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Revealing – 10 Causes of Acute Pelvic Pain In Women

February 3, 2022

Womens Pelvic Pain

Today, let’s talk about the many different causes of pelvic pain and some of the tests your doctor may want you to have to identify the cause. 

Running is one of those reasons that doesn’t immediately come to mind, but it is on the list, along with other causes that may surprise you.

Location of Pelvic Girdle Pain

A woman’s pelvis is a significant part of the body. It is responsible for many essential functions, including supporting the rest of your body’s weight and reproduction.

Your pelvis is located between your abdomen and legs.

It is the ring of hip bones in the lower part of your trunk that creates a cradle or pelvic girdle, as it used to be known. 

In the back, the hip bones join the part of your spine known as the sacrum. In front, they connect to a small bone we call the pubic symphysis.

A woman’s pelvis is much more shallow than a man’s to accommodate changes during pregnancy and childbirth.

What are the different parts of the body you will find in the pelvis?

They include:

  • Hip bones and joints
  • Parts of the large and small bowel
  • Bladder and other parts of the urinary system
  • Womb, fallopian tubes and ovaries
  •  Rectum and anus
  •  Muscles like the pelvic floor
  •  Blood vessels and nerves; fat and other supporting tissues.

What Causes Severe Pelvic Pain?

So now we know what parts make up the pelvis, let’s look closely at women’s pelvic pain causes.

Pelvic pain is any pain that you feel under your belly button and above your buttocks. Sometimes it can be challenging to differentiate between pain in the abdomen and pelvis – which is when tests come in helpful.

Pelvic pain may be acute – when it happens suddenly without warning and can be extremely painful. Or it may be milder and develop gradually over several weeks or months, which is known as chronic pelvic pain. 

Whichever the case, you should not ignore it and should get it checked out to determine the cause.

Now, let’s look at pelvic pain that happens suddenly and unexpectedly.

Pelvic Pain in Women

What Is Runner’s Pelvic Pain?

Running or other activities like abdominal exercise or kicking can occasionally lead to acute pelvic pain.  

Runner’s pelvic pain can develop when you are exercising. 

It can mean different things for many women, such as:

  1. a feeling of heaviness or pressure in that area between your vagina and anus when running
  2. pain in your tailbone or coccyx – the last part of your spine between your buttocks or 
  3. involuntary muscle spasms. 

The pain may also happen when you are not exercising. Some women complain of feeling like they are sitting on a hard object, pain in the vagina during sex or chronic low back pain.

These painful episodes may happen with any of the following:

  • embarrassing leaking of urine or even faeces while running
  • unusual sensation like numbness or tingling on your thighs or groin
  • problems with walking or standing when pain is present
  • Difficulty opening your bowels or constipation
  • Vaginal farting or gas, when air is trapped in the vagina

There are many causes of pelvic pain while running, such as poor posture, improper running form or running on hard/tough surfaces. But having a pelvic organ prolapse can also lead to acute pain when running.

Pelvic Organ Prolapse

A pelvic organ prolapse happens when one of the organs in the pelvis slips down from its normal position. It could be the womb or the bladder, for example.

Often this is due to the weakness of the pelvic floor and causes mild or moderate dragging pain or ache. However, the forceful impact of running as the organ bounces up and down can lead to acute painful episodes and leaking urine. 

So that’s the runner’s pelvic pain.

Outside of activities like running or kicking and pregnancy-related problems, we will talk about the other common causes of acute pelvic pain.

Are Ovarian Cysts Painful?

An ovarian cyst is when a cyst that develops on the ovary bursts or becomes twisted, usually causing intense pain on one side.

Sometimes your doctor may suspect this from the nature of your pain and examination. Still, the diagnosis is established with a pelvic ultrasound scan that shows the appearance of the cyst on the ovary. 

Check out my video here to learn more about how ovarian cysts are different from fibroids

How Pelvic Inflammatory Disease is Diagnosed

Pelvic Inflammatory Disease or PID is an acute bacterial infection of the womb, fallopian tubes or ovaries. PID often follows from a sexually transmitted infection (STI) like Gonorrhoea or Chlamydia that spreads from the vagina or the cervix to the higher reproductive organs.

It can cause pelvic pain, painful sex, fever and vomiting.

You may or may not also have a vaginal discharge. Your doctor will recommend an internal exam or pelvic examination to assess your internal organs. They may find other signs suggesting PID when they examine you and usually take swabs from the vagina and womb.

You will also be given a course of antibiotics to treat the infection.

Where is Appendicitis pain located?

Appendicitis is the painful swelling of the appendix, a small part of the large bowel.

Often the pain is located on the R lower side of your trunk under the belly button, but it may spread across the rest of your pelvis and abdomen.

Your blood test may show signs of very high inflammation, but the test that will show your doctors what is happening is an ultrasound scan. 

Sometimes if this is not helpful, you may require a type of surgery (exploratory laparotomy) to examine the bowel and remove the appendix if it is inflamed.

What is Peritonitis?

What if we don’t detect and treat something like appendicitis early?

In that case, the appendix may burst and spill its content into the rest of the abdomen and pelvis.

Because this material is digested matter often mixed in with germs within the bowel, it can cause inflammation of the thin layer of tissue that lines the abdomen, known as the peritoneum.

Known as peritonitis, it causes severe pain across the abdomen and pelvis, requiring emergency treatment. 

Pelvic Pain Causes

Where is Kidney Infection Pain located?

Next is a kidney infection or better known as a urinary tract infection.

Apart from a burning or stinging sensation when you wee, you may also get pain in the lower side of your pelvis to the right or left.

This pain may spread across the back on the same side and can be pretty intense if the infection is severe. 

Other symptoms that suggest a kidney infection are:

  • passing urine a lot more or less than normal
  • having dark-coloured, cloudy-looking urine or urine that is bloody (bright or dark red, pink or with blood clots)
  • urine that seems offensive in odour

Watch this video to learn natural measures to prevent urinary (kidney) infections.

Bowel Problems and Severe Pelvic Pain

 Next, bowel problems can often be a surprising cause of severe pelvic pain.

It may be from constipation with hard faeces stuck within the lower large bowel causing pain.

Or bowel spasms from trapped wind due to diet changes, some medicines, or IBS (irritable bowel syndrome).

A more severe cause is bowel obstruction, which can damage the bowel tissue and cause severe complications like peritonitis and sepsis. 

In this last condition, feeling very sick (nausea), frequent vomiting, a bloated/swollen tummy, being unable to pass gas (trump or fart), and constipation may be a clue.

Why Painful Periods Cause Pelvic Pain

Dysmenorrhoea is having pain in the pelvis during or just before a period.

Primary dysmenorrhoea is common in teenage girls and young women – it happens a couple of years after the periods start.

We are not sure of the exact cause but think it may be due to excess hormones called prostaglandins, which make the womb spasm and cause pain.

But painful periods can happen from conditions like PID or Endometriosis.

We’ve looked at PID already, but endometriosis is an important cause of chronic pelvic pain.

On our youtube channel, there is an excellent playlist on endometriosis that describes the condition with recommendations for medical, surgical and natural treatment. 

You can also read this simple breakdown of painful periods.

 Less commonly, the causes of acute pelvic pains are:

Pelvic Abscess

An abscess in the pelvis is known as a pelvic abscess. 

This collection of pus between the womb and vagina may happen if a PID is not treated correctly or a poorly treated womb infection after having a baby. 

If you have an abscess, you may sometimes require surgery to drain the pus away from your body. Antibiotics will also be used for treatment.

If we do not treat it quickly, pelvic abscesses can develop into sepsis.

Sepsis is a life-threatening condition when the organs are overwhelmed by a severe infection which progresses quickly, shutting down circulation and other key vital body functions.

Where do Kidney Stones Hurt?

These are hard lumps caused by blood waste products, which occasionally form crystals that collect inside the urine in the kidneys.

They are twice more common in men than women.

Severe pain from kidney stones can suddenly develop in the back.

Still, it may occur in the lower abdomen or pelvis, as the stones try to pass in the urinary tube.

These may also lead to urine infections.

A CT scan, which uses X-rays and a computer to create detailed images of the urinary tract, often detects kidney stones.

Why Does My Pelvic Area Hurt When I Cough?

When you have a deep cough or sneeze, the pressure inside your abdomen increases. The raised pressure makes your pelvic floor tighten or contract. 

Your pelvic floor is a sheet of muscle near the bottom of your pelvis. Its job is to hold your pelvic organs, including the womb, bladder and rectum, in their position.

Ordinarily, coughing or sneezing should not cause pelvic pain. 

Still, the force from coughing places a higher strain on the pelvic floor than running, lifting or jumping!

Suppose you have a weak pelvic floor or there is a problem within your abdomen. In that case, the force can push organs against other structures or cause inflammation, leading to pain.

Since the causes of acute pelvic pain are so broad, taking care to seek medical advice quickly is important to identify the cause and appropriate treatment.

More Reading

Editing by AskAwayHealth Team


All AskAwayHealth articles are reviewed by practising Medical Practitioners on various healthcare conditions to provide evidence-based guidance and help promote quality healthcare. The advice in our material is not meant to replace the management of your specific condition by a qualified healthcare practitioner.
To discuss your condition, please contact a health practitioner or reach us directl

Image Credits @Canva

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