Feeling of Heaviness in Your Pelvic Area? Experts Share Causes and Treatments That Actually Work
Pelvic pressure could signal anything from tight pelvic muscles to fibroids. Here’s what to know
If you’ve ever experienced a feeling of heaviness in your pelvic area, you know how uncomfortable—and worrying—it can be. While many underlying causes can be easily resolved, others may require more in-depth treatment. Either way, it’s important to discuss pelvic discomfort or abnormalities with your doctor to figure out the best path for relief.
“Pelvic heaviness is a sensation that can feel different for every patient,” says Steven J. Radtke, MD, FACOG, FMIGS, gynecologic surgeon at Norton Urogynecology Center. “Some describe it as if something is stuck in the lower pelvis, while others liken it to a feeling of being ‘weighed down’ in the pelvic area. This discomfort can intensify with activities like jumping or running, and it may or may not come with pain. Regardless, it’s often a source of stress and frustration for those experiencing it.”
Top 4 causes of pelvic heaviness and what to do about them
Various conditions can cause this type of pelvic symptom, as the pelvis is a complex area where the bladder, uterus, rectum, nerves and muscles all interact closely, explains Dr. Radtke. Here are a few of the most common causes of a heavy feeling in the pelvic area:
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Pelvic organ prolapse
One of the most likely causes of pressure in the pelvic area is pelvic organ prolapse (POP). This is where the pelvic organs like the bladder or uterus weaken and drop into the vaginal canal or walls, explains Lauren Hill, PT, DPT, pelvic floor physical therapist and instructor for Vagercise.
“You can feel heaviness or a sensation of dragging,” she says. “You might feel like there’s a bulge, or you can see or feel something at the perineum, the space between the vaginal and anal openings.”
Women who have had multiple vaginal births or a history of chronic straining (such as from constipation) are at increased risk of prolapse, Hill says. Chronic lung diseases like chronic obstructive pulmonary disease (COPD) or severe asthma can also contribute to prolapse, she adds. These conditions are often accompanied by chronic coughing, which places pressure on the pelvic floor and can exacerbate prolapse over time.
Women who have gone through menopause and those who are overweight are also at higher risk of POP because the reduction in estrogen often leads to vaginal atrophy, dryness, weakening and thinning. Additional signs of prolapse may include a noticeable bulge of tissue at or beyond the opening of the vagina, lower back pain, urinary or bowel changes and pain with sex.
How it’s treated: Pelvic floor exercises can help strengthen the muscles used to hold your pelvic organs in place. Your doctor might also recommend a vaginal pessary (a removable silicone device that gives added support to the sagging organ) or in some cases, surgery.
Pelvic floor tension
Tight muscles around your pelvis can restrict blood flow to the area, leading to a feeling of heaviness, says Hill. If you have pelvic tension, your pelvic floor muscles lack the blood flow and nutrients they need to function properly, she explains.
“Tension can also lead to muscle fatigue,” notes Hill. “When the pelvic floor muscles are held in a tight position for long periods of time, they’re going to get tired, just like any other muscles in the body. They’re not meant to be ‘on’ all the time. The fatigue can feel like heaviness, just like a clenched fist is going to feel heavier than a relaxed hand. You may feel more heaviness when you’re upright for a long period of time or exercising because the muscles are already working hard.”
One specific example of this is a hypertonic pelvic floor, which occurs when the pelvic floor is continuously contracted or spasming, struggling to relax.
Other common symptoms of pelvic floor tension often include painful intercourse, difficulty emptying the bladder or bowels, urinary urgency and frequency or pain in the pelvic area, hips or back, Hill offers.
Pelvic floor tension is common after the muscles were strained during pregnancy and childbirth, as well as through perimenopause and menopause, when a decrease in estrogen causes vaginal tissues to become dry, says Hill. It can also be related to heavy, painful periods because of a condition like polycystic ovarian syndrome (PCOS) or endometriosis.
“And the pelvic floor is also heavily tied to our nervous system,” Hill adds. “Someone who has a lot of stress may hold that tension in their pelvic floor muscles.”
How it’s treated: If your pelvic floor muscles are too tight, pelvic floor stretches can help them learn to relax. Similarly, learning how to de-stress can help your entire body (including tense pelvic muscles) unwind.
Uterine fibroids
Fibroids, which are benign tumors that grow in the uterus, can cause the organ to enlarge due to increased blood flow. This adds pressure to surrounding pelvic structures, explains Ena Cardona-Mason FNP-BC, Nurse Practitioner and owner of The Holistic Approach for Women.
Older women, African American women, those who are overweight, who have high blood pressure, a family history of uterine fibroids or have never given birth are at an increased risk of uterine fibroids.
How it’s treated: Certain hormone-regulating medications may help treat the uterine fibroids that cause chronic pelvic pain or feelings of pelvic heaviness. Your doctor may also recommend a non-invasive treatment that uses ultrasound waves to help break up troublemaking fibrous tissue. You can also try our top home remedies to shrink smaller fibroids naturally.
Pelvic congestion syndrome
Another possible cause of pressure in the pelvic area is pelvic congestion syndrome (PCS), a condition in which the veins in your pelvis aren’t functioning properly and become enlarged.
“When excess blood builds up in the blood vessels, it can feel like heaviness in the pelvis,” explains Hill. “You might also have a sensation of throbbing or pulsating, as with other vascular issues. You might feel more heaviness when you are standing or standing for a long period of time, but it might improve when you start to move or lie down.”
Women aged 20 to 45 who have given birth vaginally more than once are at the greatest risk of PCS, and it’s unlikely for postmenopausal women to develop the condition if they don’t have it already. However, varicose veins or a family history of the condition may also increase your risk of PCS.
How it’s treated: Hormonal medications may help reduce blood flow to prevent build-ups that cause pelvic pain, as can minimally-invasive procedures that target troublesome veins where blood tends to pool.
How to identify what’s causing a feeling of heaviness in the pelvic area
Figuring out the underlying cause of pelvic heaviness involves a detailed conversation with your doctor where you should discuss any related symptoms, such as changes in urination, bowel movements, sexual discomfort, menstrual issues or pain, he says.
Then, a physical exam should help identify conditions like fibroids, pelvic organ prolapse or other structural concerns. If necessary, a pelvic ultrasound may be ordered, notes Dr. Radtke.
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