Pelvic Pain Syndrome: Differences between Men and Women

Chronic pelvic pain isn't just a problem for women. Plenty of men suffer from it too. What are the common sources of pelvic pain for men and women?  It all has to do with what parts you have between your pelvic bones.

The pelvis is a basin made from our two hipbones, sacrum and coccyx bones. It is the base-support for our spinal column and leg bones. This bony structure provides protection for male and female reproductive, urologic and digestive organs. When doctors diagnose chronic pelvic pain, it isn't usually the pelvic bones that cause the trouble. It's usually what's in the basin.

Chronic pelvic pain syndrome in men is also called chronic prostatitis (CP), which is a long-lasting infection that causes swelling and irritation (inflammation) of the prostate gland. CP is the most common urological diagnosis in men older than 50 years and the third most common diagnosis in men younger than 50 years CP results in at least 2 million office visits per year. It develops slowly and continues for a long period of time. While some men have no symptoms, the National Institutes of Health lists these common symptoms of chronic prostatitis:

  • Blood in the urine
  • Decreased urinary stream
  • Delayed start of urination (urinary hesitancy)
  • Frequent urination
  • Incontinence
  • Low-grade fever
  • Pain or burning with urination
  • Low back pain
  • Pain in the perineum or pelvic floor
  • Pain with bowel movement
  • Pain with ejaculation
  • Testicular pain

Diagnosis of chronic pelvic pain syndrome is tricky because common tests don't always uncover the cause for the pain. Diagnosis is made through physical exam, lab studies and patient's reports of symptoms long-term pain. Treatment may include a combination of therapies, including long-term antibiotics and sometimes a surgical procedure called transurethral resection of the prostate.

Chronic pelvic pain in women is defined as pain that occurs below the belly button that lasts for at least six months and may or may not be associated with menstrual periods. This pain is caused by gynecologic reasons in about 20 percent of cases, including:

  • Endometriosis, when part of the uterine lining grows outside the uterus and on other pelvic organs
  • Chronic pelvic inflammatory disease, which is an infection caused by sexually transmitted organisms.
  • Fibroids of the uterus, which are non-cancerous growths on the uterus that can grow large and cause pain by pressing on other pelvic organs and in association with menstruation.

What Causes Pelvic Pain?

Chronic pelvic pain in men and women may be caused by the following conditions.

Irritable Bowel Syndrome, a gastrointestinal condition that causes chronic abdominal pain and altered bowel habits such as loose stools, more frequent bowel movements with onset of pain, and constipation.

Diverticulitis is inflammation of a diverticulum (a sac-like protrusion that sometimes forms in the muscular wall of the intestine). This usually causes abdominal pain; nausea and vomiting, constipation, diarrhea, and sometimes urinary symptoms.

Painful bladder syndrome and interstitial cystitis is bladder pain that's not caused by infection. Symptoms usually include the need to urinate frequently and a feeling of urgently needing to urinate.

Don't wait for pelvic pain to become a chronic condition before you seek medical treatment.  All new or unusual symptom should be checked out by your physician. 



Chronic Pelvic Pain in Women

Chronic Prostatitis

National Institutes of Health