Have you ever experienced pelvic pain and wondered whether it may be linked to lupus? If so, you’re in good company. Many members of the MyLupusTeam community have shared this experience.

“I have pain in my pelvic area, and when it’s bad, it’s hard to walk,” one MyLupusTeam member said. “Is this common?” Another member replied, “I have recurring pelvic pain.”

Abdominal pain, including pelvic pain, is commonly associated with lupus flare-ups. Although pelvic pain can be a symptom of lupus, it can have other causes as well.

In this article, we will discuss six possible causes of pelvic pain, both related and unrelated to lupus. Additionally, we will provide management tips and guidance on when to consult your doctor about this issue.

What Causes Pelvic Pain in Lupus?

Lupus is an autoimmune disorder. This means your immune system is working against you rather than for you.

The immune system makes proteins called antibodies that help to break down harmful viruses and bacteria that cause illnesses, diseases, and infections. In autoimmune diseases, these antibodies attack your own tissues and organs.

When antibodies signal to the immune system to start this process of breaking down cells, this leads to inflammation, which can worsen lupus symptoms and cause flare-ups (reemergence of symptoms after periods of feeling well).

Lupus can be managed with the right treatment recommended by your doctor, such as antimalarial drugs, hydroxychloroquine, corticosteroids, and immunosuppressants. Getting the condition under control may help relieve pelvic pain.

Following are six potential causes of pelvic pain.

1. Joint or Muscle Pain

Because lupus is an inflammatory disease, musculoskeletal pain is a common symptom. This can lead to pelvic pain, due to the presence of muscles and bones in the pelvic region.

The pelvis contains two important muscles, the levator ani and the coccygeus, which form part of your pelvic floor. If these muscles become inflamed, you may experience pain similar to other muscle aches in your body. Additionally, there are three major bones in your pelvis — the hip bone, sacrum, and coccyx — that can also be affected by lupus.

Corticosteroids are a common treatment for lupus. Taking corticosteroids for an extended period of time can lead to early osteoporosis (loss of bone mass and strength), which frequently causes pain in the hip joints.

Avascular osteonecrosis — bone damage caused by lack of blood flow — is a condition associated with lupus and can cause pain in the hip area.

If you suspect that this pelvic pain resembles joint or muscle discomfort you've experienced elsewhere and it’s persistent, it’s advisable to consult with a rheumatologist for further evaluation and treatment adjustment.

2. Kidney Problems

Lupus often affects the kidneys, which can lead to renal (kidney) damage and disease. Kidney damage caused by lupus is called lupus nephritis. According to the Lupus Foundation of America, up to 60 percent of people living with lupus develop lupus nephritis. Kidney pain might manifest as low back pain, but it can also show up as pelvic area discomfort.

The primary function of kidneys is filtering out waste from the blood into the urine. Urinary tract infections (UTIs) can sometimes lead to pelvic pain. These can include upper UTIs (infections from the ureter to the bladder) and lower UTIs (infections from the bladder to the urethra).

Because the kidneys and urinary tract start at the low back and extend to the groin, infections and dysfunction at any point along the way can lead to pain in the pelvic area. While these may be caused by lupus, they can also be brought on by other underlying conditions.

3. Pelvic Infections

Due to weakened immune systems, individuals with lupus have a higher risk of infections. This may include pelvic infections and sexually transmitted infections (STIs) like gonorrhea or chlamydia. Some types of barrier contraception (e.g., condoms, sponges, and spermicide) can help prevent STIs.

Pelvic infections can be accompanied by yellow discharge, itching, and fever. If you suspect you have a pelvic infection, it is best to speak with your doctor.

While lupus can worsen pelvic infections, they have other root causes. It’s important to talk to your health care provider to figure out what is going on. If lupus is not the cause of your pelvic pain, you may be able to find relief by addressing the medical issue that is causing it.

4. Gastrointestinal Disease

Gastrointestinal (GI) diseases can cause pain that feels similar to pelvic discomfort. They include:

• Irritable bowel syndrome (IBS)
• Crohn’s disease
• Ulcerative colitis
• Celiac disease

Lupus and certain treatments for the condition can also cause digestion difficulties.

In addition to pelvic pain, symptoms related to GI issues can include:

• Nausea
• Vomiting
• Diarrhea
• Gas
• Bloating
• Constipation

GI issues can also cause bowel spasms, leading to pain throughout the pelvic area. GI issues also can worsen menstrual symptoms and contribute to pelvic pain from other causes.

Diet modifications and medications can help with some GI-related diseases. For celiac disease in particular, a gluten-free diet is recommended. GI disorders can increase the risk of developing colon cancer, so if you’re having any of these symptoms with pelvic pain, you should discuss them with your doctor.

5. Reproductive Health Problems

The female reproductive system, located in the pelvic region, consists of organs that may cause pelvic pain if affected by a condition. These include the uterus, its lining, fallopian tubes, and ovaries. Issues with any of these could lead to pelvic discomfort. Some of these conditions include:

• Ovarian cysts — Blisters filled with fluid that grow on the ovaries
• Endometriosis — Tissue similar to the uterine lining that grows outside of the uterus
• Premenstrual syndrome (PMS) — A cluster of symptoms that occur before menstruation, caused by the shedding of the uterine lining
• Reproductive system blockages — Cysts or endometriosis in the fallopian tubes

It is important to note that while lupus does not cause these issues, it can cause anemia. Anemia is a condition in which your body doesn’t have enough red blood cells and, subsequently, not enough oxygen is carried to the body’s tissues. This can disturb the menstrual cycle and worsen reproductive problems.

6. Prostatitis

Prostatitis is a condition in which the prostate gland — part of the male reproductive system located below the bladder — becomes inflamed, leading to discomfort and various symptoms. The condition can be triggered by urinary tract infections.

Due to the location of the prostate, people with prostatitis may experience pain during urination, lower back pain, and frequent urges to urinate. Additionally, individuals might feel pain in other areas of the male reproductive system as a result of this condition.

This is a condition that can lead to pelvic pain, and if you have any of these symptoms, you should speak to your doctor. In some cases, prostatitis can become acute and lead to infection, requiring antibiotic treatment.

Strategies for Managing Pelvic Pain

Many management strategies can be used to treat and manage pelvic pain. Common treatment options include:

• Antibiotics — These can help in treating a bacterial infection, such as a UTI, prostatitis, or pelvic infection.
• Hormone therapy — This may be useful for problems in the menstrual cycle that could be causing pelvic pain.
• Physical therapy — Stretching and massage may help ease pelvic pain.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) — These medications could help reduce inflammation and symptoms of pelvic pain.

Never try any pelvic-pain treatments before first speaking with your rheumatology provider. They can let you know what’s best for you and advise you on whether these treatments could interfere with your existing lupus treatment plan.

Share Details of Your Pain

Whatever the cause, it is important to discuss all of your symptoms with your health care provider. Try to be as specific as possible when describing your pelvic pain. Does it come and go? Is it a dull or sharp pain? Does it only hurt when you are physically active, having sex, or urinating?

Being open will help guide your doctor on what blood tests and clinical assessments to conduct to determine the cause of your pelvic pain. With your doctor, you can decide on what treatment plans will help to improve your quality of life.

Talk With Others Who Understand

On MyLupusTeam — the social network for people with lupus and their loved ones — more than 223,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Have you experienced pelvic pain? How did you discover the cause, and what helped you feel better? Share your experience in the comments below, or start a conversation by posting on your Activities page.