Quick Answer
See a doctor for sudden severe pelvic pain, pain with fever, or pain that doesn't improve in 2-3 days. Seek immediate care for severe pain with vomiting, fainting, or abnormal vaginal bleeding.
🚨 Seek Emergency Care If:
- Sudden severe pain that makes you double over or cry out
- Pain with fever above 101°F (38.3°C)
- Heavy vaginal bleeding soaking through pad in 1 hour
- Fainting or dizziness with pelvic pain
- Pregnancy with sudden pelvic pain (possible ectopic)
- Vomiting that won't stop
📅 Schedule Appointment Within Days If:
- • Pelvic pain lasting more than 2-3 days
- • Pain that interferes with daily activities
- • Pain during sex (dyspareunia)
- • Painful urination or bowel movements
- • Unusual vaginal discharge
- • Missed period with negative pregnancy test
- • Pain that comes and goes but getting worse
- • Known history of endometriosis or ovarian cysts
Common Causes of Pelvic Pain
Gynecological Causes
- • Menstrual cramps: Normal part of period, usually improves with NSAIDs
- • Ovulation pain (mittelschmerz): Mid-cycle pain, one-sided, lasts hours to 1-2 days
- • Ovarian cysts: Usually harmless, can rupture causing sudden sharp pain
- • Endometriosis: Tissue grows outside uterus, causes chronic pain especially with periods
- • Fibroids: Benign uterine tumors, cause heavy bleeding and pressure
- • Pelvic Inflammatory Disease (PID): Infection of reproductive organs, needs antibiotics
- • Ectopic pregnancy: Emergency - pregnancy outside uterus
Other Organ Systems
- • Urinary tract infection: Burning, urgency, lower abdominal pain
- • Kidney stones: Severe flank pain radiating to groin
- • Irritable bowel syndrome: Cramping, bloating, changes in bowel habits
- • Appendicitis: Right lower abdominal pain, fever, nausea
- • Constipation: Lower abdominal fullness and cramping
What Your Doctor Will Check
- • Pregnancy test: First step for reproductive-age women
- • Pelvic exam: Check for tenderness, masses, discharge
- • STI testing: If PID suspected
- • Ultrasound: Visualize ovaries, uterus, check for cysts or masses
- • Urinalysis: Rule out urinary tract infection
- • Blood tests: Check for infection (white blood cell count)
- • Laparoscopy: Surgical visualization if diagnosis unclear
Home Care for Mild Pelvic Pain
- • Heat therapy: Heating pad on lower abdomen 15-20 minutes
- • NSAIDs: Ibuprofen or naproxen for menstrual cramps
- • Rest: Avoid strenuous activity
- • Hydration: Drink plenty of water
- • Track symptoms: Note timing, severity, associated symptoms
Medical Review
Reviewed by: Ricardo Hamilton, MD
Last Updated: November 26, 2025
Sources: American College of Obstetricians and Gynecologists (ACOG), Mayo Clinic