Pelvic pain is pain below the belly button and between the hips. In women it can come from the uterus, ovaries or tubes, but also from the bladder, bowel or pelvic muscles. Sudden severe pain needs urgent assessment to rule out ectopic pregnancy, ovarian torsion or infection; pain lasting six months or more is called chronic pelvic pain.
- Acute causes
- Ectopic pregnancy, cyst, infection
- Chronic causes
- Endometriosis, adenomyosis, IBS
- First tests
- Pregnancy test, exam, ultrasound
- Other tests
- Urine, swabs, blood tests
- Chronic pain
- 6 months or longer
- Seen by
- Dr. Sun-Ok Lee; surgery with Dr. Jung-Ho Seo
Acute vs. chronic pelvic pain
Acute pelvic pain starts suddenly, over hours or days. It may signal a condition that needs prompt treatment. Chronic pelvic pain lasts six months or longer, may be constant or come and go, and often has more than one contributing cause.
Pain that occurs only with your period is covered in painful periods; pain during sex is covered in pain during intercourse.
Possible causes by organ
| Source | Examples | Typical clues |
|---|---|---|
| Uterus | Fibroids, adenomyosis, period pain | Linked to the cycle, heavy bleeding |
| Ovaries | Ovarian cysts, cyst rupture, torsion, ovulation pain | One-sided pain, sudden onset, mid-cycle pain |
| Pelvic lining | Endometriosis | Pain worsening around periods, pain with sex |
| Infection | Pelvic inflammatory disease | Fever, abnormal discharge, recent new partner |
| Pregnancy | Ectopic pregnancy, miscarriage | Missed period, positive test, bleeding |
| Bladder | Urinary tract infection, bladder pain syndrome | Burning, frequency, pain as the bladder fills |
| Bowel | Irritable bowel syndrome, constipation, appendicitis | Bloating, change in bowel habit, right-sided pain |
| Muscles and nerves | Pelvic floor muscle tension, nerve pain | Pain with sitting, sex or exercise |
How pelvic pain is assessed at Yoonho
- Detailed history in English Where the pain is, when it started, how it relates to your cycle, urination, bowel movements and sex, plus any recent infections or procedures.
- Pregnancy test Done first for anyone who could be pregnant.
- Pelvic exam A gentle pelvic exam checks for tenderness, masses and signs of infection. You can ask to stop at any time.
- Transvaginal ultrasound Looks at the uterus and ovaries on the same visit; an abdominal scan can be used if a vaginal scan is not suitable.
- Urine, swab and blood tests To check for urinary infection, STIs and inflammation.
- Further steps Referral for bowel or bladder assessment, MRI, or diagnostic laparoscopy when the cause remains unclear.
Endometriosis lesions on pelvic organs can cause cyclical and chronic pelvic pain.
After diagnosis and treatment, many women experience less pain and better daily function.
Treatment depends on the cause
- Infections — antibiotics, with partner treatment for STIs.
- Ovarian cysts — monitoring for simple cysts; surgery for large, persistent or complex cysts.
- Endometriosis and adenomyosis — pain relief, hormonal treatment, and laparoscopy when needed.
- Fibroids — medication or uterus-sparing removal.
- Muscle and nerve pain — pelvic floor physiotherapy, pain medication and, where helpful, psychological support.
Chronic pelvic pain often improves most with a combined approach that addresses several contributing factors rather than a single treatment.
Living with chronic pelvic pain
Chronic pain can affect sleep, mood, work and relationships. Practical steps that many women find useful:
- Keep a pain diary noting your cycle, food, bowel habits and activity to spot patterns.
- Regular gentle exercise and heat can ease muscle-related pain.
- Ask about pelvic floor physiotherapy if pain is worse with sitting or sex.
- Seek support for stress or low mood — it is part of treating pain, not a sign that the pain is imagined.
Cost and documents for international patients
At Yoonho Women’s Hospital in Apgujeong, Seoul, an assessment usually includes a consultation and ultrasound on the same day. As a general guide, consultations are about ₩50,000–100,000, with ultrasound and tests charged separately; a written estimate is given after consultation. Travelers can request English diagnoses and receipts for travel insurance claims.
Why international patients choose Yoonho
Frequently asked questions
When is pelvic pain an emergency?
Sudden severe pain, pain with fainting, fever or heavy bleeding, or pain with a positive pregnancy test needs urgent care. In Korea, call 119 or go to the nearest hospital emergency department.
Can an ovarian cyst cause pelvic pain?
Yes. Most cysts cause no symptoms, but larger cysts, rupture or twisting (torsion) can cause pain. A transvaginal ultrasound can usually identify them on the same day.
Why do I have pelvic pain but a normal ultrasound?
Some causes, such as superficial endometriosis, pelvic floor muscle pain, bladder or bowel conditions, do not show on ultrasound. Further assessment can still find a cause and guide treatment.
Can stress cause pelvic pain?
Stress does not usually cause pelvic pain on its own, but it can increase muscle tension and pain sensitivity. Addressing stress is often part of managing chronic pain.
Do I need to bring anything to my visit?
Bring your passport or ARC, a list of medications, the date of your last period and any previous scan or test reports.
OB-GYN Specialist · Director of OB-GYN
M.D., Ewha Womans University College of Medicine · Former Clinical Instructor, Ewha Womans University Mokdong Hospital · Member, Korean Society of Menopause
Last reviewed: . This page is for general information and does not replace an in-person consultation.
Talk to an English-speaking gynecologist
Yoonho Hospital · 304 Apgujeong-ro, Gangnam-gu, Seoul · Mon–Fri 9:00–18:00, Sat 9:00–13:00 · Walk-ins welcome.