Sudden Stabbing Pelvic Pain: How It Feels and When It Repeats

Quick answer: what causes sudden stabbing pelvic pain?

A short, sharp stab low in the tummy is common. Ovulation pain, period pain, trapped wind, and constipation can all cause it. Pain that keeps coming back, gets worse, or stops your usual activities needs a doctor's check. Causes to rule out include an ovarian cyst, endometriosis, and nerve pain.

Call emergency services now if the pain is sudden and severe, or comes with fainting, dizziness, vomiting, a high temperature, heavy bleeding, or pain in the tip of your shoulder. The same applies to one-sided pain when you could be pregnant.

Stabbing pain and cramping pain

Two of the ways pelvic pain can feel are "a sharp, stabbing or burning pain that happens suddenly" and "a cramping or throbbing pain, which may come and go". People often describe cramps as waves that build and fade. A stab is sudden and usually in one spot.

The kind of pain gives a clue, but it does not tell you the cause on its own. When it happens, how long it lasts, and what comes with it tell you more.

Sharp pain during your period that does not feel like cramps

Period pain is not always a cramp. It can be "a sharp pain or a dull ache" in the tummy, and it can spread to the back and thighs. So a sharp pain on the first days of a period can be ordinary period pain, especially if it eases with painkillers and is similar every cycle.

Period pain can also feel like a deep ache, pressure, or heaviness. That can be normal too. What matters is the pattern.

Signs that sharp period pain needs a check

Period pain caused by a condition in the reproductive organs tends to get worse over time and to last longer than normal cramps. It may start a few days before a period and continue after it ends. See a doctor if your sharp period pain:

Is getting worse over several cycles
Starts days before your period or keeps going after it ends
Stops you from doing your usual activities, or painkillers do not help
Comes with pain during sex, or pain when you poo or pee
Comes with heavier periods, or bleeding between periods
Is new for you, after years of periods that did not hurt this way

Conditions that can cause sharp period pain

Endometriosis. Cells similar to the lining of the womb grow in other places, such as the ovaries and the lining of the pelvis. It can cause severe period pain, pain during or after sex, and pain when you poo or pee.
Adenomyosis. Womb-lining tissue grows into the muscle wall of the womb. It can cause heavy, painful periods.
Fibroids. Non-cancerous growths in or around the womb can cause heavy, painful periods.
Pelvic inflammatory disease (PID). An infection of the womb, tubes, and ovaries. It can make periods more painful than usual and needs antibiotics.
Ovarian cysts. Most cause no symptoms. A large cyst, or one that splits or twists, can cause pain from a dull ache to a sudden, severe, sharp pain.
An intrauterine device (IUD). An IUD can cause period pain, especially in the first 3 to 6 months.

Common causes of stabbing pelvic pain

Ovulation pain

Ovulation pain can feel like a dull pain or sharp sudden twinges. It happens about 14 days before a period, affects one side at a time, and lasts from a few minutes to 1 or 2 days. It is usually nothing to worry about. Painkillers or a warm bath may be all you need.

Ovarian cysts

A cyst that splits (ruptures) or twists can cause sudden, severe, sharp pain. A twisted ovary (ovarian torsion) is an emergency, because the twist can cut off the blood supply to the ovary. The pain of torsion can come and go if the ovary twists and untwists. Pain that comes and goes still needs urgent care.

Bowel and bladder

Constipation, irritable bowel syndrome, and urinary tract infections are among the common causes of pelvic pain. Trapped wind can cause sharp pain that moves. Pain that eases after you poo or pass wind points to the bowel.

Nerve pain

Pudendal neuralgia is nerve pain in the genitals, bottom, or pelvis. The pain is sharp, shooting, burning, or tingling, and it may be worse when sitting down. It is rare and is diagnosed by ruling out other causes.

Muscles

Pelvic muscle spasms and trigger points, tender spots in the muscle, are among the causes of chronic pelvic pain. Muscle pain often comes with certain movements or positions. A pelvic floor physiotherapist can assess and treat it.

When stabbing pelvic pain is an emergency

Call emergency services or go to the emergency department if you have pelvic pain and:

It is severe, getting worse, or hurts when you move or touch the area
You feel faint, dizzy, or lightheaded, or you pass out
You have pain in the tip of your shoulder
You have heavy bleeding from the vagina
You have a high temperature, or you are vomiting
You could be pregnant. One-sided pain with bleeding can be a sign of an ectopic pregnancy.

Tracking stabbing pelvic pain

Stabbing pain is often short and easy to forget. A record over two or three cycles shows patterns a single appointment cannot. For each episode, note:

The date, time, and cycle day, and whether you were bleeding
Where it was, and whether it spread
How it felt (stab, shooting, burning, ache) and how long it lasted
What you were doing, such as sitting, exercise, sex, or going to the toilet
What came with it, such as bloating, nausea, fever, or bleeding
What helped

The Endolog symptom tracker app lets you log pain type, location, and severity with your cycle and export a report for your doctor.

Managing stabbing pelvic pain

If a doctor has ruled out other causes:

Painkillers such as paracetamol or ibuprofen can help with period pain and ovulation pain. Anti-inflammatory painkillers target prostaglandins, the chemicals behind period cramps. Check with a pharmacist if you are not sure they are safe for you.
Heat on your tummy or a warm bath
Gentle exercise, such as walking, swimming, or yoga
Contraception such as the pill, implant, or injection. These thin the womb lining, which makes periods lighter and eases the pain. Contraception that stops ovulation can also stop ovulation pain.
Pelvic floor physiotherapy, if muscles are part of the problem

If the pain comes from endometriosis, adenomyosis, a cyst, or nerve pain, treatment depends on the cause.

FAQ: sudden stabbing pelvic pain

Why do I get sudden sharp pain in my pelvis during my period?

Period pain can be sharp, not only crampy. It can be a sharp pain or a dull ache. Sharp period pain that is getting worse, starts days before your period, or comes with pain during sex or when you poo or pee should be checked for conditions such as endometriosis or adenomyosis.

Is it normal to have pelvic pain during your period that is not cramps?

It can be. Period pain can feel sharp, achy, or heavy. See a doctor if the pain stops your usual activities, lasts longer than your period, or is different from what is normal for you.

Can ovulation cause stabbing pain?

Yes. Ovulation pain can feel like sharp sudden twinges on one side of the tummy, about 14 days before a period. It usually lasts from a few minutes to 1 or 2 days.

When is stabbing pelvic pain an emergency?

When it is sudden and severe, or it comes with fainting, dizziness, vomiting, a high temperature, heavy bleeding, or pain in the tip of your shoulder. One-sided pain when you could be pregnant also needs urgent care.

How can I tell if stabbing pain is from a cyst?

You cannot tell for sure without a scan. Cyst pain is often on one side and can range from a dull ache to sudden sharp pain. A doctor may refer you for an ultrasound, often with a probe placed inside the vagina.