Pelvic pain may include:

  • Pain in the genitalia
  • Pudendal Pain ( pain near the anus or perineum) or you might feel burning, electric shock, shooting, aching,itch or a raw feeling in your clitoris, labia, vagina, urethra, perineum, anus or rectum.
  • Painful Intercourse
  • Inability to have intercourse

Sudden, unexpected pelvic pain

Pelvic pain that comes on suddenly for the first time is called acute pelvic pain.

Common causes of acute pelvic pain

The most common causes of acute pelvic pain in women who aren’t pregnant are:

  • an ovarian cyst – a fluid-filled sac that develops on an ovary and causes pelvic pain when it bursts or becomes twisted
  • acute pelvic inflammatory disease – a bacterial infection of the womb, fallopian tubes or ovaries, which often follows a chlamydia or gonorrhoea infection and needs immediate treatment with antibiotics
  • appendicitis – a painful swelling of the appendix (a finger-like pouch connected to the large intestine) which usually causes pain on the lower right-hand side of your abdomen (tummy)
  • peritonitis – inflammation of the peritoneum (the thin layer of tissue that lines the inside of the abdomen); it causes sudden abdominal pain that gradually becomes more severe and requires immediate medical treatment
  • a urinary tract infection – you’ll probably also have pain or a burning sensation when you urinate, and you may need to urinate more often
  • constipation or bowel spasm – this may be brought on by changes in diet, medication, irritable bowel syndrome or, in rare cases, a bowel obstruction

Less common reasons for acute pelvic pain

Less common causes of acute pelvic pain include:

  • a pelvic abscess – a collection of pus between the womb and vagina that needs urgent treatment in hospital
  • endometriosis – a long-term condition where small pieces of womb lining are found outside the womb, such as on the ovaries, leading to painful periods

Persistent or recurrent pelvic pain

If you’ve had pelvic pain for 6 months or more that either comes and goes or is continuous, it’s known as chronic pelvic pain.  Chronic pelvic pain is more intense than ordinary period pain and lasts longer. It affects around 1 in 6 women.

Common causes of chronic pelvic pain

The most common causes of chronic pelvic pain are:

  • endometriosis
  • chronic pelvic inflammatory disease – a bacterial infection of the womb, fallopian tubes or ovaries, which often follows a chlamydia or gonorrhoea infection and needs immediate treatment with antibiotics
  • irritable bowel syndrome – a common long-term condition of the digestive system that can cause stomach cramps, bloating, diarrhoea and constipation

Another cause of chronic pelvic pain is overactivity in the muscles of the pelvic floor, making them overstrained leading to pain. Overactive muscles can also press on the pudendal nerve, leading to pudendal neuralgia.  A Physiotherapist would assess the pelvic floor in detail. Quite often there is tension, or trigger points in the muscles. Physiotherapists work with clients to release these muscles and re- train them to work in a more coordinated way.

Less common reasons for chronic pelvic pain

Less common causes of chronic pelvic pain include:

  • recurrent ovarian cysts – fluid or blood-filled sacs that develop on the ovaries
  • a recurrent urinary tract infection
  • lower back pain
  • prolapse of the womb – where the womb slips down from its normal position and usually causes a “dragging” pain
  • adenomyosis – endometriosis that affects the muscle of the womb, causing painful, heavy periods
  • fibroids – non-cancerous tumours that grow in or around the womb; fibroids can be painful if they twist or deteriorate, but uncomplicated fibroids aren’t usually painful
  • chronic interstitial cystitis – long-term inflammation of the bladder
  • inflammatory bowel disease – a term used to describe two chronic conditions, ulcerative colitis and Crohn’s disease, which affect the gut
  • a hernia – where an internal part of the body pushes through a weakness in the surrounding muscle or tissue wall
  • trapped or damaged nerves in the pelvic area – these may cause sharp, stabbing or aching pain in a specific area, which often gets worse with certain movements