Chronic Pain Types Causes of Male Pelvic Pain and Treatment Options Everything you need to know about pain in pelvic pain in men By Erica Jacques Erica Jacques LinkedIn Erica Jacques, OT, is a board-certified occupational therapist at a level one trauma center. Learn about our editorial process Updated on February 07, 2022 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Violetta Shamilova, PharmD Medically reviewed by Violetta Shamilova, PharmD Violetta Shamilova, PharmD, is a board-certified pharmacist and assistant professor at Touro College in New York. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Causes When to See a Healthcare Provider Diagnosis Treatment Prevention Male pelvic pain—that which is centered around the lower abdomen or buttocks—can be a sign of several different conditions. Pelvic pain may begin suddenly, as with a kidney stone or a pulled muscle, or it can come on gradually, as with prostatitis or a urinary tract infection (UTI). Other possible causes include, but are not limited to, an inguinal hernia, prostatitis, a bladder infection, or digestive problems. mediaphotos / Getty Images Male pelvic pain can have other varying characteristics depending on the cause and its severity. Pain may be very localized or spread throughout a large area. Some may describe the pain as dull or sharp, feeling more like pressure, constant or circumstantial, or having other qualities. If you are experiencing pelvic pain, its important that you see your healthcare provider promptly. While the cause may not be serious, there are other cases when pain can rapidly worsen and even cause long-term complications (such as infertility) without appropriate treatment. Causes Some causes of pelvic pain only affect people with male genitourinary organs and anatomy, while others can affect any person. Prostatitis Prostatitis is inflammation of the prostate gland. An infection can cause acute cases. Chronic prostatitis, on the other hand, is usually caused by inflammation, often without an infection. In addition to pelvic pain, prostatitis may cause urinary problems or problems with ejaculation. When a bacterial infection is not the cause of prostatitis, the condition is known by several names including chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), prostatodynia (painful prostate), and abacterial prostatitis. Prostatic Hyperplasia (Enlargement) The prostate can enlarge due to benign prostate hyperplasia (BPH), prostate cancer, or prostatitis. A large prostate can cause pelvic pain, bladder issues, or it might not cause any symptoms at all. Urinary Difficulty Due to Enlarged Prostate Hernia A number of different hernia types affect people with male anatomy, such as inguinal hernia, femoral hernia, umbilical hernia, and hiatal hernia. An inguinal hernia is a protrusion of the intestines into the inguinal canal, which is a "tunnel" where the testes descend, and it only affects males. Male Chronic Pelvic Pain Syndrome This pain syndrome may be associated with prostatitis or BPH, but the pain can last longer than expected with these conditions. It can even occur without an identifiable cause. Male chronic pelvic pain syndrome is a diagnosis of exclusion, meaning that your healthcare provider will attempt to identify other causes of pelvic pain before concluding that your symptoms are attributable to this pain syndrome. Overview of Chronic Prostatitis/Chronic Pelvic Pain Syndrome Testicular Torsion Testicular torsion can cause severe pelvic pain. While uncommon, it is a medical emergency. Surgical treatment is necessary, and a delay could cause loss of the affected testicle. An Overview of Testicular Torsion \Other Causes Pelvic pain can also be caused by health issues that affect people of any sex, including: Muscle strain Gastrointestinal problems, such as irritable bowel syndrome (IBS) Sexually transmitted infections (STIs) Urinary tract infections (UTIs) Appendicitis Kidney stones Cancer in the pelvis or the pelvic bones When to See a Healthcare Provider If you have a chronic condition, such as IBS or recurrent constipation, pelvic pain can recur when your condition acts up. In this type of situation, your healthcare provider may have already prescribed medication for you to use whenever this happens. But if you develop new pelvic pain, you should see a healthcare provider. Associated issues that signal that your pelvic pain could be caused by a serious issue include: Fever Frequent urination, particularly at night (nocturia) An urgent need to urinate Pain or burning sensation when urinating (dysuria) A bulge of the pelvis, groin, testicles, or lower abdomen A rash or discharge Difficulty urinating, such as dribbling or urinary hesitation Abdominal pain or tenderness Difficulty having a bowel movement Blood in the stool (can appear bright red or dark and tarry) If you have severe pelvic pain and any of these symptoms of testicular torsion, seek immediate medical attention: Swelling of a testicle, redness/darkening of the scrotum, abdominal pain, nausea/vomiting, frequent urination, or fever. Diagnosis Your medical evaluation will include a history and physical examination. You may also need a blood test, urinalysis (U/A), and/or imaging. Intake and Exam During your medical history, your healthcare provider will ask about the severity of your pain, if you have had this type of pain in the past, whether it is constant or comes and goes, whether anything makes it better or worse, and if you have any associated symptoms. As part of your physical examination, your healthcare provider will look at and around the area where you have pain. Your physical examination will include palpation (touching and gentle pressure) in the area of your pain. A hernia can usually be identified on a physical examination. Depending on your symptoms, you might also have a prostate examination, which involves a digital rectal examination (DRE). Labs and Tests If there is a concern that you could have a bladder infection or inflammation of the bladder, your healthcare provider may order a U/A to evaluate your urine for evidence of infection (bacteria and/or white blood cells) or a tumor (abnormal bladder cells or red blood cells). You might also need to have a blood test to see if there are signs of an infection, especially if there is concern about appendicitis. A blood test can also be used to detect prostate-specific antigen (PSA), which may indicate prostate cancer. However, the results of a PSA test do not necessarily rule prostate cancer in or out. How a PSA Test Is Used to Screen for Prostate Cancer Imaging Imaging tests can include pelvic and/or abdominal X-ray, computerized tomography (CT), ultrasound, or magnetic resonance imaging (MRI). These tests may detect signs of appendicitis, pelvic infection, kidney stones, tumors, gastrointestinal disease, an enlarged prostate, or testicular torsion. Treatment Your treatment depends on the cause of your pelvic pain. You might need pain control as well as management of your underlying medical issue. Each cause of pelvic pain requires its own approach. For example, antibiotics are needed if you have a bacterial infection. Kidney stones may be treated by drinking lots of fluids, or with lithotripsy or surgical removal if necessary. And tumors may require surgery, chemotherapy, or radiation. Physical therapy has been used to manage different causes of male pelvic pain, including chronic pelvic pain syndrome and pelvic pain after a prostatectomy. Common treatments used for managing pelvic pain include: Short-acting pain medications, such as acetaminophen or non-steroidal anti-inflammatories (NSAIDs) Antidepressants that are used off- label for pain management, such as selective serotonin reuptake inhibitors (SSRIs) Treatment of prostate hypertrophy, such as Flomax (tamsulosin), an alpha-adrenergic blocker Oral muscle relaxants or Botulinum toxin A injections for treatment of bladder muscle spasticity Other treatments used in the management of chronic pelvic pain syndrome include acupuncture, prostatic massage, and impulse wave therapy. Prevention Sometimes it is not possible to avoid pelvic pain, but there are some approaches that can help reduce your chances of developing it. Practice safe sex. Because STIs are among the causes of male pelvic pain, protecting yourself can prevent pain and other symptoms. Barrier protection is the most effective way to avoid becoming infected. Manage digestive issues. Constipation and intestinal irritability can contribute to pelvic pain. If you are prone to digestive problems, follow your healthcare provider's instructions regarding medication and/or diet. Drink adequate fluids. Dehydration can increase the risk of kidney stones and bladder infections. Both conditions can often be prevented by drinking enough water, and getting enough fluids can even help in recovery if you have been diagnosed with either condition. Get recommended health screenings. Be sure to have your recommended screenings for colon cancer and prostate cancer. These serious diseases can cause pelvic pain and may be life-threatening, but the sooner they are identified, the better your chance of a cure. Prevent Kidney Stones With These Tips A Word From Verywell Male pelvic pain can limit your activity and be a sign of an underlying medical condition that needs to be treated. It is not always easy to distinguish pelvic pain from groin pain (between your lower abdomen and upper thigh) or rectal pain. If you experience pain in these areas, it is important that you don't ignore it or attempt to manage it on your own. 5 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Bharucha AE, Lee TH. Anorectal and pelvic pain. Mayo Clin Proc. 2016;91(10):1471-1486.doi.10.1016/j.mayocp.2016.08.011 Archambault-ezenwa L, Markowski A, Barral JP. A comprehensive physical therapy evaluation for male chronic pelvic pain syndrome: A case series exploring common findings. J Bodyw Mov Ther. 2019;23(4):825-834. doi:10.1016/j.jbmt.2019.05.021 Lakhoo J, Khatri G, Elsayed RF, et al. MRI of the male pelvic floor. Radiographics. 2019;39(7):2003-2022. doi.10.1148/rg.2019190064 Scott KM, Gosai E, Bradley MH, et al. Individualized pelvic physical therapy for the treatment of post-prostatectomy stress urinary incontinence and pelvic pain. Int Urol Nephrol. 2020;2,655–659. doi:10.1007/s11255-019-02343-7 Franco JV, Turk T, Jung JH, et al. Non-pharmacological interventions for treating chronic prostatitis/chronic pelvic pain syndrome. Cochrane Database Syst Rev. 2018;5:CD012551. doi:10.1002/14651858.CD012551.pub3 Additional Reading National Institute of Diabetes and Digestive and Kidney Diseases. Prostatitis: Inflammation of the Prostate. Updated July 2014. Rees J, Abrahams M, Doble A, Cooper A, Prostatitis Expert Reference Group (PERG). Diagnosis and treatment of chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome: a consensus guideline. BJU Int. 2015;116(4):509-525. doi:10.1111/bju.13101 Andriole GL. Prostatitis (Prostatodynia). The Merck Manuals Online Medical Library. 2016. Editorial Process Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit