Causes of Pelvic Pain

Pelvic pain is a significant problem for women of all ages.

Causes of Pelvic Pain

It can come on suddenly or last for months.

This pain occurs below the belly button (lower part of the abdomen) and can be severe enough to impact the quality of life, work, and intimacy.

Sources of pain include:

  • Gynecologic (tubes, ovaries, and uterus)
  • Urologic (bladder)
  • Gastrointestinal (bowels – IBS, constipation, etc…)
  • Neurologic (pain syndromes, trauma)
  • Musuloskeletal (muscles, ligaments, and bones)
  • Psychological (physical, emotional, or sexual abuse; anxiety and/or depression)

These causes can be hard to identify and there may be more than one.

Given this, a thorough history and physical exam is required. In addition, a pelvic ultrasound and/or surgery to look at the pelvis are often necessary.


One common cause of pain in women of reproductive age is endometriosis.

Endometriosis is a condition where the lining of the uterus (the endometrium) is located outside of the uterus, typically in the pelvis or abdomen.

This can occur in up to 10-15% of women, and when it happens, can cause pelvic pain, painful periods, pain with intimacy, and infertility.

Diagnosis is often based on a woman’s history, but a certain diagnosis is made by surgical evaluation (laparoscopy) and biopsy.

Endometriosis can be treated with medicines such as non-steroidal pain medicines, birth control pills, as well as other forms of hormone therapy. Sometimes surgery is needed to adequately treat this condition.