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Possible Causes of Pelvic Pain & Inflammation

Published on 10/12/22

There are many possible causes of pelvic pain and inflammation. Pelvic pain and inflammation are a condition that could be identified by a single issue or the result of several medical conditions. The pain normally sits between the belly button, the groin and the hips. Pain and symptoms are known to last for six months or longer. 

Identifying a single issue that contributes to the causes of your pelvic pain and inflammation can be enough to eliminate pain. However, in a lot of cases, it is hard or impossible to identify a single cause for chronic pelvic pain. Getting treatment will hopefully set a goal of finding the cause of your pain and improve your symptoms and quality of life. 

Types of Pelvic Pain

Your doctor may ask you to locate where you feel pain. A lot of patients might describe the pain as across the entire area rather than a specific spot. Which can be explained several different ways:

  • A Dull aching
  • Sharp pain or cramping
  • Pressure within your pelvis
  • Pain that is intermittent
  • Or severe and steady pain

In addition to everyday pain, you also may experience:

  • Pain while having a bowel movement or urinating
  • Pain when sitting for long periods of time
  • Pain during intercourse

Discomfort may be worsened not only for sitting for longer periods of time but also standing for long durations. The pain may be relieved when you lie down and can range from mild and annoying to severe, missing work and not being able to eat or exercise. 

Conditions that Contribute to Pelvic Pain and Inflammation

It will be for your doctor to determine if it’s a singular issue or more than one condition causing your pelvic pain and inflammation. A lot of conditions have similar symptoms and can make it difficult to identify the source of the pain. Some of those symptoms may last a few to six months with other symptoms coming and going. Understanding your symptoms can help your doctor determine and pinpoint the cause or causes of your chronic pains.

The female reproductive system may cause pain to arise with conditions such as:

  • Menstrual Cramps
  • Ovarian Cysts
  • Pelvic Inflammatory Disease (PID)
  • Miscarriage
  • Endometriosis
  • Adenomyosis
  • Ovulation Pain
  • Uterine Fibroids
  • Vulvodynia


What Are These Conditions That Are Causes for Pelvic Pain and Inflammation?

Endometriosis Cells that normally line the inside of the uterus grow outside on organs like the ovaries, rectum, or bladder. The pelvic pain and inflammation this will resemble are pains such as cramps before or during your period, pain during and after sex, painful bowel movements, lower back pain, pain when your ovulate, rectal bleeding during your period, infertility, spotting between periods, bloating in your abdomen, and pain when your urinate. All which contribute to one or multiple signs of chronic pelvic pain.

AdenomyosisSimilar to Endometriosis, cells that normally line your uterus, invade muscle tissue of the uterus wall. However, it is known that a lot of women don’t display any symptoms. If they do, they could be anything from pain during your period, feeling of pressure on your bladder or rectum, spotting between periods, heavy periods and periods that last longer than usual. 

Menstrual Pain and Cramps This is a very common cause of pelvic pain and inflammation in women. Over half of the women who menstruate will experience pain for one to two days each cycle. Menstrual cramping will begin right before a woman starts her period and during the beginning of her period cycle. The cramps or contractions is the uterus starting to shed its lining. Which feel similar to a muscle spasm or a jabbing pain. 

Pain relief for menstrual cramps can be helped by a heating pad or over the counter medications such as ibuprofen and Aleve. For more severe cases, doctors can recommend other medications. 

OvulationOr Mittelschmerz. Doctors use this German word to describe painful ovulation. Usually when a woman feels a painful sensation on one side of her pelvis in the middle of her menstrual cycle. 

During ovulation, the ovaries release an egg in addition to some fluid. The egg then travels down the fallopian tube into the uterus. When the ovary releases the fluid into the uterus, it can spread within the pelvic area and at times, cause irritation to the pelvis. 

It may cause mild discomfort that can last for minutes to hours and depending on which side the ovary is released, may switch sides of the body. Since this condition is temporary, there is not specific treatment to alleviate the discomfort.

Pelvic Inflammatory Disease (PID)Is an infection of the womb. That infection can damage the surrounding tissue. Which can start from bacteria in the vahina or cervix that enters the womb. This may cause abnormal discharge and bleeding. Normally the root of infection being an STI like Gonorrhea or Chlamydia. 

It is known that 1 in 8 women who have had a PID also have issues trying to become pregnant. Although it can be treated with antibiotics, the scarring that the infection can leave cannot be treated unless it’s caught in early stages, which is crucial.


Irritable Bowel Syndrome (IBS)A gut disorder. This disorder causes symptoms such as diarrhea, bloating, and constipation. These and other symptoms of IBS tend to flare up and go away over time, most likely after a bowel movement. 

Considering there is no cure for IBS, the only treatment is change in diet, behavioral changes, medications, stress levels, and psychotherapy depending on how severe the symptoms are. 

Ovarian CystsAre fluid-filled sacs or pockets in an ovary or on it’s surface. Ovarian Cysts occur when ovaries fail to release an egg and may become clogged with fluid. Many women have ovarian cysts some time. In many cases, they pose no pain or discomfort and are completely harmless. 

However, in other cases, when this happens, the cyst forms in an area which can cause bloating, pressure or pain on the side of the body with the cyst. There are also times when the cyst can rupture and cause serious symptoms that can signal a potentially serious problem. 

Most cysts are noncancerous. Doctors can identify ovarian cysts using ultrasound and treatments can vary from watching and waiting to surgery.

Uterine FibroidsFibroids are lumps of fibrous tissue and muscle inside the uterus. Often appearing during child birthing years. They are noncancerous growths and do not tend to cause symptoms but can be a source of pain. They may cause discomfort during sex, in the pelvis or lower back. They may also cause excessive bleeding or cramping during a period. 

Fibroids can range in size from seedlings completely undetectable, to masses that can enlarge the uterus. Fibroids can develop singularly or in multiples. Many women have gone their entire lives and had no indication of fibroids absent of symptoms. 

Since some fibroids do not require treatment, the ones that do may be managed by medications, noninvasive procedures, or surgery.

Do Any of These Conditions Require Surgery?

Fibroids: Surgery could be the removal of the fibroids, or removal of the uterus (or a hysterectomy) for surgical treatment options.

Pelvic or Ovarian Mass: Before child bearing, this could include just the removal of the mass without the removal of the ovary. 

The preservation of the ovary is dependent on several factors. Is the mass considered cancerous? How old is the patient? The size of the mass? Is there any part of the ovary worth saving?

Endometriosis: Two or three small incisions for Laparoscopic (low risk minimally invasive procedure that requires only small incisions) resection of the endometriotic implants. In cases of severity, the removal of the uterus and ovaries is an option

Adenomyosis: With a woman of significant symptoms from Adenomyosis. A laparoscopic hysterectomy or removal of the uterus would be the chosen treatment.

Alternative Treatment Options for Chronic Pelvic Pain

Not everyone is looking to surgery for an option. Unfortunately for some symptoms, that may be the only option. For other conditions there can be alternative treatment for the causes of pelvic pain and inflammation. 

Options such as physical therapy, local anesthetics, psychotherapy, relaxation therapies, nerve stimulation, and trigger-point injections can all be used to combat chronic pelvic pain and their symptoms.

If causes for pelvic pain and inflammation are a new development or has gotten worse over time. Be sure to get pelvic pain checked by your doctor especially if it disrupts your daily life. If you develop severe pelvic pain you might need to see an emergency professional or medical help as soon as possible. 

You shouldn’t have to live in silence with pelvic pain. Talk to our team by phone or book an appointment online to get started finding relief. Call one of our six convenient NYC locations or schedule a video consultation online today. Women with pelvic pain and inflammation can count on the experienced and compassionate care of the team at Rosh Maternal & Fetal Medicine in NYC. They’ve helped thousands of women. Come visit your NYC OBGYN.