Common Causes of Pelvic Pain in Women

Acute pelvic pain is pain that starts over a short period of time anywhere from a few minutes to a few days. This type of pain is often a warning sign that something is wrong and should be evaluated promptly.

Close up of gynecological examining table with a woman in the background holding her stomach
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Ovarian Cysts

Women who have ovarian cysts may experience sharp pain if a cyst leaks fluid or bleeds a little, or more severe, sharp, and continuous pain when large cyst twists or ruptures. This is probably the most common gynecologic cause of acute onset pelvic pain. Fortunately, most small cysts will dissolve without medical intervention after 2 or 3 menstrual cycles; however large cysts and those that don't rectify themselves after a few months may require surgery to remove the cysts.

Ectopic Pregnancy

An ectopic pregnancy is one that starts outside the uterus, usually in one of the fallopian tubes. Pain caused by an ectopic pregnancy usually starts on one side of the abdomen soon after a missed period and may include spotting or vaginal bleeding. Ectopic pregnancies can be life-threatening if medical intervention is not sought immediately. The fallopian tubes can burst and cause bleeding in the abdomen if left untreated. In some cases, surgery is required to remove the affected fallopian tube.

Non-Reproductive Causes

Pelvic pain can be caused by an infection or inflammation. An infection doesn't have to affect the reproductive organs to cause pelvic pain. Pain caused by the bladder, bowel, or appendix can produce pain in the pelvic region; diverticulitis, irritable bowel syndrome, kidney or bladder stones, as well as muscle spasms or strains are some examples of non-reproductive causes of pelvic or lower abdominal pain.

Additional Causes of Acute Pain

Acute pelvic pain can also be a symptom of appendicitis.

Other causes of pelvic pain can include pelvic inflammatory disease (PID), vaginal infections, vaginitis, and sexually transmitted diseases (STDs). All of these require a visit to your healthcare provider who will take a medical history, and do a physical exam which may include diagnostic testing.

Chronic Pelvic Pain

Chronic pelvic pain can be intermittent or constant. Intermittent chronic pelvic pain usually has a specific cause, while constant pelvic pain may be the result of more than one problem. A common example of chronic pelvic pain is dysmenorrhea or menstrual cramps. Other causes of chronic pelvic pain include endometriosis, adenomyosis, and ovulation pain. Sometimes an illness starts with intermittent pelvic pain that becomes constant over time, this is often a signal that the problem has become worse. A change in the intensity of pelvic pain can also be due to a woman's ability to cope with pain becoming lessened causing the pain to feel more severe even though the underlying cause has not worsened.

Women who have had surgery or serious illness such as PID, endometriosis, or severe infections sometimes experience chronic pelvic pain as a result of adhesions or scar tissue that forms during the healing process. Adhesions cause the surfaces of organs and structures inside the abdomen to bind to each other.

Fibroid tumors (a noncancerous, benign growth from the muscle of the uterus) often have no symptoms; however, when symptoms do appear they can include pelvic pain or pressure, as well as menstrual abnormalities.

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  1. Office of Women's Health. Symptoms of ovarian cysts. Updated April 1, 2019.

  2. Sivalingam VN, Duncan WC, Kirk E, Shephard LA, Horne AW. Diagnosis and management of ectopic pregnancyJ Fam Plann Reprod Health Care. 2011;37(4):231–240. doi:10.1136/jfprhc-2011-0073

  3. American College of Obstetricians and Gynecologists. Chronic pelvic pain. Updated August, 2011.

  4. ten Broek RP, Issa Y, van Santbrink EJ, et al. Burden of adhesions in abdominal and pelvic surgery: systematic review and met-analysisBMJ. 2013;347:f5588. doi:10.1136/bmj.f5588