Pelvic Pain When Lying Down at Night

Pelvic pain is not uncommon. Millions of women, and men, experience pain in discomfort in their pelvises. But in some circumstances, the pain is worse than others. For example, many people experience pelvic pain when lying down at night and aren’t sure why it happens. Why do I get pelvic pain at night, you wonder. The answer to your question is in the post below. Scroll down to learn about the causes of pelvic pain and potential treatment options.

What Is Pelvic Pain?

Pelvic pain is the pain felt in the lowest part of the abdomen and pelvis. Anatomically speaking, the pelvis is a structure that supports the spinal column and also protects abdominal organs. Pain in the pelvic area can be dull or sharp and constant or intermittent (on and off). The intensity of pelvic pain ranges from mild to moderate and severe. Women are primarily affected by pelvic pain, which can also spread to their lower back area, thighs, and buttocks.

Okay, but what is pelvic girdle pain then?

Pelvic girdle pain (PGP) is pain that affects pelvic joints, hips, thighs, and the lower back area. One in four pregnant women experiences pelvic girdle pain. This kind of pain happens due to a combination of factors including the pregnancy hormones that loosen the ligaments.

what-is-pelvic-pain

When that happens, movements in the pelvic area increase or become uneven thus inducing pain. The growth and development of a baby in the womb puts strain on the pelvic and lower back area, which can also cause PGP. Position of a baby in the womb, history of back pain, and misaligned joints of the pelvis can also cause pelvic girdle pain.

Why Do I Have Pelvic Pain When Sitting or Lying Down?

Pelvic pain happens due to a number of causes. We will discuss them in greater detail below. It’s not uncommon for patients to feel their pain is worse when sitting or lying down. As you can presume, pelvic pain when sitting or lying down results from several causes too. Pelvic congestion syndrome is one of them. Basically, pelvic congestion syndrome is a type of chronic pelvic pain described as aching or dull.

This kind of pain is, actually, the worst when a patient is sitting or standing. It improves once you lie down. Besides pain, you may experience symptoms such as fatigue, bloating, nausea, pain after sexual intercourse, and leg fullness.

Pudendal nerve entrapment can cause this kind of pain too. Essentially, the pudendal nerve supplies feeling to the urethra, genital area, and anus. What happens here is that surgery, injury, or growth can form pressure onto the pudendal nerve in the region where it leaves or enters the pelvis. Pudendal nerve entrapment leads to nerve pain that feels like deep aching pain like an electric shock. The pain is at its worst when you sit.

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In other words, you may experience pain when sitting or lying down due to excess pressure on the pelvic area, especially if the pain is also radiating to your lower back region. Some lying positions don’t provide enough comfort to the pelvic area, and pain may occur.

What Are the Causes of Pelvic Pain?

I have a sharp stabbing pain uterus, but not pregnant. Why does it happen? As seen above, pregnancy is a common cause of pelvic pain. But, it can also affect non-pregnant women. Multiple causes are involved, let’s discuss them below.

The sections below act as pelvic pain symptom checkers. You can use them to learn why you feel discomfort and stabbing sensation in this area. However, this is not a replacement for scheduling the appointment to see the doctor about severe pelvic pain when lying down, sitting, or standing even.

Ovarian Cyst

The main cause of pelvic pain in non-pregnant women is an ovarian cyst, especially as it bursts or becomes twisted.

Essentially, an ovarian cyst is a fluid-filled sac or pocket on or in the ovary. Some reports show ovarian cysts are detected in almost all premenopausal women and about 18% of postmenopausal patients.

Ovarian cysts can be asymptomatic, especially when they’re small. Larger cysts may cause dull or sharp aches in the lower abdomen on the side where the cyst is located. Bloating and feeling heaviness in the pelvic area or abdomen are also symptoms of ovarian cysts.

In most cases, ovarian cysts form as a result of the menstrual cycle and they are called functional cysts. Other cysts are not as common. A woman is more likely to develop an ovarian cyst due to hormonal problems, endometriosis, previous ovarian cyst, and severe pelvic infection.

Interestingly, pregnant women can also have ovarian cysts. For that reason, if you have pelvic pain when lying down at night during pregnancy, you shouldn’t rule out an ovarian cyst as a potential culprit.

Ovarian cysts can cause sudden stabbing pain in the pelvic area in female patients.

Endometriosis

Endometriosis is a painful disorder wherein tissue that normally lines the uterus forms in other areas of a patient’s pelvis. Estimates show endometriosis affects one in 10 women during their childbearing years. This accounts for 176 million women worldwide. The condition usually affects the ovaries, the tissue lining the pelvis, and the fallopian tubes.

The most common signs and symptoms of endometriosis, besides pelvic pain, include:

  • Pain with sexual intercourse
  • Painful periods
  • Heavy menstrual periods
  • Fertility problems
  • Pain with urination and bowel movements
  • Constipation or diarrhea
  • Nausea and/or bloating
  • Fatigue

The exact cause of endometriosis is unclear, but various factors are involved ranging from retrograde menstruation to immune system disorder, embryonic cell transformation, endometrial cell transport, among others.

While every woman of childbearing age can develop endometriosis, some women are at a higher risk than others. Common risk factors include never giving birth, reproductive tract disorders, short menstrual cycle, low BMI, higher estrogen levels in the body, among others.

Mittelschmerz

In German, Mittelschmerz means “middle pain” and it’s a type of pain that occurs in the lower abdomen and pelvis. Women get this form of pelvic pain when they ovulate. The pain is sharp, dull, and cramp-like. It can last anywhere from a few minutes to a few hours and affects the size of the abdomen where the egg is released.

PMS and Menstruation

Premenstrual syndrome (PMS) and menstruation are common reasons behind the lower pelvic pain when lying down at night. Hormonal changes and the contraction of the uterus cause discomfort and pain.

menstruation

Pelvic pain is accompanied by other symptoms such as bloating, sore breasts, mood changes, food cravings, fatigue, irritability, nausea and/or vomiting, headaches, and diarrhea.

Pelvic Inflammatory Disease

Pelvic inflammatory disease (PID) is a reproductive tract infection. The main culprits here are the bacteria that enter the vagina and reach fallopian tubes, ovaries, and other organs. Sexually transmitted infections can cause PID. Pain associated with PID is centered in the lower abdomen and may be accompanied by vaginal discharge, pain during sex, painful urination, urinary frequency.

Uterine Fibroids

Uterine fibroids are tiny growths in uterine walls. While they’re quite common in women of reproductive age, these growths are non-cancerous. Smaller fibroids may not cause symptoms, but larger ones do cause pelvic pain. Other symptoms linked to uterine fibroids include heavy menstrual periods, feeling of fullness or swelling in the stomach, backache, pain during sex, urinary frequency, constipation, difficulty to completely empty the bladder.

Pelvic Organ Prolapse

Age and childbirth can weaken the pelvic muscles and lead to a prolapse of the uterus, bladder, and rectum into the vagina. While this problem can affect women of all ages, it is particularly common in older women. Besides pain, the biggest telltale sign of this condition is a feeling of fullness in your pelvis.

Is this the only cause of pelvic pain in 60-year-old women? Pelvic pain can affect women (and men) of all ages. Older women can experience pain in the pelvic area due to several causes including mild diverticulitis. Diverticulitis is defined as an inflammation or infection of diverticula, pouches that may form in a patient’s intestines. The most common symptoms of this condition include abdominal or pelvic pain, tenderness in the abdomen, and fever.

Pelvic Pain in Pregnant Women

In pregnant women, causes of pelvic pain happen due to hormonal changes, uneven and increased movement of the pelvis. You may experience pelvic bone pain when lying down at night due if you were particularly active during the day. As you lie down to get some rest, you may notice pain and discomfort.

However, it is also important to mention the following causes of pelvic pain in pregnant women:

  • Ectopic pregnancy – the fertilized egg grows outside of the uterus. Pain is sharp, stabbing, and appears quickly and often in waves. Only one side of the pelvis can be affected.
  • Miscarriage – loss of a baby before week 20. Severe pain and cramps are a sign of miscarriage. Other symptoms may include bleeding or spotting.

Causes of Pelvic Pain in Men

Pelvic pain is usually associated with women, but men can also have this condition. So, when we’re discussing this subject, it’s also useful to mention the reasons behind pelvic pain when lying down in male patients. And pelvic pain among men, in general! The most common reasons behind pelvic pain in men include:

  • Prostatitis – inflammation of the prostate gland. There are different types of prostatitis including acute and chronic bacterial prostatitis, nonbacterial, and asymptomatic inflammatory prostatitis. Pelvic pain is particularly common in acute and chronic bacterial prostatitis and it happens because bacteria may spread to the pelvis, groin, and lower back.
  • Hernia – indicated by sudden pain in the lower abdomen. It occurs when a piece of intestine or tissue pushes out through a weakened point in the muscle. As a result, the bulge forms.
  • Benign prostatic hyperplasia (BPH) – also known as enlarged prostate. The expansion of the prostate forms pressure on the urethra. This leads to problems with urination and pain in the pelvic area.
hernia

Basically, pelvic pain when lying down at night in male patients stems from urinary, reproductive, or intestinal issues. It’s difficult to determine the cause of pelvic pain on your own. You need to see the doctor. A healthcare provider will ask about symptoms, family and medical history, perform a physical exam, and order necessary tests to make an accurate diagnosis.

Other Causes of Pelvic Pain (In Men and Women)

In addition to the abovementioned causes, pelvic pain affects women and men due to other factors including:

  • Urinary tract infections –tend to occur in the middle of the pelvis and around the pubic bone. Besides pelvic pain, UTIs can also cause a burning sensation when urinating, frequent urination, fever or chills, changes in color or smell of urine, lower back pain.
  • Sexually transmitted infections – pain in the pelvis usually occurs with urination or bowel movement. Both gonorrhea and Chlamydia can cause pelvic pain as well as other symptoms like discharge from the penis or vagina.
  • Hernia – a bulge that disappears when you lie down.
  • Appendicitis – the swelling or inflammation of the appendix. It starts suddenly and can be severe.
  • Kidney stones or infection – kidney stones are more common in men and they usually don’t cause symptoms until they start moving through the ureters. Kidney infection happens due to bacteria but kidney stones can also cause it.
  • Cystitis – Inflammation of the bladder usually caused by UTI. The condition forms pressure on the pelvis and causes pain.
  • Adhesions – the bands of scar-like tissue that make tissues and organs in the abdomen stick together. They don’t always cause problems but may induce uncomfortable symptoms if the intestines become blocked and stuck together.

How to Treat Pelvic Pain

Mild and temporary pelvic pain is usually not a source of concern. If you get pelvic pain only when lying down at night and it’s preventing you from getting enough sleep, you should schedule an appointment to see your doctor.

Many men and women are reluctant to see a healthcare professional about this problem. They usually hope pelvic pain will go away on its own. Keep in mind pelvic pain is not a condition by itself, but usually a sign of a much bigger problem. It’s understandable to wonder “why do I have pelvic pain when I lie down”.

But, the only way to know the exact cause is to get a proper diagnosis from your healthcare provider. Diagnosis will also make the treatment of pelvic pain a lot easier.

So, how to relieve pelvic pain when sleeping? How to treat this kind of pain in general?

One way to relieve pelvic pain when sleeping is to sleep with a pillow between your knees. Pillow will keep your pelvic area aligned and take the pressure off the hip and pelvic muscles. While you can use a regular pillow, you can also invest in a body pillow if you’re pregnant.

Instead of cotton pajamas, you may want to opt for silk and satin pajamas. That way you can slide around in bed. Cotton would cause more friction.

Another option is to wear a belly band or a pregnancy support band to maintain proper alignment of the pelvis and reduce pain.

You may also want to try sleeping at an incline to improve comfort, alleviate pressure, and minimize lower abdominal pain at night when lying down.

Lifestyle modifications are also necessary, especially for persons whose pelvic pain is chronic or comes and goes. These tips can help you out:

  • Improve your posture; avoid standing on one leg
  • Don’t slouch
  • Try exercising in water (e.g. pool)
  • Do light exercises that won’t put a lot of pressure on your pelvis
  • See a physiotherapist who can manipulate your hip, back and pelvis
  • Soak in a warm bath
  • Practice yoga and meditation
  • Eat a well-balanced diet that won’t cause constipation
  • Take OTC pain-relievers as instructed by your doctor

Conclusion

Pelvic pain isn’t uncommon. Various causes are behind this uncomfortable problem. Some are well-known e.g. PMS, menstruation, but others are not. If your pelvic pain is moderate to severe, you may want to see a doctor. Treatment of the underlying cause can help tackle pain. For example, persons with bacterial infections may get a prescription for antibiotics.

FAQs

Why is my pelvic girdle pain worse at night?

Many women claim their pelvic girdle pain is worse at night. This could be due to your sleeping position that makes joints more vulnerable. Another potential cause is the fact buttock muscles, the main stabilizers for the pelvis, are not active while you sleep i.e. when you’re in a resting position.

Why does my pelvic floor hurt at night?

The pelvic floor often hurts at night due to muscle spasms. An uncomfortable sleeping position may also cause this problem.

How do you relieve pelvic pain while sleeping?

The best way to alleviate pelvic pain while sleeping is to place a pillow between your knees. Doing so can support proper alignment of the pelvis and relieve the pressure from muscles in the hip and pelvic areas. You can use a regular pillow here.

Is ovarian cyst pain worse at night?

For some patients, ovarian cyst pain may be worse at night, but this is not a general symptom. The experience of pain caused by ovarian cysts may vary from one patient to another. Some patients don’t experience pain at all.

Why is my pelvic pain radiating down leg?

Pelvic pain can occur due to problems with pelvic bone and muscle. Also, in some cases compressed spinal nerves (pinched nerves) can cause pelvic pain radiating down the leg and even your buttocks.

Dr Ahmed Zayed

Dr. Ahmed Zayed holds a baccalaureate of Medicine and Surgery. He has completed his degree at the University of Alexandria, Egypt. Dr. Ahmed believes in providing knowledgeable information to readers. Other than his passion for writing, Dr. Ahmed spends his time outside the hospital, either reading or at the gym.

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