What Causes Pelvic Pain in Males and How to Treat It

Male pelvic pain causes

There are many possible causes of male pelvic pain. It’s important to take note of other symptoms, which can help you determine the cause.

Urinary tract infection

The urinary system, or urinary tract, produces urine and removes it from the body. It consists of the kidneys, ureters, bladder, and urethra.

A urinary tract infection (UTI) happens when bacteria overgrow in any of these parts. Most UTIs affect the bladder. A bladder UTI causes cystitis, or bladder inflammation.

UTI symptoms include pelvic pain, along with:

• pelvic pressure
• frequent urge to urinate
• bloody urine
• painful urination

UTIs are common in women, but men can get them too.

Cystitis

Cystitis, or inflammation of the bladder, is usually caused by a UTI. But it can be caused by other factors, including:

• reaction to medication
• reaction to chemicals in products
• radiation treatment
• long-term catheter use

Cystitis pain appears in your pelvic area. Other symptoms include:

• painful or burning urination
• frequent urge to urinate
• cloudy, dark, or smelly urine
• bloody urine

Prostatitis

The prostate is a gland that makes the fluid in semen. Prostatitis occurs when the prostate is inflamed.

The condition may be caused by a bacterial infection or nerve damage in the lower urinary tract. Sometimes there’s isn’t a clear cause.

Along with pelvic pain, prostatitis symptoms include:

• genital pain (penis and testicles)
• pain the abdomen or lower back
• pain between scrotum and rectum
• bloody urine
• cloudy urine
• frequent urination
• painful urination
• painful ejaculation
• flu-like symptoms (bacterial prostatitis)

Sexually transmitted infection

A sexually transmitted infection (STI) is an infection that’s passed through sexual contact. STIs can cause a range of symptoms or no symptoms at all.

In men, pelvic pain may indicate chlamydia or gonorrhea. These infections are caused by bacteria and often appear together.

In addition to pelvic and abdominal pain, symptoms include:

• discharge from penis
• painful urination
• testicular pain

Hernia

A hernia happens when tissue pokes through the muscle that contains it. The most common type is an inguinal hernia, which occurs when intestinal tissue pushes through the abdominal muscle.

Inguinal hernias frequently affect men. If you have an inguinal hernia, you’ll have a painful lump in your lower abdomen or groin. The lump will go away when you lie down, and you might be able to push it back in.

Hernias cause dull pelvic pain. Other symptoms include:

• groin weakness
• worsening pain when you laugh, cough, or bend over
• bulge that slowly grows
• feeling of fullness

Irritable bowel syndrome

Irritable bowel syndrome (IBS) is a gastrointestinal disorder that affects how your large intestine functions. The exact cause isn’t clear, but it may be related to problems with your intestinal muscles, gut bacteria, or nervous system.

IBS causes digestive issues, including pelvic and abdominal pain. Other symptoms include:

• cramping
• diarrhea, constipation, or both
• bloating
• gas
• white mucus in stool

Appendicitis

The appendix is a small, finger-shaped sac that’s attached to the first part of the large intestine. It’s located on the lower right side of your abdomen.

Appendicitis is inflammation of the appendix. It can cause severe pelvic pain, which often starts around your belly button then moves to your lower right abdomen. The pain usually gets worse, especially when you cough or sneeze.

Medical emergency

Appendicitis requires emergency help. Call 911 if you think you have appendicitis and have severe pelvic pain along with:

• appetite loss
• constipation
• diarrhea
• nausea
• vomiting
• abdominal swelling
• low grade fever
• inability to pass gas

Urinary stones

Urinary stones are mineral deposits that develop in your urinary tract. They can form in your kidneys (kidney stones) or bladder (bladder stones). It’s also possible for small kidney stones to enter your bladder, where they turn into bladder stones.

Kidney and bladder stones don’t always cause symptoms, but they can cause pelvic pain if they move around.

Other symptoms include:

• pain in the side and back, under ribs (kidney stones)
• painful urination
• frequent urination
• bloody urine
• cloudy, dark urine

Urethral stricture

In men, the urethra is a thin tube that connects the bladder to the penis. Urine passes through the urethra to leave the body. It also carries semen.

The urethra can develop scarring due to inflammation, infection, or injury. The scarring narrows the tube, which reduces urine flow. This is called a urethral stricture.

Pelvic pain is a common symptom. You might also have:

• painful urination
• bloody or dark urine
• slow urine stream
• leakage
• swollen penis
• blood in semen
• UTIs

Benign prostatic hyperplasia

Benign prostatic hyperplasia (BPH) occurs when the prostate gland is enlarged. It’s not a cancerous condition.

An enlarged prostate can put pressure on the urethra and bladder. This reduces urine flow and causes pain in the lower abdomen and pelvis.

Other BPH symptoms include:

• painful urination
• frequent urination, especially while sleeping
• consistent urge to urinate
• weak urine stream
• smelly urine
• urinary incontinence
• pain after ejaculation

Pudendal nerve entrapment

The pudendal nerve is the main pelvis nerve. It provides sensation to the surrounding areas, including the buttocks and penis. Pudendal nerve entrapment, or pudendal neuralgia, occurs when the pudendal nerve is irritated or damaged.

The primary symptom is constant pelvic pain, which might get worse when you sit down. The pain may feel like:

• burning
• crushing
• prickling
• stabbing

Other symptoms include:

• numbness
• increased pain sensitivity in the pelvis
• frequent urination
• sudden urge to urinate
• painful sex
• erectile dysfunction

Abdominal adhesion

Abdominal adhesions are fibrous bands of scar tissue that form in the abdomen. The bands can develop between the surfaces of organs or between organs and the abdominal wall. These adhesions can twist, pull, or press on your organs.

Usually, abdominal adhesions affect people who have had abdominal surgery. Most adhesions don’t cause symptoms. If symptoms occur, you may have abdominal pain that spreads to the pelvis.

Abdominal adhesions can lead to intestinal obstruction.

Medical emergency

Intestinal obstruction is an emergency. If you think you have intestinal obstruction and have the following symptoms along with pelvic pain, call 911 and go to the nearest emergency room immediately.

• abdominal swelling
• bloating
• constipation
• nausea
• vomiting
• not passing gas
• inability to have a bowel movement

Chronic pelvic pain syndrome

Chronic pelvic pain syndrome (CPPS) is a common cause of pelvic pain in men. It’s often called chronic nonbacterial prostatitis because it makes the prostate tender, but it isn’t caused by bacteria. Scientists don’t know why CPPS happens.

CPPS typically causes pelvic pain that comes and goes. Other symptoms include:

• pain in the lower back
• pain in the genitals (penis, testicles, rectum)
• frequent urination
• pain that gets worse with prolonged sitting
• painful urination or bowel movements
• worsening pain during sex
• erectile dysfunction

Post-vasectomy pain syndrome

A vasectomy is a form of male birth control. It’s a surgical procedure where the vas deferens, the tubes that carry sperm, are cut or blocked off.

About 1 to 2 percent of men who get a vasectomy develop chronic pain. This is called post-vasectomy pain syndrome (PVPS).

PVPS causes genital pain that spreads to the pelvis and abdomen. Other symptoms include:

• painful sex
• painful erections
• painful ejaculation
• poor erectile function

Male lower abdominal pain causes

In some cases, abdominal pain can radiate to the pelvic region. This type of pain may be caused by:

• hernia
• IBS
• appendicitis
• abdominal adhesions

Lower back and pelvic pain

Pelvic pain can also appear with lower back pain. Possible causes include:

• kidney stones
• prostatitis
• CPPS

Hip and pelvic pain in males

If you have pudendal nerve entrapment, you’ll have pain in your pelvis and buttocks. The pain may spread to your hips.

A pelvic injury can also lead to hip pain.

Diagnosing pelvic pain

A doctor will use different tests to diagnose your pain, including:

• Physical examination. A physical exam lets the doctor check your pelvis and abdomen. They’ll look for any swelling and tenderness.
• Blood tests. Blood panels allow doctors check for signs of infection or poor kidney function.
• Urine samples. If a doctor suspects a problem with your urinary tract, they’ll have a lab analyze your urine.
• Imaging tests. A doctor might have you get an ultrasound, CT scan, or MRI. These tests create detailed images of your organs and tissues.

Pelvic pain home treatment

While you’re waiting to see the doctor, you can try pelvic pain home treatments. These methods can also help manage pelvic pain while you’re getting medical treatment.

Heating pad

A heating pad can help pelvic pain and pressure. The heat reduces pain signals in the area, which provides temporary relief.

Over-the-counter pain medications

Mild pelvic pain can be relieved with over-the-counter (OTC) medications. This treatment is often recommended for conditions like small kidney stones.

Treating pelvic pain in males

While it’s possible to manage pelvic pain at home, it’s still important to treat the underlying cause. A doctor might recommend:

Antibiotics

Some causes of male pelvic pain are treated with antibiotics. These conditions include:

• UTI
• prostatitis
• STI

Prescription pain medication

If OTC medicine doesn’t work, a doctor may prescribe stronger medication. Always follow the doctor’s recommended dosage.

Surgery

For more serious conditions, surgery might be required. This includes:

• kidney stones
• hernia
• appendicitis
• urethral stricture
• abdominal adhesions
• PVPS

When to see a doctor

See a doctor as soon as you have pelvic pain. It’s especially important to get help if you have:

• pain that suddenly gets worse
• redness or swelling
• vomiting
• nausea
• fever

Takeaway

In men, pelvic pain might stem from reproductive, urinary, or intestinal issues. Depending on the cause, it can range from mild discomfort to severe pain.

If the pain appears suddenly, or if you also have a fever, seek medical help. Your symptoms might indicate a more serious condition.