What causes persistent pelvic pain?

Pain that continues or returns may arise from endometriosis, fibroids, pelvic infection, bladder or bowel disorders, pelvic-floor muscle tension, or nerve irritation. In some people, pain is related to a growth in a pelvic organ. A symptom alone cannot identify the cause.

Cervical cancer can present with pelvic pain, as can womb cancer and ovarian cancer. Fallopian tube cancer is another possible pelvic cause, although these conditions require examination and testing for diagnosis. Pain may feel aching, cramping, pressure-like, or sharp, and its location and timing can help guide assessment.

Arrange a clinical assessment if pain persists, affects sleep or movement, or keeps returning. Note where it is felt, when it began, whether it relates to periods, sex, urination, or bowel movements, and any bleeding, discharge, fever, weight change, or urinary symptoms.

A clinician may examine the abdomen and pelvis and recommend urine tests, blood tests, imaging, or other investigations based on your history. Do not start antibiotics or hormonal treatment without advice. The symptom overview on Persistent Pelvic Pain can help you prepare for the visit.

Seek urgent medical help for severe or rapidly worsening pain, fainting, heavy vaginal bleeding, a swollen or rigid abdomen, repeated vomiting, fever with feeling very unwell, or inability to pass urine or stool. New weakness, numbness, or loss of bladder or bowel control also needs prompt assessment.

Which causes fit my pain pattern and examination? What tests are appropriate? Could my menstrual, urinary, bowel, muscle, or nerve symptoms be connected? What changes should prompt urgent review? How can the pain be managed while the cause is being investigated?