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What should you do if you experience pelvic pain symptoms?

Pelvic pain is a common problem affecting women and men. Pain in the pelvic area typically stems from the reproductive, urinary, digestive or musculoskeletal systems. Patients often describe the pain as a stabbing or cramping sensation.

However, pelvic pain can be tricky to diagnose as the causes and symptoms of pelvic pain can vary widely.

鈥淧elvic pain can come in many shapes and forms,鈥� says Mitchell Goldenberg, MD, a urologist with 喵咪社区 Urology, part of 喵咪社区, who sees patients at . 鈥淲e have to take more than just the characteristics of the pain into account when we鈥檙e deciding what鈥檚 going on.鈥�

Pelvic pain during pregnancy

Dr. Goldenberg says it鈥檚 normal to experience pelvic pain during pregnancy. 鈥淟igaments become stretchy, and there is pressure being put on them,鈥� he explains, 鈥渁nd the bones are changing in structure as the body prepares to deliver the child.鈥�

Pelvic pain during pregnancy is often centered in the middle front of the pelvis and can stretch to the hips and back. Dr. Goldenberg says people who are pregnant should avoid heavy physical activity if they鈥檙e having pelvic pain, but that gentle exercises like walking and yoga are safe.

To ease pubic bone pain, he recommends that people who are pregnant sleep on their side with a pillow between their legs and rest whenever possible.

Pelvic pain causes and treatments

For people who are not expecting a baby, Dr. Goldenberg explains other possible causes of pelvic pain:

• A urinary tract infection is a common explanation for pelvic pain, he says. 鈥淚t鈥檚 often accompanied by other symptoms, like a fever, going to the bathroom more often or lower abdominal pain.鈥� Urinary tract infections are typically treated with antibiotics.
• Chronic constipation is another common cause of pelvic pain. Dr. Goldenberg says he may recommend dietary changes and fiber supplements, or laxatives in more severe cases.
• It鈥檚 possible to strain the pelvic floor muscles. 鈥淧eople may feel pain with sitting, while urinating or during sex,鈥� Dr. Goldenberg says. 鈥淚 almost always recommend pelvic floor physical therapy for pelvic pain because even if the muscles aren鈥檛 the underlying problem, they鈥檒l tighten over time because of the discomfort. Therefore, physical therapy is useful in most cases.鈥�
• If vaginal pressure or bulge accompanies the pelvic pain, then it may be a uterine or bladder prolapse. Pelvic floor physical therapy can be used, but often placing a device called a 鈥減essary鈥� is needed, or surgery in some cases.
• Interstitial cystitis affects the lining of the bladder, and resulting inflammation can lead to pelvic pain. Treatments include oral medications, bladder training and sometimes surgery.
• Clinicians may explore neurological conditions once other causes have been ruled out, says Dr. Goldenberg. 鈥淭he pain may be related to the nerves and how the brain is perceiving sensations from pelvic organs.鈥�

Urologists may use additional diagnostic techniques to determine the root cause of pelvic pain, such as an ultrasound or a CT scan of the pelvis, or a cystoscopy to view the inside of the bladder and urethra.

鈥淎 patient may be diagnosed with chronic pelvic pain syndrome,鈥� Dr. Goldenberg says, 鈥渨hen there鈥檚 no clear and readily treatable cause. We鈥檒l then focus on how best to manage symptoms and restore the patient鈥檚 quality of life.鈥�

When to call your doctor for pelvic pain

Consult with a doctor if pelvic pain is accompanied by blood in the urine, urinary incontinence or recurrent urinary tract infections. Pelvic pain that is progressively worsening is also a signal to see a doctor as soon as possible.

Dr. Goldenberg warns that men who experience a urinary tract infection need to see a specialist because it could indicate a serious bladder or prostate issue. 鈥淏ecause of our anatomical differences, men shouldn鈥檛 be getting urinary tract infections.鈥�

He adds that patients shouldn鈥檛 feel ashamed or embarrassed if they do experience pelvic pain. 鈥淧elvic pain is rarely caused by anything you鈥檝e done,鈥� assures Dr. Goldenberg.

鈥淒on鈥檛 suffer in silence,鈥� Dr. Goldenberg says. 鈥淧ain is an important symptom that tells us something is wrong. Pelvic pain isn鈥檛 something you necessarily need to call 911 about, but you don鈥檛 want to ignore it, either.鈥�

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