asking about your pain, medical history, and any other symptoms. They will do a physical exam, which may include checking your lower belly, back, and hips. Depending on your symptoms, they may also examine your pelvis or prostate.

Tests that may be done

• Urine test to check for infection or blood
• Blood tests to look for signs of infection or inflammation
• Imaging tests like ultrasound, X-ray, or CT scan to see the organs and bones
• Stool test if constipation or bowel problems are suspected

What to expect at your appointment

The doctor will talk with you about your symptoms and do a gentle physical exam. They may suggest a urine sample or blood test. Some tests, like an ultrasound, are painless. The doctor will explain each step and answer your questions. You may be referred to a specialist, such as a urologist or gynecologist.

Treatment

Treatment for pelvic pain depends on the cause. The goal is to relieve pain and treat the underlying problem. Your doctor will create a plan that is safe for your age and overall health.

Self-care at home

• Apply a warm compress or heating pad to your lower belly or back for 15–20 minutes at a time
• Do gentle stretches for your lower back and hips, as recommended by a physiotherapist
• Stay hydrated and eat a high-fiber diet to prevent constipation
• Take gentle walks to keep your muscles and joints moving

Medical treatments

Your doctor may recommend pain relievers (such as paracetamol or topical creams), medications to relax the bladder or treat an infection, or physical therapy to strengthen the pelvic floor. For some people, injections into the joints or muscles can help. Always use medicines exactly as prescribed by your doctor.

When is surgery considered?

Surgery is rarely needed for pelvic pain in older adults. It may be considered if the pain is caused by a problem that does not improve with other treatments, such as a large fibroid, a bladder stone, or a pelvic organ prolapse that causes severe symptoms.

Living with this condition

Living with pelvic pain can be challenging, but many people find relief with the right treatment. Keep a pain diary to track what makes it better or worse. Share this with your doctor. Plan your day to include gentle activity and rest.

Lifestyle tips

• Use a supportive chair and avoid sitting on hard surfaces for long periods
• Practice good posture when standing and sitting to reduce strain on your pelvis
• Ask for help with heavy lifting or tasks that cause pain
• Try relaxation techniques like deep breathing to manage pain-related stress

Diet and exercise

Eat plenty of fruits, vegetables, and whole grains to prevent constipation, which can worsen pelvic pain. Drink enough water. Gentle exercise like walking, swimming, or chair-based yoga can strengthen muscles and improve blood flow. A physiotherapist can give you safe exercises.

Mental health and emotional wellbeing

Ongoing pain can affect your mood, sleep, and relationships. It is common to feel frustrated or worried. Talk to your doctor about these feelings. They can suggest support, such as counselling or joining a pain management group. If you ever feel overwhelmed or hopeless, reach out for help – contact your local crisis line or speak to someone you trust.

Prevention

Not all pelvic pain can be prevented, but you can reduce your risk by staying active, eating well, and managing chronic conditions like diabetes or high blood pressure. Avoid long periods of sitting and keep your bowels regular.

Vaccines

There are no specific vaccines for pelvic pain, but staying up to date with recommended vaccines (like the flu and pneumonia vaccines) can help prevent infections that might affect your pelvis.

Screening programmes

Routine health checks, such as blood pressure and blood sugar tests, can help catch conditions early that might lead to pelvic pain. For older women, pelvic exams and bone density tests may be recommended. Men should discuss prostate health with their doctor.

Complications

If left untreated

• Chronic (long-lasting) pain that becomes harder to treat
• Urinary tract infections that can spread to the kidneys
• Bowel problems like persistent constipation or fecal impaction
• Decreased mobility and muscle weakness from avoiding movement
• Depression or anxiety due to ongoing discomfort

Long-term outlook

The outlook for pelvic pain in older adults is often good. Many people find relief with the right treatment and self-care. Even if the pain cannot be fully cured, it can usually be managed so you can stay active and enjoy your daily life. Working closely with your healthcare team gives you the best chance of improvement.

Find support

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