Pelvic Pain? Why Your Uterus Is Hurting & Medically Approved Next Steps

Pelvic pain can be confusing, frustrating, and sometimes frightening. If you're feeling pain low in your abdomen, you may wonder: Is it my uterus?

The uterus (womb) sits in the lower pelvis between the bladder and rectum. It plays a central role in menstruation, pregnancy, and hormonal cycles. When something isn't right, the uterus can send clear signals — including cramping, pressure, heaviness, or sharp pain.

The good news: many causes of uterine pain are treatable. The key is understanding what may be happening and knowing when to speak to a doctor.

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What Does Uterus Pain Feel Like?

Pain coming from the uterus is often described as:

• Cramping in the lower abdomen
• A heavy or pulling sensation in the pelvis
• Dull, constant aching
• Sharp or stabbing pain
• Pain that worsens during your period
• Pain during or after sex
• Lower back discomfort

Because the uterus sits near other organs, it can be hard to tell whether pain is from the uterus, bladder, bowel, ovaries, or muscles. That's why tracking patterns and symptoms matters.

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Common Reasons Your Uterus May Hurt

Below are medically recognized causes of uterine pain, based on gynecologic research and clinical guidelines.

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1. Menstrual Cramps (Dysmenorrhea)

This is the most common cause of uterine pain.

During your period, the uterus contracts to shed its lining. These contractions are triggered by hormone-like substances called prostaglandins.

Symptoms:

• Cramping 1–2 days before or during your period
• Lower abdominal pain that may spread to the back or thighs
• Nausea or diarrhea

Mild to moderate cramping is common. Severe pain that interferes with work, school, or daily life is not something you should ignore.

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2. Adenomyosis

Adenomyosis occurs when tissue similar to the uterine lining grows into the muscular wall of the uterus. This can make the uterus enlarged, tender, and painful.

Common signs:

• Heavy or prolonged periods
• Severe cramping
• Pelvic pressure or fullness
• Pain during sex

Adenomyosis often affects people in their 30s and 40s, especially those who have given birth.

If you're experiencing heavy periods combined with severe cramping and pelvic pressure, you can use a free AI-powered Adenomyosis symptom checker to help determine if your symptoms match this condition before your doctor's appointment.

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3. Uterine Fibroids

Fibroids are noncancerous growths in or on the uterus. They are very common, especially during reproductive years.

Fibroids may cause:

• Heavy bleeding
• Pelvic pressure
• Frequent urination
• Constipation
• Pain during sex
• Lower back pain

Some fibroids cause no symptoms at all. Others can significantly affect quality of life.

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4. Endometriosis

While endometriosis grows outside the uterus, it often causes severe pelvic pain that feels uterine in origin.

Symptoms include:

• Intense menstrual cramps
• Pain before and during periods
• Pain with bowel movements during menstruation
• Fertility challenges

Endometriosis pain often worsens over time and should be evaluated by a gynecologist.

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5. Pelvic Inflammatory Disease (PID)

PID is an infection of the reproductive organs, including the uterus. It is usually caused by untreated sexually transmitted infections.

Symptoms may include:

• Lower abdominal pain
• Fever
• Unusual vaginal discharge
• Pain during sex
• Irregular bleeding

PID requires prompt medical treatment to prevent long-term complications like infertility.

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6. Pregnancy-Related Causes

Early pregnancy can cause mild cramping as the uterus expands. However, severe pain in early pregnancy is not normal.

Seek urgent medical care if you experience:

• Sharp one-sided pelvic pain
• Dizziness or fainting
• Shoulder pain
• Heavy bleeding

These could signal an ectopic pregnancy, which is life-threatening.

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7. Miscarriage

Cramping with bleeding during pregnancy may signal miscarriage. The pain can feel similar to strong menstrual cramps.

Immediate medical care is necessary if bleeding is heavy or accompanied by severe pain.

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8. Uterine Polyps

Polyps are small growths in the lining of the uterus. They may cause:

• Irregular bleeding
• Spotting between periods
• Heavy periods
• Mild cramping

Most are benign but should still be evaluated.

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9. IUD-Related Pain

An intrauterine device (IUD) sits inside the uterus. Some cramping is normal after placement, but persistent or worsening pain should be checked.

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When Uterus Pain Is an Emergency

Most pelvic pain is not life-threatening — but some situations require immediate care.

Go to the emergency room or seek urgent medical help if you have:

• Severe, sudden pelvic pain
• Pain with fever over 100.4°F (38°C)
• Fainting or dizziness
• Heavy bleeding (soaking a pad every hour)
• Pain during pregnancy

These symptoms could indicate infection, ectopic pregnancy, ovarian torsion, or other serious conditions.

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How Doctors Evaluate Uterus Pain

If you speak to a doctor, they may:

• Ask detailed questions about your menstrual cycle
• Perform a pelvic exam
• Order an ultrasound
• Recommend MRI imaging
• Run blood tests
• Test for infections

Tracking your symptoms before your appointment can help. Note:

• When the pain occurs
• How long it lasts
• What makes it better or worse
• Flow changes
• Clot size
• Pain during sex

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Medically Approved Next Steps

If your uterus is hurting, here's what you can safely do:

✅ 1. Track Your Cycle

Use a calendar or app. Patterns help doctors identify hormonal causes.

✅ 2. Use Anti-Inflammatory Medication (If Safe for You)

Ibuprofen or naproxen can reduce prostaglandins and ease cramps. Follow dosing instructions and avoid if contraindicated.

✅ 3. Apply Heat

Heating pads increase blood flow and relax uterine muscles.

✅ 4. Gentle Movement

Light walking or stretching can reduce cramping.

✅ 5. Schedule a Gynecology Visit

Especially if pain:

• Is worsening
• Disrupts daily life
• Is paired with heavy bleeding
• Occurs outside your period

✅ 6. Consider a Symptom Assessment

If heavy, painful periods are your main issue, a free AI-powered Adenomyosis symptom checker may help clarify whether your symptoms align with that condition before your appointment.

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Treatments for Uterus-Related Pain

Treatment depends on the cause, but options may include:

• Hormonal birth control
• Progesterone therapy
• IUDs
• Non-hormonal medications
• Antibiotics (for infection)
• Minimally invasive procedures
• Surgery (in severe cases)

Many conditions improve significantly with proper diagnosis and care.

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Don't Normalize Severe Pain

It's common for people to dismiss pelvic pain as "just bad periods." But severe uterine pain that interferes with work, relationships, sleep, or mental health deserves medical attention.

Pain is information. Your uterus should not control your life.

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The Bottom Line

Uterine pain can stem from:

• Normal menstrual cramping
• Adenomyosis
• Fibroids
• Endometriosis
• Infection
• Pregnancy-related complications
• Structural growths like polyps

Most causes are treatable. Some require urgent care.

If you are experiencing persistent, severe, or unusual pelvic pain, speak to a doctor. This is especially important if symptoms include heavy bleeding, fever, fainting, or pain during pregnancy — as these can signal serious or life-threatening conditions.

Your body is giving you signals. Listening early — and getting medically guided next steps — can make a meaningful difference in your long-term health.