What are the most common causes of pelvic pain in men?

By | November 28, 2018
Pelvic pain occurs between the navel and groin. It may result from a urinary tract infection, sexually transmitted infection, or prostatitis, which is inflammation of the prostate.

These issues are relatively common. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) estimate that chronic pelvic pain syndrome affects 10–15 percent of the male population of the United States.

Pelvic pain often occurs with other symptoms. Treatments vary, depending on the cause, so it is essential to receive a thorough checkup in each case.

1. Urinary tract infection (UTI)

Pelvic pain in men side
A person with a UTI may experience a burning sensation while urinating.

A UTI is a bacterial infection somewhere along the urinary tract, which includes the urethra, bladder, ureters, and kidneys. UTIs are a frequent complaint, and a more common symptom is pain in the lower abdomen or pelvis.

Other symptoms include:

  • a burning sensation while urinating
  • needing to urinate frequently
  • changes in the color or smell of urine
  • fever or chills
  • pain in other areas, such as the sides or lower back

A doctor will treat a UTI with a round of antibiotics.

2. Sexually transmitted infection (STI)

Some STIs, such as gonorrhea and chlamydia, also cause pelvic pain. The Centers for Disease Control and Prevention (CDC) estimate that 2.86 million chlamydia infections occur in the U.S. each year.

Symptoms include:

  • pain in the pelvis
  • inflammation in the urethra
  • discharge from the penis

Chlamydia may also infect the rectum or anus, possibly causing pain there as well.

A condition called lymphogranuloma venereum can result from different versions of the bacteria that causes chlamydia. It may lead to pelvic pain that is difficult to treat.

The CDC note that lymphogranuloma venereum can cause of outbreaks of proctitis, or inflammation of the anus and rectum, in men who have sex with men.

Gonorrhea infects about 820,000 people annually, according to the CDC. The infection may cause symptoms such as pain and discharge from the penis. If it affects the rectum, it can cause discharge from the anus or painful bowel movements.

3. Prostatitis

Prostatitis is inflammation of the prostate, a small gland in the male reproductive system. The prostate produces a fluid that goes into semen.

There are a few types of prostatitis:

Acute bacterial prostatitis

This condition arises from a bacterial infection in the prostate. Bacteria can reach the gland through the urethra, and as the bacteria spread, they can cause pain in the pelvis, groin, or lower back.

Acute bacterial prostatitis can also lead to discomfort in the penis or testicles. Pain may accompany other symptoms, including:

  • a burning feeling during urination
  • fever
  • chills
  • nausea and vomiting
  • difficulty urinating
  • frequent urination
  • urinary blockage, or being unable to urinate
  • a weak or broken urine stream
  • waking up many times at night to urinate
  • painful ejaculation

A bacterial infection in the prostate can be serious, and anyone with these symptoms should seek immediate medical care. A urologist can treat a bacterial infection with antibiotics.

Chronic bacterial prostatitis

Chronic bacterial prostatitis is a recurring infection of the prostate. The symptoms are similar to those of acute bacterial prostatitis, though they may be less severe.

A urologist will typically treat it with a low dose of antibiotics or a combination of antibiotics, over a longer period.

If the issue causes difficulty urinating, the urologist may prescribe medicines called alpha-blockers to help relax the bladder and nearby muscles so that the body can release urine.

In some cases, the doctor will recommend surgery.

Nonbacterial prostatitis

Inflammation in the prostate that lasts a long time may result from nonbacterial prostatitis, a type of chronic pelvic pain syndrome.

Doctors are uncertain about the exact cause of this condition. It is important to understand that the inflammation has nothing to do with a bacterial infection, so it will not respond well to antibiotics.

According to the University of California, San Francisco, nonbacterial prostatitis is a common issue. Various medications can manage symptoms and provide relief.

Asymptomatic inflammatory prostatitis

Prostatitis can cause virtually no symptoms. Blood tests may show higher white blood cell counts, and doctors will want to rule out prostate cancer before making a diagnosis.

4. Hernia

Pelvic pain in men weight lifting
Weightlifting can exacerbate an existing hernia.

Sudden pain in the lower abdomen may indicate a hernia.

A hernia develops when a piece of tissue or intestine pushes out through a weak point in the muscles. It often forms a small, painful bulge in the area.

The pain may grow worse when the person strains the muscles, such as when laughing, coughing, or lifting.

NIDDK estimate that about 25 percent of males will experience a hernia, typically as they age and the muscles become weaker. Surgery is the only treatment, and it is necessary in order to prevent severe complications.

5. Irritable bowel syndrome (IBS)

IBS commonly causes symptoms along the intestinal tract, such as:

These symptoms tend to go away temporarily after a bowel movement.

Doctors may recommend lifestyle and diet changes to help provide relief, and medications may help control some symptoms.

6. Appendicitis

The appendix is a small organ on the right side of the body, and inflammation in the appendix can cause pelvic pain.

Other symptoms include:

  • fever
  • loss of appetite
  • nausea and vomiting
  • swelling in the lower abdomen

If sharp pain in the lower right abdomen accompanies any of the symptoms above, seek immediate medical attention. Surgery may be necessary.

7. Urinary stones

Urinary stones form when salts or minerals, such as calcium, build up in the urine, and the body has trouble getting rid of them. These minerals can clump together and crystallize into urinary stones.

The stones only tend to cause symptoms when the body tries to pass them, and pain in the pelvis or lower back is common. Other changes include difficulty urinating and blood in the urine.

Doctors may prescribe pain medication to help with passing the stones, and some medicines may break up the stones. The largest stones require surgery, in some cases.

8. Cystitis

Pelvic pain in men antibiotics cystitis
Taking a short course of antibiotics will often treat cystitis.

Cystitis is inflammation in the bladder, generally resulting from infection.

It causes pain in the pelvis, along with symptoms including:

  • difficulty urinating
  • a weak urine flow
  • having to urinate frequently
  • burning pain when urinating
  • blood in the urine
  • changes in the look or smell of the urine

A doctor will typically use a short course of antibiotics to treat a bladder infection.

9. Urethral stricture

Urethral stricture occurs when the urethra narrows or becomes blocked, making it difficult for urine to flow out. Beyond pain in the lower abdomen, symptoms include:

  • pain while urinating
  • trouble urinating
  • leaking urine
  • blood or urine appearing in semen
  • a loss of bladder control

Treatment tends to involve a surgical procedure, and these vary.

10. Benign prostatic hyperplasia (BPH)

BPH occurs when the prostate gland enlarges due to something other than cancer.

As the prostate expands, it presses on the urethra. This can cause trouble urinating and pain in the pelvis. Eventually, the bladder muscles may weaken from the strain, making the symptoms worse.

According to NIDDK, BPH grows more common with age, affecting at least 50 percent of males older than 50.

Treatment may include lifestyle changes, medications, and surgery.

When to see a doctor

While occasional pelvic pain is common, anyone unsure about the source should see a doctor.

Even if the cause of the pain is clear, any changes, such as increasing severity, may signal the need for a medical reassessment.

Takeaway

Identifying the underlying cause of pelvic pain is important.

Even seemingly simple issues, such as UTIs, often need treatment to prevent serious complications. Anyone unsure about the cause of pelvic pain should see a doctor.

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