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Causes of Pelvic Pain: What You Need to Know

Posted on June 05, 2024

What are the causes of pelvic pain and how can you find relief? Unfortunately, pelvic pain is a common symptom of many conditions that affect women, regardless of age. As such, it may take some time to figure out the source of your discomfort and get you on the path to pain relief.

How can we help? In today's post, we'll review some of the top causes of pelvic pain. Then, we hope you'll use this guide to speak to your healthcare provider and find the correct diagnosis!

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Causes of Pelvic Pain: Uterine Fibroids 

As fibroid specialists with offices in Houston, Katy, Sugar Land, The Woodlands and Clear Lake, TX, this is the cause of pelvic pain we see most often. Fibroids are growths of muscular tissue that form in your uterine cavity, within the walls of your uterus, or they may grow outside the uterus, attached to the organ by stalk-like growths. Depending on the location of your tumors, these growths may cause fibroid symptoms such as pelvic pain or long and heavy periods.

While fibroids aren't cancerous, the tumors can grow very large if left untreated. That's why we offer a non-surgical treatment, Uterine Fibroid Embolization (UFE), so you can find pain relief without an invasive procedure!


Like uterine fibroids, endometriosis can cause pelvic pain. That's why it can be hard to tell if you have fibroids vs endometriosis. Still, the reason this condition causes pelvic pain is different. With endometriosis, your uterine endometrial tissue grows outside of the uterus. In addition to often severe pelvic pain, you may also experience heavy periods and other disruptive symptoms.

Asherman's Syndrome

This condition develops when scar tissue forms in your cervix or uterus. Like the other conditions on this page, pelvic pain is a symptom of Asherman's syndrome. Other signs include getting fewer or no periods. Plus, getting or remaining pregnant can be challenging.

Now, changes in periods, pelvic pain and fertility challenges are common symptoms of several gynecologic conditions. But, unlike fibroids or endometriosis, Asherman's syndrome is usually the result of a D&C infection or complication.  (Also called a dilation and curettage, this is a procedure performed after an incomplete miscarriage or if you don't completely expel your placenta when you deliver your baby.) And, unlike fibroids, you must treat Asherman's by surgically removing your scar tissue.

PCOS, Polycystic Ovary Syndrome

PCOS is a hormonal disorder that causes enlarging in your ovaries. Small cysts will also develop on their outer edges. Like many other conditions affecting women's reproductive systems, we don't know exactly why you might develop PCOS. But we do know that symptoms include irregular periods; acne; excess hair growth; obesity; and, according to research, an increased risk for endometriosis, IBS and pelvic pain.

Causes of Pelvic Pain: Adenomyosis

With this condition, endometrial tissue grows within the walls of your uterus, causing it to become enlarged. As the uterus presses against other internal structures, it causes pelvic pain. Plus, menstrual cycles are extra painful because, as you shed your uterine lining each month, blood travels through your vaginal canal as always. But it also must travel through your uterine walls, causing additional discomfort.

Unfortunately, this condition can be very difficult to diagnose. In fact, one Australian woman suffered for 30 years with painful, heavy periods. Initially, she was diagnosed and treated for PCOS, but didn't find relief until much later. Finally, one doctor diagnosed her adenomyosis and offered her relief with UAE, or uterine artery embolization. Luckily, you don't have to go to Australia to find relief for the pelvic pain of adenomyosis. Because, in our interventional radiology practices, many women find adenomyosis relief with UAE.

Uterine Polyps

Uterine polyps are growths that form in the inner lining of the uterus, also known as the endometrium.

Although uterine polyps do not typically cause pain directly, these growths can cause symptoms such as irregular menstrual bleeding, heavy menstrual flow, and in some cases fertility issues.

While uterine polyps are typically benign, they can sometimes be cancerous and are often evaluated and removed.

Pelvic Congestion Syndrome

PCS is a condition caused by varicose veins within your lower pelvis and abdomen. Basically, your ovarian veins develop reflux. (That means blood flows back into the veins, pooling and causing pressure.) Unlike the other causes of pelvic pain, PCS tends to give a chronic ache rather than sudden pain, or pain that's tied to your menstrual cycle. While this condition is hard to diagnose, and often misdiagnosed as endometriosis, we can treat your PCS using a procedure called Pelvic Vein Embolization (PVE.) In fact, PVE has proven to be so beneficial that there is now a clinical trial to investigate the effectiveness of PVE and ovarian vein embolization (OVE) for women suffering from the pelvic pain of pelvic venous disease (PeVD), an umbrella term describing multiple conditions, including PCS and May-Thurner syndrome.

Ovarian Cysts

Unlike fibroids, which are hard, muscular growths, cysts fill with fluid. And they develop on the ovaries, not on or in your uterus. Still, it's sometimes tough to tell if you have ovarian cysts or fibroids, because these growths are also known causes of pelvic pain, in addition to other varying symptoms.

Pelvic Inflammatory Disease

PID, or pelvic inflammatory disease (PID) develops when you contract an infection in your reproductive organs. In addition to pelvic pain, PID can lead to painful sex, changes in your vaginal discharge and fever. As such, it may be easier to distinguish PID as the cause of your pelvic pain, since it shares fewer symptoms than other causes such as fibroids, endometriosis and adenomyosis.

As may be clear by now, there are many causes of pelvic pain, and many different paths to relief. Want to start treating the root cause of your symptoms? You need an accurate diagnosis. So, if you're currently experiencing pelvic pain, discuss all your symptoms with your healthcare provider. Then, if you are diagnosed with fibroids, adenomyosis or PCS, we invite you to schedule an appointment with our Houston specialists. Together, we'll discuss the minimally invasive treatment options that can finally bring you lasting relief!

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