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Dec 14, 2021 By Ashley Abramson
For individuals assigned female at birth, a urinary tract infection (UTI) may be the first thing that comes to mind if you start to develop pelvic pain. Bladder infections are relatively common — and they can certainly cause discomfort in the pelvic or lower abdominal region, but they aren’t the only culprits. Here are 6 potential causes for pelvic pain and discomfort, and how they’re treated.
Bladder pain syndrome
Also known as interstitial cystitis, bladder pain syndrome can cause mild discomfort or severe pain in the bladder, along with bladder pressure and pelvic pain. Unlike a UTI, which is caused by an acute infection, interstitial cystitis is a chronic, non-infectious, and potentially long-term condition.
The cause of the pain in this condition is not well understood, but may involve increased sensitivity of the pain signals between the bladder and the nervous system. Bladder pain syndrome may cause:
- Bladder pressure or spasms
- Pelvic pain
- Pain between the vagina and anus or between the scrotum and anus
- Persistent urge to urinate
- Frequent urination in small amounts
- Pain while the bladder fills
- Pain during sex
There’s no cure for bladder pain syndrome, but healthcare providers can help people manage the symptoms. Pelvic floor physical therapy can help relieve muscle tenderness and correct muscle/tendon abnormalities to help reduce pelvic pain. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen may also help relieve pain. In some cases, a healthcare provider may consider prescription medications to help manage the symptoms.
Vaginal atrophy — also known as atrophic vaginitis — is a condition that most commonly affects individuals during or after menopause. With vaginal atrophy, the lining of a person’s vagina becomes dry and thin due to lower estrogen levels in the body. Vaginal atrophy can cause a feeling of pressure in the pelvis and urinary discomfort, which may mimic symptoms of a UTI. Dryness in the vagina can also make people more prone to UTIs.
Other symptoms of vaginal atrophy may include:
- Burning and itching in the vagina
- Pain during sex
- Yellow vaginal discharge
- Spotting or bleeding
- Frequent urination
If you have vaginal atrophy, your provider may recommend an over-the-counter treatment to relieve your symptoms. For example, vaginal moisturizers or lubricants can restore moisture in the vaginal area and reduce discomfort. Estrogen therapy may also be an option if lubricants or moisturizers are not working, but these will need to be prescribed by your healthcare provider.
Pelvic floor dysfunction
Your pelvic floor is a group of muscles that sits at the base of your pelvis and supports organs such as the bladder and uterus. Pelvic floor dysfunction occurs when the muscles of the pelvic floor are tight, painful, and difficult to relax. This can cause problems with urinating or having a bowel movement. Because pelvic floor dysfunction can cause frequent urination or difficulty urinating, it may be confused for a urinary tract infection.
Pelvic floor dysfunction may also includes other symptoms, such as:
- Constipation or pain during bowel movements
- Leaking urine or stool
- Lower back pain
- Pelvic pain
- Pain in the genitals or rectum
- Pain during sex
- Difficulty keeping an erection
Pelvic floor dysfunction can be uncomfortable, but symptoms can improve with treatment. Relaxation and stress reduction can make a big difference in relaxing pelvic floor muscles. For some patients, symptoms can improve with a few months of pelvic floor physical therapy. You can also practice kegel exercises on your own to help strengthen your pelvic floor. Medication prescribed by your healthcare provider can also help with symptoms of pelvic floor dysfunction.
Endometriosis is a condition that causes the tissue that normally lines the inside of the uterus to build up on other organs, most commonly reproductive organs, such as the ovaries and fallopian tubes. In some cases, endometriosis can cause tissue to build up on the bladder or in the pelvic region, which may result in bladder discomfort or pain. Common symptoms of endometriosis include:
- Painful periods with pelvic pain, lower back pain, and abdominal pain
- Pain during or after sex
- Pain with urination or bowel movements
- Excessive bleeding during periods
If you have endometriosis, your healthcare provider may start by treating painful symptoms with anti-inflammatory medication. Hormone therapy, such as hormonal birth control, may also help manage the hormones responsible for menstruation and, as a result, minimize symptoms. In severe cases, surgery to remove the endometrial tissue may be necessary.
Pelvic inflammatory disease
Pelvic inflammatory disease is a serious pelvic infection that occurs when bacteria travel from the vagina to the reproductive organs. It most commonly affects a person’s uterus, ovaries, or fallopian tubes, and like a UTI, it can involve pelvic pain. The most common cause of pelvic inflammatory disease is sexually transmitted infections, such as gonorrhea and chlamydia. Other symptoms of pelvic inflammatory disease may include:
- Lower abdomen and pelvic pain
- Painful or frequent urination
- Abnormal vaginal discharge
- Abnormal uterine bleeding between menstrual cycles
- Pain during sex
- Fever and/or chills
Pelvic inflammatory disease results from a bacterial infection, so it’s generally treated with oral antibiotics; however, sometimes the infection is severe enough to require hospitalization. A healthcare provider may also treat an infected person’s partner if it was caused by a sexually transmitted infection. Treatment should be started as soon as possible to prevent disease progression and complications, including scarring of the reproductive tract and pelvic abscess. If you have symptoms of pelvic inflammatory disease or are concerned you have an STI, it’s important to reach out to your healthcare provider ASAP. A same-day, in-person office visit is best so that your provider can examine you, but if you’re not able to be seen in person, you can request a video chat from your One Medical app to consult a provider to determine the best next steps.
Ovarian cysts are fluid-filled sacs that can develop in or on the ovaries. Most ovarian cysts are functional cysts, meaning they occur as part of the menstrual cycle. Many times, ovarian cysts are so small that they don’t cause noticeable symptoms, and they often resolve on their own. Because the ovaries are located near the pelvis, they can cause symptoms that feel similar to a UTI, but can also cause severe abdominal pain if they rupture. If you do experience symptoms, they may include:
- Pressure or bloating in the lower abdomen
- Bloating and swelling
- Pelvic pain
- Lower back pain
- Difficulty with urination or bowel movements
- Pain during sex
- Pain during menstruation
- Breast tenderness
- Frequent urination
Ovarian cysts usually go away on their own within a few months without medical intervention. If your provider is concerned about recurring ovarian cysts, they may prescribe hormonal birth control (but birth control won’t help with existing cysts). If you have a large cyst that’s causing significant pain, surgery may be an option.
When to see your healthcare provider
If you’re experiencing bladder pain or pelvic discomfort that won’t go away or is getting worse, reach out to your healthcare provider. Your provider can properly diagnose what’s going on — UTI or not — and come up with a treatment plan that helps you feel better ASAP.
In-person office visits can be booked using your app or the One Medical website. If you’d like to consult with a provider urgently in real time to help you make a plan, on-demand video chats can be requested from your One Medical app.
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What causes pelvic pain with no infection? ›
Conditions affecting your bones, joints and connective tissues (musculoskeletal system) — such as fibromyalgia, pelvic floor muscle tension, inflammation of the pubic joint (pubic symphysis) or hernia — can lead to recurring pelvic pain. Chronic pelvic inflammatory disease.What causes pain like a UTI but isn t? ›
Interstitial cystitis (in-tur-STISH-ul sis-TIE-tis) is a chronic condition causing bladder pressure, bladder pain and sometimes pelvic pain. The pain ranges from mild discomfort to severe pain. The condition is a part of a spectrum of diseases known as painful bladder syndrome.What else can cause pelvic pain? ›
- Colon cancer.
- Crohn's disease.
- Inguinal hernia.
- Interstitial cystitis (also called painful bladder syndrome)
Lots of women get pelvic pain and cramping, but your period isn't always to blame. Cysts, constipation, pregnancy -- even cancer -- can make it feel like your monthly visitor is about to stop by. It can be tough to tell whether having cramps without a period is caused by something simple or more serious.Can bowel problems cause pelvic pain? ›
Constipation can cause pelvic pain, especially if it affects the lower colon. This type of pain tends to go away once a person has a bowel movement. A variety of other intestinal conditions can cause pain in the lower abdomen or pelvis.How to tell the difference between UTI and interstitial cystitis? ›
The Difference Between a UTI and IC
In women who have interstitial cystitis, urine culture results will be negative, meaning that no bacteria are found in the urine as with a urinary tract infection. With IC, women may also experience pain during sexual intercourse, another symptom not commonly associated with a UTI.
Interstitial cystitis (IC) is a painful bladder condition with an unknown cause. Urinary tract infection (UTI) happens when bacteria infect parts of the urinary tract, usually the bladder. They are separate conditions, but because they cause similar symptoms, it's easy to confuse the two.What are signs of cystitis? ›
- pain, burning or stinging when you pee.
- needing to pee more often and urgently than normal.
- urine that's dark, cloudy or strong smelling.
- pain low down in your tummy.
- feeling generally unwell, achy, sick and tired.
Understand the Cause
Common factors include sexual activity, stopping or changing your self-care regimen, added stress, prolonged sitting, changes in physical activity or exercise, diet change or medication change.
Vitamin D insufficiency and deficiency may interfere with normal pelvic floor muscle and visceral function and contribute to pelvic floor disorders by affecting vitamin D receptor function in pelvic floor musculature and its calcium homeostasis.
When should you worry about pelvic pain? ›
Sudden and severe pelvic pain could be a medical emergency. Seek prompt medical attention. Be sure to get pelvic pain checked by your doctor if it's new, it disrupts your daily life, or it gets worse over time.What interstitial cystitis feels like? ›
Symptoms of IC include changes in urination such as frequency and urgency; pressure, pain, and tenderness around the bladder, pelvis, and the area between the anus and vagina or anus and scrotum; and pain during sex.How do you test for interstitial cystitis? ›
Cystoscopy. Doctors may use cystoscopy to look inside the urethra and bladder. Doctors use a cystoscope, a tubelike instrument, to look for bladder ulcers, cancer, swelling, redness, and signs of infection. A doctor may perform a cystoscopy to diagnose interstitial cystitis (IC).Can dehydration cause pelvic pain? ›
Bladder inflammation: Because dehydration concentrates the urine, resulting in a high level of minerals, it can irritate the lining of the bladder and cause painful bladder syndrome, or interstitial cystitis. Frequent, urgent urination and pelvic pain are common symptoms.What hormones cause pelvic pain? ›
In pelvic congestion syndrome, the veins in the pelvis are unusually dilated and engorged, causing pelvic pressure and pain. This has been shown to be related to high levels of estrogen, as estrogen causes veins to dilate. There are often other signs of hormone imbalance, such as heavy and painful periods.Is pelvic pain a symptom of endometriosis? ›
The primary symptom of endometriosis is pelvic pain, often associated with menstrual periods. Although many experience cramping during their menstrual periods, those with endometriosis typically describe menstrual pain that's far worse than usual. Pain also may increase over time.Can IBS cause pelvic pain? ›
Called IBS for short, irritable bowel syndrome causes bloating, pain, and gastrointestinal issues. This can lead to pelvic pain, discomfort, and pressure. Irritable bowel syndrome is common and often difficult to diagnose and treat.What is IBS pelvic pain like? ›
One may experience steady sharp or dull pain, cramping, pressure or heaviness within the pelvis, and have pain with intercourse, while having a bowel movement or urinating, or pain when sitting for long periods of time.Can backed up stool cause pelvic pain? ›
Constipation and pelvic floor problems often go hand in hand. Often symptoms such as pelvic pain, painful intercourse, urge incontinence and prolapse exist alongside constipation. You can see how extra stool in the bowel can put increased pressure on the rest of the pelvic organs.Can gas get trapped in your pelvic area? ›
Flatulence and vaginal gas may sound alike. Although trapped gas in the pelvic area is normal, it can cause discomfort and embarrassment to many women, especially during sexual intercourse.
Where is the pain located in interstitial cystitis? ›
People with interstitial cystitis (IC) have repeat discomfort, pressure, tenderness or pain in the bladder, lower abdomen, and pelvic area. Symptoms vary from person to person, may be mild or severe, and can even change in each person as time goes on.What can mimic interstitial cystitis? ›
- Kidney stone.
- Recurring urinary tract infection.
- Bladder cancer.
- Sexually transmitted diseases.
- Endometriosis (in women)
- Prostatitis (in men)
If left untreated, cystitis can progress into a kidney infection (pyelonephritis). The bacteria causing the infection can travel from the bladder up into one or both kidneys, causing a kidney infection.How I get rid of my interstitial cystitis? ›
- Lifestyle changes. Change your eating and drinking habits. ...
- Bladder training. ...
- Bowel training. ...
- Physical therapy. ...
- Medicines. ...
- Bladder instillation. ...
- Bladder stretching. ...
In the early phase of IC the symptom flares are intermittent in most patients. Over time symptoms increase and pain cycles may appear and last for 3-14 days.How serious is interstitial cystitis? ›
What is the outlook for interstitial cystitis? IC is a chronic disease. Patients may find some comfort in the fact that it is not life-threatening and it does not lead to cancer. However, because the symptoms are always present, patients need to develop coping skills to deal with them.What is the number one cause of cystitis? ›
UTIs typically occur when bacteria outside the body enter the urinary tract through the urethra and begin to multiply. Most cases of cystitis are caused by a type of Escherichia coli (E. coli) bacteria.
The study discovered that women who drank an additional 1.5 liters of water had 50% fewer episodes of recurrent cystitis, and required fewer antibiotics than women who did not drink additional fluid.Can you have PID without infection? ›
You can also get PID without having an STI. Normal bacteria in the vagina can travel into a woman's reproductive organs and can sometimes cause PID. Sometimes the bacteria travel up to a woman's reproductive organs because of douching. Do not douche.Why am I have constant pelvic pain? ›
Chronic pelvic pain can be a symptom of a gynecologic problem, including endometriosis (when tissue that normally lines the uterus grows outside the uterus) or adenomyosis. It can also occur in certain conditions that affect the bladder, intestines, the muscles in the pelvic floor, or even your spine.
What is Salpingitis? ›
Salpingitis is inflammation of the fallopian tubes, caused by bacterial infection. Common causes of salpingitis include sexually transmitted diseases such as gonorrhoea and chlamydia. Salpingitis is a common cause of female infertility because it can damage the fallopian tube.Is it obvious if you have PID? ›
PID often does not cause any obvious symptoms. Most symptoms are mild and may include 1 or more of the following: pain around the pelvis or lower tummy. discomfort or pain during sex that's felt deep inside the pelvis.How do you test for pelvic inflammatory disease? ›
Swabs are usually taken from the inside of your vagina and cervix. These are sent to a laboratory to look for signs of a bacterial infection and identify the bacteria responsible. A positive test for chlamydia, gonorrhoea or mycoplasma genitalium supports the diagnosis of PID.