Pelvic Pain Deserves a Closer Look
Pelvic pain can be sharp or dull, constant or on and off. It may come with your period, during sex, or without a clear pattern. When pain keeps returning or makes it hard to work, exercise, or rest, it deserves attention.
Many different conditions can cause pelvic pain, and finding the cause is the first step toward the right care. Dr. Yakov Levy can help you understand what may be behind your pain and explore your treatment options.
You do not need to know the cause before your visit. Tell us what you feel and when it happens.
Manhattan & Rego Park
What Is Pelvic Pain
Pelvic pain is pain in the lowest part of your abdomen, below your belly button and between your hips. It can start in the reproductive organs, such as the uterus, ovaries, or fallopian tubes. It can also come from the bladder, bowel, muscles, or nerves nearby.
Pain that begins suddenly is called acute pelvic pain. Pain that lasts six months or longer is called chronic pelvic pain. Some pain follows your menstrual cycle, and some does not. These patterns give the doctor important clues about the cause.
When Pelvic Pain Is Worth Discussing
Pelvic pain is common, but it should not be ignored. Talk with a gynecologist if you have:
- Period pain (dysmenorrhea), associated with your menstrual cycle, that may keep you from work, school, or your usual activities.
- Pain during or after sex (dyspareunia). Dyspareunia can be persistent or recurrent and has multiple causes. Our personalized approach focuses on identifying the underlying cause and providing individualized treatment to restore comfort, improve sexual wellness, and enhance quality of life.
- Pain between periods or pain that does not follow your cycle.
- Pain or pressure that lasts for weeks or keeps coming back.
- Pain when you urinate or have a bowel movement, especially during your period.
- Pain on one or both sides of the pelvis.
- Pain together with unusual bleeding or discharge.
You do not need to have every symptom to ask for help. How pain affects your life matters.
What Can Cause Pelvic Pain
Pelvic pain has many possible causes, and more than one can be present at the same time. Finding the cause helps the doctor choose the right care.
- Painful periods. Cramping during your period is common. Pain that is severe or disrupts your life can be a sign of another condition.
- Endometriosis. Tissue similar to the uterine lining grows outside the uterus. It can cause painful periods, pain during sex, and ongoing pelvic pain. It may affect or damage other pelvic organs, such as the fallopian tubes, and lead to infertility, or the bowel and bladder, leading to pain and dysfunction of these organs.
- Adenomyosis. A condition in which tissue similar to the uterine lining grows into the muscular wall of the uterus, potentially causing heavy menstrual bleeding, painful periods, and pelvic discomfort.
- Fibroids. These are usually noncancerous growths in or around the uterus. Depending on their size and location, they may cause pressure, pain, or heavy bleeding.
- Ovarian cysts. These are fluid-filled sacs on or in an ovary. Many go away on their own, but some cause pain. A cyst that breaks open or twists the ovary can cause sudden, severe pain and needs emergency care.
- Pelvic infections. Pelvic inflammatory disease (PID) is an infection of the reproductive organs that often starts with a sexually transmitted infection. Without treatment, it can lead to ongoing pain and affect future fertility.
- Pregnancy-related causes. Pain in early pregnancy always needs medical attention. An ectopic pregnancy, which grows outside the uterus, is a medical emergency. Pain could also be a sign of early miscarriage.
- Muscle, bladder, and bowel causes. Tight or tender pelvic floor muscles, bladder conditions, and bowel conditions such as irritable bowel syndrome can also cause pelvic pain. When the cause is not gynecologic, the doctor can help guide your next step.
Sometimes no single cause is found. Even then, there are ways to manage pain and help you feel more like yourself.
What Happens at Your Consultation
The doctor will ask where you feel pain, when it started, how it changes during your menstrual cycle, and how it affects your daily life. Depending on your needs, evaluation may include a pelvic exam, a pregnancy test, urine or swab tests to check for infection, and an ultrasound to look at your uterus and ovaries.
Some patients may need further imaging or a laparoscopy, a minimally invasive procedure that uses a thin camera to look inside the pelvis. You may not need every test. The doctor will explain what is recommended and why.
Treatment Depends on the Cause
Your care plan depends on the cause of your pain, your health, and your goals, including any plans for future pregnancy. Options may include:
- Pain relief. Over-the-counter or prescription medicines can ease cramps and inflammation. Heat and gentle movement may also help with milder pain.
- Hormonal treatment. Some birth control methods, including a hormonal IUD, can reduce painful periods and help manage conditions such as endometriosis.
- Treating infections. Antibiotics can treat infections such as PID. A partner may also need treatment to keep the infection from coming back.
- Care for fibroids or cysts. Some growths only need monitoring. Others may be treated with medicine or removed.
- Pelvic floor physical therapy. When tight or weak pelvic floor muscles contribute to pain, a specialized physical therapist can help them relax and work better.
- Surgery. When needed, minimally invasive surgery can help diagnose and treat conditions such as endometriosis, fibroids, or ovarian cysts.
- New emerging treatment options. There are new, promising reports from preclinical studies of successfully treating various types of pelvic pain and endometriosis with different types of peptides. Dr. Levy is carefully watching and evaluating these developments and the possible use of peptides to treat pelvic pain. No peptide is FDA-approved to treat pelvic pain or endometriosis.
The doctor can help you understand which options fit your situation and can refer you to other specialists when needed.
Frequently Asked Questions
Is it normal to have pain during my period
Mild cramps are common. Pain that keeps you from your usual activities, gets worse over time, or does not improve with over-the-counter medicine deserves an evaluation.
What if sex is painful
Pain during sex can have several causes, including vaginal dryness, infection, endometriosis, or tight pelvic floor muscles. It is worth discussing, and treatment depends on the cause.
Can pelvic pain affect my fertility
Some causes, such as endometriosis or untreated pelvic infections, can affect fertility. Tell the doctor if you hope to become pregnant in the future so your care plan can reflect your goals.
Will I need surgery
Not necessarily. Many causes of pelvic pain improve with medicine or other treatments. The doctor will discuss options based on your symptoms and test results.
Could my pain be coming from my bladder or bowel
Yes. The bladder, bowel, and pelvic muscles sit close to the reproductive organs, and their symptoms can overlap. The doctor can help find the likely source and guide your next step.
More Questions You May Have
Should I mention pain that comes and goes
Yes. Pain that appears at certain times of your cycle, after sex, or with exercise can offer important clues, even if it does not happen every day.
How can I prepare for my visit
If possible, note when your pain starts, how long it lasts, how strong it feels, and what makes it better or worse. Bring a list of your medicines and any previous test results. You do not need complete records to schedule a visit.
When to Get Help Sooner
Contact a healthcare professional promptly if pelvic pain is new, keeps getting worse, or comes with fever, unusual discharge, or burning when you urinate.
Seek emergency care right away for sudden, severe pelvic or abdominal pain, especially with fainting, dizziness, vomiting, heavy bleeding, or a high fever. If you could be pregnant, pelvic pain with bleeding or dizziness needs emergency care. Do not wait for a reply to an online appointment request if you need urgent help.
Tell Us What You Are Feeling
You do not need a diagnosis to make an appointment. Tell us where it hurts, when it started, and how it affects your life. Dr. Yakov Levy can help you understand the possible causes and decide on the next step.
Dr. Yakov Levy
