What Is Pelvic Pain? Causes, Symptoms, and What You Need to Know

Key Highlights:

• Pelvic pain is discomfort felt in the lower abdomen, between the hips and above the legs.

• It can appear as a dull ache, sharp cramps, or pressure that may spread to the lower back or thighs.

• Common symptoms include pain during periods, sex, or toileting, bloating, and muscle tightness.

• Causes range from gynecological conditions like endometriosis and adenomyosis, to bowel, bladder, nerve, or hernia-related issues.

• Women are more likely to experience pelvic pain, though men can also be affected.

• Persistent or chronic pelvic pain should never be ignored — understanding what’s causing it is the first step toward finding relief.

What is Pelvic Pain?

Do you sometimes feel pain or discomfort in the lower part of your belly, between the hips and just above the legs? This type of discomfort is often referred to as pelvic pain.

The pelvis is a busy area of the body. It holds the bladder, bowel, and reproductive organs, as well as

layers of muscles, ligaments, and nerves that support movement and daily function. Because so much is located here, pain in this region can come from many different sources — some temporary and harmless, others more persistent and requiring attention.

For some, pelvic pain feels like a dull ache that comes and goes. For others, it can be sharper, last longer, or spread into the lower back or thighs. It might show up just before or during a period, after sitting for a long time, or during activities like exercise or sex.

Over time, pelvic pain can begin to affect daily life — planning work or social activities around flare-ups, avoiding certain types of movement, or simply feeling drained from ongoing discomfort. It can also be accompanied by other symptoms such as bloating, changes in bowel or bladder habits, or fatigue.

While pelvic pain is a common experience, it isn’t something to dismiss or “just put up with.” If it starts to interfere with your life, it’s worth paying attention to and seeking support to understand what might be causing it.

Pelvic Pain Symptoms

Pelvic pain can feel different from person to person. For some, it shows up as a steady ache, while for others it may come as sharp cramps or sudden twinges. The pain might stay in one spot or spread to the lower back, abdomen, or thighs.

Common symptoms include:

• Pain linked to the menstrual cycle, such as cramping or heaviness

• Discomfort during or after sex

• Pain when using the toilet, or changes in bowel or bladder habits

• Muscle tightness or spasms in the pelvic floor

• Pins and needles and tingling around the hips or down the leg should be addressed sooner rather than later.

• Tiredness or low energy from living with ongoing pain

For some people, these symptoms come and go. For others, they may be constant and interfere with daily life. What can make pelvic pain particularly frustrating is its unpredictability—you might feel fine one day and then struggle with discomfort the next, often without a clear reason.

If symptoms are severe, sudden, or accompanied by fever, nausea, or swelling, it may signal an infection or another condition that needs urgent medical care.

Who Experiences Pelvic Pain?

While anyone can experience pelvic pain, it is more common in adult women. Certain factors can increase the risk, such as:

• Multiple surgeries in the abdomen or pelvis

• Pre-existing anxiety or depression

• Chronic health conditions affecting the bowel, bladder, or reproductive system

Men can also develop pelvic pain, often linked to conditions affecting the prostate, bladder, or testicles.

Common Causes of Pelvic Pain

Because the pelvis contains several organs, muscles, and nerves, pain can come from many different sources. Understanding the possible causes is the first step to managing it.

• Gynecological Causes

  • Period pain (dysmenorrhea): Common, but severe or prolonged pain that lasts more than 3 days may point to another condition.

  • Endometriosis: Tissue similar to the uterine lining grows outside the uterus, causing pain, inflammation, and scarring.

  • Adenomyosis: Cells that normally line the uterus grow into its muscle wall, leading to heavy, painful periods.

  • Ovarian cysts or fibroids: Can cause pressure, heaviness, or sudden sharp pain if they twist or rupture.

  • Pelvic inflammatory disease: Inflammation of the uterus, ovaries, or fallopian tubes.

  • Pelvic Congestion Syndrome: enlarged veins in the pelvis leading to blood pooling and increased pressure in the pelvis. Often feels like a dull ache that worsens with prolonged sitting or standing, and/or painful intercourse.

• Bowel and Digestive Causes

  • Irritable bowel syndrome (IBS): Cramping, bloating, constipation, or diarrhea. Pain often eases after passing stool or wind.

  • Inflammatory bowel disease (Crohn’s or ulcerative colitis): Chronic inflammation of the digestive tract.

  • Constipation, diverticulitis, or post-surgical adhesions: Can all contribute to pelvic discomfort.

• Bladder Causes

  • Urinary tract infections (UTIs): Burning, urgency, and pelvic pressure. If untreated, they can lead to kidney infection.

  • Painful bladder syndrome (interstitial cystitis): Chronic irritation of the bladder without infection.

• Musculoskeletal and Nerve Causes

  • Pelvic floor muscle spasm: Can feel like ongoing cramps or sharp pain, sometimes worsened by exercise, sex, or tampon use.

  • Myofascial trigger points: Tight knots in the pelvic or abdominal muscles that cause referred pain.

  • Nerve pain (neuropathy or pudendal neuralgia): May spread from the pelvis to the back, buttocks, or legs.

  • Spinal or joint issues: Arthritis in the spine, sacroiliac joint, or hips can mimic pelvic pain.

• Hernias

  • A hernia happens when tissue pushes through a weakness in the muscle or tissue wall.

  • Signs to watch for: a visible or palpable lump, pain that increases with activity or straining, or pain that radiates into the groin or inner thigh.

• Male Causes

  • Prostatitis: Inflammation of the prostate.

  • Testicular pain (orchialgia): Can result from infection, swelling, injury, or torsion (a medical emergency).

Pelvic pain can have many possible causes, and understanding them is the first step toward finding relief. While some discomfort may settle with time or small lifestyle changes, ongoing or worsening pain deserves care and proper assessment.

In Part 2 of this blog, we’ll talk about managing pelvic pain. This includes treatment options to know when it’s time to seek help and how a women’s health physiotherapist can support recovery.