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Sometimes, recognizing the difference between bladder pain and uterus pain is difficult. Both pain from your uterus and pain from your bladder show up as pain in the pelvic area. If you’re having pelvic pain, your doctor will do an exam and order tests to diagnose the cause.

Sometimes, treating pelvic pain is simple (like a course of antibiotics for a urinary tract infection, for example). Or, it may require lifestyle changes, long-term medication, or even surgery. The first step is determining what’s causing your pain.

What Bladder Vs. Uterus Pain Feels Like

Problems in either of these organs can cause sharp or aching pain in the pelvic area. You may feel the pain constantly, or it may come and go.

One key difference between bladder pain and uterus pain is that problems with the uterus may change with your menstrual cycle. So, if the pain is coming from your uterus, you may find that you have unusual menstrual bleeding. Or you may find that the pain gets worse when you have your period.

You may think that pelvic pain with urinary issues, like more frequent urination or pain when urinating, is always a bladder issue. But this isn’t necessarily true. Sometimes, problems with the uterus can put pressure on the bladder.

It’s also possible that what feels like bladder or uterus pain is an issue with the bowel.

What Causes Bladder Pain?

The leading causes of bladder pain are urinary tract infections and bladder pain syndrome.

Urinary tract infections

A urinary tract infection is an infection in one or more of the following parts of the urinary tract.

The urinary tract includes the following:

• Bladder.
• Kidneys.
• Ureters (the tubes between the kidneys and bladder).
• Urethra (the tube from which urine exits the body).

Symptoms of a urinary tract infection include:

• Burning or pain when you urinate.
• A frequent urge to urinate.
• Peeing only a little at a time despite feeling a strong urge to urinate.

Symptoms alone won’t always indicate where in the urinary tract the infection is. However, a kidney infection can cause back pain and fever. Kidney infections are potentially serious, so if you think you may have one, you should seek prompt medical care.

If your doctor diagnoses you with a urinary tract infection, they’ll prescribe antibiotics.

Bladder Pain Syndrome (interstitial cystitis)

Bladder pain syndrome is when the bladder lining becomes swollen or irritated. Doctors don’t know what causes it, but they know it’s more common in women than in men.

In most cases, bladder pain syndrome can be managed with lifestyle changes. Eating less acidic foods, training the bladder (waiting to pee for longer, for example), and reducing stress or physical therapy can help. Doctors may recommend different medications but would only suggest surgery in severe cases that don’t improve with lifestyle changes.

Symptoms of bladder pain syndrome are similar to urinary tract infections.

They include the following:

• An increased urge to urinate.
• Frequent urination.
• Pain during sex due to pressure on the bladder.
• Pelvic pain that is constant or may come and go.
• Urinating small amounts at a time.

In most cases, bladder pain syndrome gets worse over many months. This is different from urinary tract symptoms, which come on more suddenly.

Bladder cancer

Though bladder cancer can cause pain, cancer is rarely the reason for bladder or other pelvic pain. Bladder cancer is especially unlikely in younger people. The average age for a bladder cancer diagnosis is 73.

What Causes Uterus Pain?

The most common causes of uterus pain are uterine fibroids or endometriosis.

Uterine fibroids

Uterine fibroids are noncancerous tumors that grow on the wall of the uterus. They may not cause symptoms, especially if they’re small.

Large fibroids can press on the bladder or bowel, causing pain and affecting bowel movements, urination, or both.

Symptoms of uterine fibroids can include:

• Heavy or irregular periods.
• Painful periods.
• An increased need to urinate.
• Lower back pain.
• Constipation and bloating.
• Pain during sex.

Doctors can treat fibroids in different ways, depending on their size and the symptoms they cause. Read more about the treatment of uterine fibroids.

Endometriosis

Endometriosis is a health problem in which uterus-like tissue grows outside of the uterus. For some people, endometriosis can cause infertility.

Birth control pills, implants, injections, or intrauterine devices can help with the heavy bleeding and pain that come with endometriosis. Surgery to remove the extra endometrial tissue is also an option.

Symptoms of endometriosis include:

• Diarrhea or constipation.
• Long and heavy periods (the tissue outside the uterus thickens and bleeds just like the uterus does).
• More painful periods.
• Pain during or after sex.
• Pain during urination.
• Pelvic pain that gets worse at the time of your period.

Other Causes of Pelvic Pain

Whether your pelvic pain is due to a problem in the urinary tract, the digestive system, or the reproductive system isn’t always obvious.

Other causes of pelvic pain include:

• Inflammatory bowel disease, or chronic swelling in the digestive tract due to Crohn’s disease or ulcerative colitis.
• Irritable bowel syndrome, or a sensitive intestine. Symptoms include constipation, diarrhea, gas, and bloating, as well as pelvic pain.
• Pelvic inflammatory disease, or an infection in one or more parts of the female reproductive system. This can result from an untreated sexually transmitted disease.
• Many other conditions — including a hernia, appendicitis, certain cancers, or a twisted ovary — can cause pelvic pain.

When to See a Doctor About Pelvic Pain

See your doctor if you have:

• An increased urge to urinate.
• More frequent urination (not related to increased liquid intake).
• Pain when you urinate.
• Pelvic pain that lasts more than a few days, even if it comes and goes.
• Severe pain with periods.
• Severe pelvic pain.
• Very heavy or irregular periods.

Your doctor will ask you about your symptoms, including when they started, how severe the pain is, and how it affects your life. Your doctor may do a pelvic exam with your consent. This exam involves pressing on the abdomen while feeling parts of the reproductive system using gloved fingers inserted in the vagina.

Your doctor will order a urine test if they think you may have a urinary tract infection. If you have heavy bleeding, they may also order blood tests to check for anemia. You may need other tests, like an ultrasound, to check for signs of endometriosis or fibroids in the uterus.