5 Possible Causes of Pelvic Pressure in Women

Whether it's felt during sex, in the bathroom or at that special time of the month, pelvic pressure is a rather common complaint among women and can be caused by a variety of conditions.

Once you're with child, pregnancy — and every condition that accompanies it — is a major cause of pelvic pressure.

According to the American College of Obstetricians and Gynecologists (ACOG), it may be difficult to pinpoint the exact cause of pelvic pressure and it can be sporadic in nature. "Pelvic pressure is a very common symptom during pregnancy and increases as the pregnancy enlarges," confirms Martha Rac, MD, an assistant professor of ob/gyn at Baylor College of Medicine.

Read more: What to Expect With Pregnancy, Week by Week

But women who have never been pregnant can experience symptoms, too. Whether it's constant or intermittent, sharp or dull, women should always report pelvic pressure or pain to their doctors.

Here's more about the common reasons for pelvic pain and pressure during pregnancy and at times when you're not expecting, too.

1. "Lightening"

Towards the end of pregnancy, the baby usually drops deeper into the pelvis, in anticipation of birth. This is called “lightening,” and in exchange for the increased pelvic pressure, women may find that they're finally able to breathe better as their lungs have more room (phew!).

If this happens much earlier than the 37th week of pregnancy, however, women should contact their obstetrician immediately. According to the Centers for Disease Control and Prevention, a sensation of pressing down could be a sign of premature labor.

"This lighter feeling occurs near the end of the third trimester and may be associated with a change in the shape of the mother’s abdomen," says Dr. Rac. "It's not necessarily predictive of spontaneous labor but this often follows a few weeks after."


A common cause of pelvic pressure not associated with pregnancy is pelvic inflammatory disease (PID), which is marked by the frequent urge to urinate. PID can be diagnosed by your doctor and treated with antibiotics.

2. Symphysis Pubis Dysfunction

Mid-section view of a woman holding her pelvic area in pain

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Symphysis pubis dysfunction, or SPD, is a condition in which a pregnant woman produces extra relaxin, the hormone responsible for loosening the joints for birth, per the Royal College of Obstetricians & Gynaecologists. This can cause pelvic pressure and distress as ligaments and bones stretch outward.

SPD, also called pelvic girdle pain, is expected in pregnancy and is usually something women simply have to endure until the baby is born, according to a 2013 study in the journal _Facts, Views & Visions in ObGyn. T_his same journal report also found that about 20 percent of pelvic girdle pain cases are severe, causing high levels of discomfort and disability.

Pain caused by SPD is usually localized to the pubic bone, but other areas of discomfort include the lower back, hips, groin and legs — and some women describe a 'click' heard or felt when walking, says Dr. Rac. "If you are diagnosed with SPD, your doctor may have you wear a pelvic support device or use crutches, though most cases resolve with conservative management during the postpartum period," she adds.

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3. Ectopic Pregnancy

Ectopic pregnancy is a life-threatening condition in which an embryo implants on a fallopian tube rather than in the uterus, according to ACOG. As the embryo grows, pelvic pressure and pain increases, usually only on one side. The pain is considerable and must be fixed by surgery before the fallopian tube bursts and bleeds into the abdomen.

Common risk factors for an ectopic pregnancy include a history of chlamydia or gonorrhea infection; prior pelvic infections, including pelvic inflammatory disease (more on that below); and a history of abdominal surgery, in vitro fertilization or becoming pregnant with an intrauterine device (or IUD) in place, explains Dr. Rac.


If you suspect you may have an ectopic pregnancy, see your doctor immediately.

4. Pelvic Inflammatory Disease

Mid-section view of a woman holding her pelvic area in pain

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Pelvic inflammatory disease, or PID, is an infection of the female reproductive organs in the lower pelvic region, according to the Mayo Clinic. The increased pelvic pressure of PID often leads women to believe they need to urinate more frequently, even when they have little urine.

PID can be easily treated with antibiotics as long as it is caught early. If women wait to report symptoms, the infection can potentially spread to the kidneys, which can be dangerous. See your doctor as soon as possible if you suspect you may be suffering from PID.

5. Uterine Fibroids

The presence of non-cancerous fibroids in the uterus may cause pelvic pressure. According to ACOG, the cause of these fibroids is unknown, though an excess of estrogen is suspected and they are most common in African-American women between the ages of 30 and 40.

Because fibroids grow rapidly and may twist, they are often surgically removed before pelvic pressure worsens. "There are many ways uterine fibroids can be removed depending on size and location, ranging from hysteroscopic resection of fibroids on the inside of the uterus to laparoscopic or open abdominal surgery to remove larger fibroids on the surface of the uterus," says Dr. Rac.

"In 1 to 2 percent of cases, these fibroids are the cause of infertility, but most women with uterine fibroids will achieve a successful pregnancy," she notes.

If you are experiencing infertility and are found to have uterine fibroids, your doctor can remove them to improve your chances of achieving pregnancy, she adds.

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