Pelvic pain

Category: Women's Health · All women's health symptoms

What it can feel like

Pelvic pain is pain in the lowest part of the abdomen, between the hip bones. Acute pelvic pain is a new, often severe symptom with its own emergencies; chronic pelvic pain lasts six months or more and usually has several overlapping contributors — gynaecological, bladder, bowel and musculoskeletal — rather than one tidy cause.

Possible causes

A symptom can have many causes, and most are not serious. The lists below group conditions this symptom can be associated with — common causes first. They are possibilities to discuss with a clinician, not a diagnosis.

Common causes

Pelvic pain can be associated with period pain, ovulation pain mid-cycle, pelvic infection, ovarian cysts, urinary infection, constipation and irritable bowel patterns.

Other possible causes

Pelvic pain can also be associated with ectopic pregnancy (in anyone who could be pregnant), ovarian torsion (twisting of the ovary — sudden and severe), endometriosis, inflammatory bowel disease, and, in the chronic form, bladder pain syndrome and pelvic floor muscle problems.

Red flags — when to seek help promptly

Sudden severe pelvic pain, especially with vomiting, fainting or a positive pregnancy test — emergency
Pelvic pain in pregnancy of any pattern — assess promptly
Pelvic pain with fever, offensive discharge or pain on sex (possible infection)
Pelvic pain with inability to pass urine, blood in the urine or severe one-sided pain with vomiting

What a clinician may do

A clinician will take a pregnancy test wherever relevant, characterise the pain (timing with cycle, bowels, bladder, sex), examine the pelvis and abdomen, and take infection swabs. Ultrasound is the first imaging step; chronic pain may need a multidisciplinary approach and sometimes keyhole surgery.

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Frequently asked questions

What is ovarian torsion and why is it an emergency?

An ovary — often enlarged by a cyst — twists on its stalk, cutting off its blood supply. The pain is typically sudden, severe and one-sided with vomiting. The ovary can be saved if unwound surgically within hours, so the pattern goes straight to emergency assessment.

Why does chronic pelvic pain involve so many systems?

The pelvis is crowded — womb, ovaries, bladder, bowel and pelvic floor share space and nerve pathways, and each sensitises the others over time. That is why chronic pelvic pain is usually managed by addressing several contributors at once rather than hunting a single cause.

Related symptoms — Women's Health

Bleeding after sex Bleeding after the menopause Bleeding between periods Breast lump Breast pain Heavy periods

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Please note: This page is educational information about a symptom. A symptom alone cannot diagnose any condition, and the causes listed here are possibilities, not a diagnosis. If you are worried about a symptom — especially one that is new, severe, getting worse or not going away — please see your own clinician, who can examine you and arrange tests. In an emergency, call your local emergency number.