Pelvis
Pelvic pain
Pain low in the tummy or pelvis that often comes from the reproductive organs, bladder or bowel and is frequently linked to periods, but which can occasionally signal an emergency such as an ectopic pregnancy or a twisted ovarian cyst.
Education and reference only. This explains the common causes of pelvic pain and the warning signs that need urgent help, in plain language — it is not a diagnosis or a substitute for advice from a clinician. If you feel very unwell or are worried, seek medical help.
Quick answer
What is pelvic pain?
Pelvic pain is felt in the lowest part of the tummy, below the navel, and has many possible sources because the pelvis houses the womb, ovaries, bladder and lower bowel. Pain that comes with periods, often cramping and predictable, is very common and frequently due to ordinary period pain or to endometriosis, where womb-like tissue grows outside the womb.
- Get urgent help: Call 999 or go to A&E for sudden severe one-sided pelvic pain, especially with a missed period, faintness or shoulder-tip pain — this may be an ectopic pregnancy. Seek urgent help for pelvic pain with a high temperature, feeling very unwell, or abnormal bleeding, which can mean a serious infection.
- Self-care: For familiar pelvic pain such as period pain that a clinician has already assessed, simple comfort measures often help.
About pelvic pain
Pelvic pain is felt in the lowest part of the tummy, below the navel, and has many possible sources because the pelvis houses the womb, ovaries, bladder and lower bowel. Pain that comes with periods, often cramping and predictable, is very common and frequently due to ordinary period pain or to endometriosis, where womb-like tissue grows outside the womb. Infection of the reproductive organs, called pelvic inflammatory disease, causes pain with abnormal discharge and sometimes fever, while ovarian cysts can ache or, if they burst or twist, cause sudden severe pain. The bladder is another common source, as urinary infections cause low pelvic pain and burning. Most pelvic pain has a treatable cause, but sudden, severe one-sided pain — especially with a missed period, faintness or shoulder-tip pain — can mean an ectopic pregnancy and is a medical emergency.
When to get help
Call 999 or go to A&E if pelvic pain comes with any of these warning signs:
- Call 999 or go to A&E for sudden severe one-sided pelvic pain, especially with a missed period, faintness or shoulder-tip pain — this may be an ectopic pregnancy.
- Seek urgent help for pelvic pain with a high temperature, feeling very unwell, or abnormal bleeding, which can mean a serious infection.
- Seek urgent help for sudden severe pelvic pain with vomiting, which can mean a twisted ovarian cyst.
- Seek urgent assessment for pelvic pain with heavy vaginal bleeding or during pregnancy.
- See a doctor promptly for pelvic pain with pain or bleeding after sex, or unusual discharge.
When to see a doctor
Mild pelvic pain linked to your periods can often be managed at home, but book an appointment if pelvic pain is new, severe, persistent, getting worse, or interfering with daily life, or if it comes with pain during sex, abnormal bleeding or discharge, or problems passing urine. Seek help promptly, rather than waiting, if there is fever, feeling very unwell, or pain in early pregnancy. Sudden severe one-sided pain with a missed period, faintness or shoulder-tip pain is an emergency and needs immediate care, as is sudden severe pain with vomiting.
Not sure how urgent it is? It is always OK to call NHS 111 for advice, day or night.
What can cause it
Common causes of pelvic pain
Pelvic pain has many possible causes. Each links to a full, plain-language guide to that condition — what it is, how it's treated and when to seek help.
What helps
Self-care and what you can do
For familiar pelvic pain such as period pain that a clinician has already assessed, simple comfort measures often help. A warm pad or hot water bottle held against the lower tummy can ease cramping, as can a warm bath, gentle exercise such as walking, and relaxation techniques. A pharmacist can advise on suitable over-the-counter pain relief for period cramps. Keeping a diary of when the pain occurs, how it relates to your menstrual cycle, and what makes it better or worse helps you and your clinician understand the pattern. None of this replaces assessment for new, severe or unexplained pelvic pain, and any sudden severe pain should be treated as urgent.
Answers
Pelvic pain: frequently asked questions
What causes pelvic pain in women?
Common causes include period pain, endometriosis, ovarian cysts, infection of the reproductive organs and bladder infections. Pelvic pain can also come from the bowel. New, severe or persistent pelvic pain should be assessed to identify the cause.
When is pelvic pain an emergency?
Sudden severe one-sided pelvic pain, especially with a missed period, faintness or shoulder-tip pain, may be an ectopic pregnancy and is an emergency. Severe pain with vomiting, or with a high fever and feeling very unwell, also needs urgent care.
Could my pelvic pain be endometriosis?
It is possible, particularly if the pain is worse around your periods and comes with pain during sex, when passing stools, or difficulty conceiving. Endometriosis can take time to diagnose, so persistent period-related pelvic pain is worth discussing with a doctor.
How is pelvic pain investigated?
A clinician will ask about your symptoms and cycle and examine you, and may arrange swabs, urine tests, blood tests, a pregnancy test or a scan depending on the likely cause. Keeping a diary of your pain and periods beforehand can help the assessment.
Sources
Where this is drawn from
- NICE CKS: Pelvic pain.
- Endometriosis UK: about endometriosis.
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