Pelvic Pain

Whether it's the occasional cramp or something more persistent, pelvic pain deserves to be taken seriously.

For some women and people assigned female at birth, it can impact so many aspects of life, from getting through the work day to social activities and even their love life. Women experience pelvic pain for a variety of reasons, from menstrual cramps to conditions like endometriosis and pelvic inflammatory disease. But here’s the thing: understanding what's behind that discomfort is key to managing it. 

Proper treatment isn’t just about easing the pain (though that’s a big part of it); it’s about addressing the root cause. Chronic pelvic pain, in particular, can be tricky to diagnose and manage, but don’t worry—you’ve got options.  With the right knowledge and treatment plan, you can take control of your health and say goodbye to pain that holds you back.

What is pelvic pain?

Pelvic pain is exactly what it sounds like—pain in the lower abdomen and pelvic region. It’s one of those things that can range from mildly annoying to downright unbearable, and it affects women in different ways.

Pelvic pain is not just one condition—it’s a symptom that can be caused by a variety of conditions, making it tricky to pinpoint. Pelvic pain can be acute or chronic, but either way, it’s not something you should just ignore. 

• Acute pelvic pain  is a sharp, intense pain in the lower belly or pelvis that sticks around for less than three months. The symptoms can be annoyingly vague, and the list of possible causes is long—depending on your age, whether you're pregnant, and whether the issue is gynecological or something else entirely. In short, it’s a bit of a diagnostic guessing game.
  
  
• Chronic pelvic pain (CPP) is persistent pelvic pain that sticks around for at least six months, whether it comes and goes with your cycle or not. It may or may not bring along unwelcome guests like painful periods, sex, urination, or bowel movements. The cause? Well, that depends on which case is stirring up the drama.

Common complaints women experience with pelvic pain include painful pelvic cramps, a constant dull pelvic ache, or even more intense issues like painful intercourse. These symptoms can dramatically affect daily life, making even the simplest activities a challenge.

Pelvic pain can also take a toll on mental and emotional wellbeing, adding stress and frustration to an already difficult situation. So, if you’re feeling like pelvic pain is taking over, you’re not alone—and there’s help out there.

Common causes of pelvic pain in women

Pelvic pain isn’t a condition in itself — but a symptom of other problems going on within the pelvic region. Let’s break down some of the most common culprits, starting with gynecological issues—because, as it turns out, your uterus is often the primary offender.

Gynecological issues:

• Endometriosis: This is when tissue similar to the lining of your uterus grows outside of it, causing severe pain, especially during your period or intercourse. This can cause pelvic pain and can affect your fertility, too.
• Uterine fibroids: These non-cancerous growths in the uterus can lead to heavy periods, pelvic pressure, and yes, pain. Fibroids can vary in size, but even small ones can pack a punch.
• Pelvic Inflammatory Disease (PID): A result of untreated infections in the reproductive organs, PID can lead to chronic pelvic pain and even scarring of the uterus or fallopian tubes. 
• Ovarian cysts: These fluid-filled sacs that form on your ovaries can sometimes rupture or twist, causing intense pelvic pain that might feel like a sharp stabbing sensation.

Gastrointestinal disorders:

Sometimes, pain that feels like it's coming from your pelvic region is actually caused by Irritable Bowel Syndrome (IBS) or other food intolerances. IBS often leads to cramps, bloating, and discomfort that can mimic pelvic pain. In fact, one study found that 40% of women with pelvic pain met the criteria for IBS.

If you've been dealing with unexplained discomfort in your lower abdomen, it’s worth considering whether your bowels might be the culprit.

Urinary tract conditions:

• Interstitial Cystitis (IC): This bladder condition can cause chronic pelvic pain and frequent, urgent urination.  Unlike a UTI, IC is not caused by an infection, and the pain is usually persistent over time. It’s a condition that often gets overlooked, but it’s a real pain in the—well, pelvic region.
• Urinary Tract Infections (UTIs): We all know the discomfort of a UTI, but if left untreated, it can worsen and lead to persistent pelvic pain or even a more serious infection. So don’t ignore that burning sensation—get it treated ASAP.

Musculoskeletal and neurological conditions:

• Pelvic Floor Dysfunction: Your pelvic muscles support your bladder, uterus, and rectum. When these muscles aren’t working properly—whether too tight or too weak—it can cause pelvic floor pain.
• Nerve Pain (Posterior Pelvic Pain): Nerve issues can lead to pain that shoots through your lower back and pelvis, often radiating from your spine. This can feel like a burning or aching pain and is sometimes mistaken for muscle or joint issues.

Pelvic pain can stem from a wide range of causes, from gynecological problems to nerve pain, and even your digestive system. Identifying the root cause is key to finding the right treatment—because, let’s face it, no one should have to “just live with it”. 

Symptoms of pelvic pain

Pelvic pain doesn’t feel the same for everyone, or every condition —it can show up in a variety of ways, making it frustrating to deal with. The ways we experience pelvic pain can vary widely, but one thing’s for sure: it’s no picnic.

Pelvic pain can show up in a number of ways:

• Sharp, stabbing pain:
  You know that moment when out of nowhere, it feels like someone stabbed you in the pelvis with a knife? That sudden, intense pain can be a hallmark of conditions like ovarian cysts or endometriosis, sometimes striking out of nowhere and leaving you doubled over.
• Dull, aching pain:
  This is the slow burn—the kind of discomfort that lingers and wears you down over time. It may not be sharp, but it’s relentless, often linked to Pelvic Floor Dysfunction (PFD) or Chronic Pelvic Pain Syndrome (CPPS).
• Cramping:
  Menstrual cramps can be brutal, but cramping isn’t always tied to your cycle. Pelvic Inflammatory Disease (PID), fibroids, and adenomyosis can also cause that deep, squeezing pain that makes you want to curl up in a ball.
• Burning, sharp, or deep pain during intercourse:
  If sex is painful, you’re far from alone. Conditions like endometriosis, pelvic floor dysfunction, and interstitial cystitis (IC) can turn intimacy into agony.
• Painful urination or bowel movements:
  That burning, stabbing pain when you pee? Interstitial cystitis or a UTI could be to blame. If bowel movements bring discomfort, IBS, endometriosis, or inflammatory bowel disease (IBD) might be the hidden culprit.

When to see a doctor about pelvic pain

Now, let’s get real. Not all pelvic pain is created equal. While some discomfort can be managed at home with monthly over-the-counter pain medications or hot water bottles, severe pelvic pain is a different beast. If you’re experiencing any of the following, it might be time to call your doctor and stop suffering in silence:

• Pain that doesn't go away or gets worse over time.
• Pain that affects your daily life, whether it’s preventing you from working, exercising, or enjoying time with loved ones.
• Pain that gets worse during menstruation, or doesn’t go away with usual menstrual remedies.

More serious symptoms might require a trip to the emergency room. These include:

• Pain accompanied by abnormal bleeding, fever, or nausea
• Severe, sudden pelvic pain that comes on quickly and feels sharp or intense.
• Heavy or uncontrolled bleeding (soaking through a pad or tampon in an hour or less, or passing large clots).
• Fainting, dizziness, or weakness, which could indicate internal bleeding or shock.
• Pain with a high fever and chills, which could signal a serious infection like pelvic inflammatory disease (PID) or an abscess.
• Severe nausea or vomiting along with pelvic pain, which could be a sign of ovarian torsion or another urgent condition.
• Swelling or tenderness in the lower abdomen that worsens rapidly.
• Pain during or after pregnancy—especially if it’s sharp and one-sided, which could indicate an ectopic pregnancy.
• Inability to pass urine or have a bowel movement, which could suggest a serious blockage or complication.

Even if it’s not a lights and sirens situation, remember: you don’t have to endure unnecessary pelvic pain, even if it’s mild. When in doubt, don’t hesitate to book an appointment with a doctor. It’s time to take back control of your body and your comfort.

Diagnosing pelvic pain

When it comes to pelvic pain, it’s best not to play guessing games or just hope it goes away. A proper diagnosis is key to getting the right treatment and relief. Let’s break down what you can expect during the diagnostic process and why it's so important to get it right the first time.

Diagnosing pelvic pain involves a deep dive into your symptoms, medical history, and sometimes, a bit of detective work from your healthcare provider. They’ll ask you a lot of questions—like when the pain started, its intensity, and any triggers (e.g., painful intercourse or monthly cramps). It’s important to be as specific as possible, so they can get a clearer picture of what's going on.

After getting an idea of your symptoms and general health, doctors will often use testing and imaging to narrow down the cause of your pain. Some diagnostic tools they may use include: 

• Physical exams: Don’t be surprised if your doctor asks you to undergo a physical exam, which may include internal pelvic exams to check for abnormalities like masses or tenderness. While it can be uncomfortable, it can help to get to the root of any issues. But remember, your body, your rules—if anything doesn’t feel right or you’re unsure, you have every right to ask questions, request alternatives, or decline an exam.
  
• Ultrasound: This common test uses sound waves to create images of the organs in your pelvis, helping doctors identify things like cysts, fibroids, or other structural issues. It’s usually one of the first tests to rule out obvious causes.
  
• Laparoscopy: If the pain’s origin is a mystery and other tests haven’t yielded results, your doctor might recommend a laparoscopy. This minimally invasive procedure involves inserting a tiny camera into the pelvis to directly view organs and check for conditions like Endometriosis or Pelvic Inflammatory Disease (PID). It’s like a mini-exploration of your insides to get down to the root cause of your pain. 

Importance of a proper diagnosis:

Getting the right diagnosis is the key to determining the best treatment plan. Without it, you might end up on a trial-and-error journey with treatments that don’t address the real cause. Whether it’s Chronic Pelvic Pain Syndrome, Pelvic Floor Pain, or something else entirely, the right diagnosis means you can find a tailored treatment that works for you, whether that involves medications, physical therapy, lifestyle changes, or even surgery.

At Hazel, we understand that women deserve answers, not uncertainty. So don’t wait—get the answers you deserve. After all, you’re the expert when it comes to your own body. Let your doctor help you get the diagnosis that can lead to the best possible treatment and results.

Treatment options for pelvic pain

Managing pelvic pain is not a one-size-fits-all situation—it’s all about finding what works best for your specific condition. Whether it’s a quick fix or a long-term management plan, treatment options range from medical interventions to holistic approaches. Let’s break it down.

Medical treatments for pelvic pain

Sometimes, a little help from medicine is all you need to reclaim your comfort. Don’t skip discussing side effects with your healthcare provider—finding the right medication might take a little trial and error.

• Pain relief medications: Over-the-counter NSAIDs (non-steroidal anti-inflammatory drugs) like ibuprofen can help reduce inflammation and manage pain. For severe cases, your doctor may prescribe stronger painkillers.
• Hormonal treatments: For conditions like endometriosis or painful periods, hormonal birth control (pills, patches, or IUDs) can help regulate or even stop periods, which often reduces pelvic pain.
  
  A small study on women with bowel endometriosis found that taking a low dose of oral NETA (norethisterone acetate, synthetic progesterone hormonal treatment) significantly reduced chronic pelvic pain, pain during sex, and pain with bowel movements.

Surgical treatments

When conservative treatments aren’t cutting it, surgical options may provide relief. Surgery isn’t always the first choice—it’s often reserved for when other treatments haven’t worked or the condition is severe.

• Laparoscopy: This minimally invasive surgery can diagnose and treat conditions like endometriosis, removing scar tissue or lesions to reduce pain.
  
• Pelvic floor surgery or hysterectomy: In extreme cases, such as chronic pelvic pain that doesn’t respond to other treatments, surgery to correct structural issues or even remove the uterus (hysterectomy) may be considered.
  While a hysterectomy is an accepted treatment for chronic pelvic pain, it’s not a one-size-fits-all fix. While some women experience less pain and better daily function after the surgery, if the root cause of the pain isn’t known the results are not as clear cut.
  Most women see an improvement in pain and daily function, but studies show that if no clear cause for the pain is found, 21-40% may still have pain afterward, and 5% may develop new pain.

‍Physical therapy and alternative treatments

Sometimes the solution lies beyond prescriptions and scalpels.These approaches often focus on treating the whole person—not just the pain.

• Pelvic floor therapy: Specialised physical therapists can work wonders for conditions like pelvic floor dysfunction, teaching exercises to relax or strengthen the pelvic muscles.
• Medicinal cannabis:  Some patients find this natural therapy can help reduce inflammation and manage chronic pelvic pain. Vaginal or rectal suppositories, in particular, offer targeted relief by delivering cannabinoids directly to the affected area.
• Alternative medicine: Treatments like acupuncture and yoga may help reduce pain and improve overall wellbeing.
• Counseling: Chronic pain can take a toll on your mental health. Therapists who specialise in chronic illness can help you process emotions, manage stress, and develop coping strategies.
• Mindfulness practices: Techniques like meditation, deep breathing, and guided imagery can help reduce stress and create a sense of calm, even on tough days.

Lifestyle and home remedies

Small changes at home can make a big difference. While these options might not eliminate severe pelvic pain, they’re great complementary tools to ease discomfort and support overall health.

• Diet changes: For conditions like IBS, identifying food triggers (looking at you, spicy tacos) can reduce pelvic pain related to digestion.
• Stress management and exercise: Stress can intensify pain, so finding ways to manage it—through exercise, meditation, or even a relaxing bath—can help.
• Heat therapy: Heating pads or warm baths can provide temporary relief for pelvic discomfort.

There’s no magic cure-all for pelvic pain, but a combination of treatments can get you closer to relief. The key? Work closely with your healthcare provider, like one of our Hazel experts, to create a plan that’s tailored to your needs. Whether it’s medication, surgery, or holistic care, you’ve got options—and with the right approach, you’re on the path to feeling better.

How Hazel supports women with pelvic pain

At Hazel, we know that women’s health is complex, and finding the right answers takes persistence. Our clinical team goes beyond the surface. We listen, dig deeper, and explore every option until you get the care and clarity you need. We’re dedicated to helping women take control of their pelvic pain through personalised, compassionate care. Whether your pain is acute or chronic, we offer expert support to help you feel like yourself again. 

Our team takes a holistic approach that can combine pain management, counseling, and alternative treatments to address both the physical and emotional aspects of pelvic pain. We understand that every woman’s journey is unique, so we focus on creating tailored care plans that fit your specific needs. 

Pelvic pain in a nutshell

Pelvic pain is a complex issue with many potential causes, from gynaecological conditions like endometriosis to urinary tract issues, and musculoskeletal problems. It can be felt as a dull ache or sharp cramps to pain during menstruation, intercourse, or everyday activities—no matter how you experience pelvic pain, it can significantly impact your quality of life.

Fortunately, there are many effective treatments available. From medical options like pain relief medications, hormonal therapies, and surgery to physical therapy, lifestyle changes, and alternative therapies, relief is possible.

If you’re struggling with pelvic pain, don’t wait to seek help. Professional care can make all the difference. At Hazel, we’re here to support you every step of the way.

Pelvic pain FAQs

Can chronic pelvic pain syndrome be cured?
Chronic pelvic pain syndrome is, unfortunately, a long-term condition. While there isn’t a magic cure, effective treatments can help manage symptoms and improve quality of life. These might include medications, physical therapy, lifestyle changes, and in some cases, surgery. The goal is to keep symptoms under control rather than eliminate them entirely, but with the right approach, many people find significant relief and get back to living life on their own terms.

Does chronic pelvic pain go away on its own?
Chronic pelvic pain doesn’t usually just disappear on its own. Sure, some people might get lucky with periods of relief, but most need targeted treatment to keep symptoms in check. This can include physical therapy, medications, or other pain management strategies. Waiting for it to magically sort itself out isn’t the best bet, so working with a healthcare professional is the smartest way forward.

What is the cause of pelvic pain in women?
Pelvic pain in women can come from a variety of sources, including conditions like endometriosis, ovarian cysts, pelvic inflammatory disease, and gastrointestinal issues. Hormonal imbalances, muscle tension, and urinary tract problems can also be to blame. Since there are so many potential culprits, getting a proper medical evaluation is essential to pinpoint the cause and find the right treatment. No guessing games here—getting to the root of the problem is the way to go.