A sharp pain in the pelvic area is a common symptom that can be caused by many things. For women, it can be a sign of conditions that affect the reproductive organs, or it could indicate problems with the urinary tract or digestive system.

Pelvic pain is discomfort that occurs in the lower trunk area between the belly button and thighs. In women, it can occur in the vagina or vulva.

Menstrual Cramps

Menstrual cramps are a type of pain that happens right before and during your period. They’re a normal part of getting your period, and they help your body get rid of the lining that builds up inside your uterus. The throbbing pain is usually mild to moderate, but it can be severe for some girls. Sometimes, a girl may have pain so bad that it interferes with her daily life for a few days each month. (1)

The throbbing pain is called primary dysmenorrhea, and it’s triggered by the build-up of chemicals in your uterus. These chemicals, called prostaglandins, make your uterus muscles tighten and relax. They’re usually the main cause of your period pain. This type of period pain is common for a year or two after a girl first gets her periods, but it often goes away as she grows up and after she gives birth (2).

If your cramps are severe or last more than two or three days, it’s a good idea to talk to your doctor. They’ll ask about your symptoms and menstrual cycles and do a pelvic exam. They might also do a Pap test. Putting something warm (like a heating pad) on your belly might help relieve the pain, too. Studies show that heat deactivates the nerves that send signals to your brain about pain, just like drugs do (3).

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Infections

Sharp pain in the vulva is a sign of infection or inflammation. This can be anything from a yeast infection to sexually transmitted infections such as chlamydia or gonorrhea. These conditions can be very painful, especially if left untreated, and should always be checked out. Symptoms of an STI can also include itching, rash, difficulty peeing, abnormal vaginal discharge, spotting and pain during sex. It’s important to get tested for STIs if you experience these symptoms as they can lead to serious long term health problems.

Many things can irritate the vulva and cause pain, including shaving, soaps or bath products, feminine hygiene products, certain types of fabric and condoms. Sometimes irritation is just due to over-washing or having sex without a condom. This can upset the complex bacterial balance that keeps the pH level of your vagina balanced.

Constant and knife-like pain in the vulva is called vulvodynia and can be caused by yeast infections, BV or an STD like chlamydia or genital herpes. It’s also possible to have a Bartholin’s cyst, which are fluid-filled sacs that sit on either side of the entrance to your vagina and help it lubricate. They can become enlarged for several days before they rupture or disappear on their own. It’s a good idea to keep track of the pain and any other symptoms, as this will help a doctor diagnose what is causing it.

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Trauma

Injury to the vulva or vagina is a common cause of pain. It may be structural, like a tear of the perineum (the area of skin between the vagina and anus) from childbirth, or non-structural, such as a yeast infection close to the vulva or genitalia.

Trauma symptoms typically last from a few days to a few months and can fade over time. If you experience trauma symptoms, talk to your healthcare provider to be sure there is no serious internal damage.

Genital injuries are usually a result of sexual assault or non-consensual sex. Children can also injure the vulva by straddling objects in the body, such as playground equipment or the crossbars of a bike. Most of these injuries are mild and will heal over time, but it is important to rule out any sexual abuse or rape.

Non-structural pain of the vulva is often due to a yeast infection; irritation from hygiene or birth control aids; scars of surgery, childbirth, or other accidents; inflammation of the urethra or bladder (which can be caused by an untreated urinary tract infection); or vaginismus which is involuntary muscle tightness of the labia majora. Yeast infections are also common in women and girls and can be treated with oral medication.

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Cancer

If cancer is the cause of sharp pain in your pelvic area, it’s important to let your doctor know as soon as possible. They can do tests to determine if you have vaginal cancer, which is rare. They may use X-rays, CT scans or magnetic resonance imaging (MRI) to see how big the tumor is. They can also do a procedure called cystoscopy, which involves inserting a small lighted tube with a camera into your bladder. This can show if the cancer has spread to your lymph nodes or other parts of your body.

Cancer develops when healthy cells grow and multiply out of control, but don’t die at the usual time. The accumulating abnormal cells form a mass called a tumor. The cancer can also break off and spread to other parts of the body, including your vagina.

There are six types of gynecological cancer that can cause severe pelvic pain: cervical, ovarian, fallopian tube, uterine and vulvar cancer. These cancers can be treated if they are caught in the early stages, but the treatment you get depends on what type of cancer you have and how far it has progressed.

You can help lower your risk of gynecological cancer by getting regular pelvic exams and having Pap tests. You should also avoid smoking and get the HPV vaccine if you are eligible.