Sudden stabbing pain in the pelvic area may occur for many reasons. Some causes of sudden stabbing pelvic pain are harmless. However, severe pain may indicate a medical problem, like an ovarian cyst, ectopic pregnancy, or endometriosis.

Some causes, such as round ligament pain and ovulation pain, are harmless and usually go away on their own. Severe pain, though, may indicate a ruptured cyst, infection, or another serious issue. The cause is more likely to be serious if the pain is intense, does not go away, and causes additional symptoms.

Pelvic pain is not always an emergency or even a sign of a medical problem. However, because some pelvic pain may signal an emergency, it is important to see a doctor for any sudden, intense pain that does not resolve on its own.

Read on to learn more about sudden stabbing pain in the pelvic area.

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The following are possible causes of sudden stabbing pelvic pain.

Ovarian cysts

Ovarian cysts are growths on the ovaries. They are usually harmless and often resolve on their own.

Sometimes they cause pain that may ache or become more intense, and rarely, they may rupture. They can also cause the ovary to twist, which is known as ovarian torsion.

Ruptured cysts are sometimes medical emergencies, but they can also be part of the ovulation process. However, in some cases, ruptured ovarian cysts or ovarian torsion can cause severe pain that makes a person unable to concentrate on anything other than the pain and feel dizzy or weak.

People who experience intense, unrelenting stabbing pain should speak with a doctor about whether or not medical attention is needed.

Endometriosis

Endometriosis causes tissue similar to the uterine lining to grow outside the uterus. It can cause chronic pelvic pain, heavy menstrual bleeding, and pain during sex.

While endometriosis is usually not a medical emergency, it can steadily undermine health and fertility. It is a progressive condition, which means it worsens over time, so it is important to seek medical attention if a person has symptoms of endometriosis.

It is also important to note that in rare cases, endometriosis can cause medical emergencies like torsion of an endometrioma, ureter blockage, and bleeding into the lungs.

Pelvic inflammatory disease

Pelvic inflammatory disease (PID) is an infection in the upper reproductive tract, such as in the uterus. It can cause chronic symptoms such as pain and infertility. Additionally, it can cause sudden, intense pelvic pain.

Sexually transmitted infections such as chlamydia and gonorrhea are common causes of PID.

If a person has PID, they may feel intense stabbing pain or develop signs of an infection, such as vaginal discharge or feeling sick. They may develop a fever in serious cases.

Round ligament pain

The round ligaments on either side of the uterus help stabilize the uterus. Some people experience round ligament pain during pregnancy as the uterus grows and stretches.

This pain is sharp and sudden — many people describe it as a stabbing or stretching sensation. Sudden movements may trigger it, especially sitting up from lying down or climbing.

Round ligament pain is not dangerous and usually goes away after pregnancy.

Ovulation pain

Ovulation pain is a type of pain that occurs right around the time of ovulation, midway between a person’s last period and their next. People sometimes call it mittelschmerz.

The pain is not dangerous but can cause mild aching or intense stabbing pain. If it does not go away, it may signal another problem.

Ectopic pregnancy

In a person who is pregnant or may be pregnant, an ectopic pregnancy can cause sharp, stabbing pain.

An ectopic pregnancy occurs when the egg implants outside the uterus, usually in the fallopian tubes. As the pregnancy grows, it puts pressure on the fallopian tubes and other structures, causing pain. Some people notice aching pain that becomes progressively worse.

If the pregnancy grows too large, it can rupture. This can cause life threatening bleeding, damage to the reproductive structures, and shock. If a person has symptoms of an ectopic pregnancy, they should seek medical attention.

  • vaginal bleeding
  • abdominal pain
  • a missed period
  • a positive pregnancy test

Muscle pain

Other types of soft tissue pain, such as a muscle spasm or a minor muscle injury, may occasionally cause pain.

Treatment depends on the cause.

Round ligament and ovulation pain do not require treatment, but a person might use pain relievers to ease symptoms.

An ectopic pregnancy is a medical emergency that requires immediate attention. If the pregnancy ruptures, a person may need additional treatment.

An ovarian cyst is usually harmless, but if it causes pain, it may have ruptured or caused another issue. A doctor may need to surgically remove it.

Many treatment options are available for endometriosis, ranging from oral contraceptives to reduce pain and bleeding to surgery to remove excess endometrial tissue. Similarly, treatment for PID varies, and depends on the cause. In most cases, a person will need antibiotics.

Contact a doctor about stabbing pelvic pain if:

  • It does not go away on its own.
  • It keeps coming back.
  • It is constant.
  • A person has other symptoms, such as infertility.

A person should seek emergency care if:

  • They are pregnant and experience intense, unexplained pain that does not get better.
  • A person experiences unbearable sudden pelvic pain.
  • A person has symptoms of a serious infection, such as a fever.

Sudden stabbing pelvic pain can happen for many reasons. If it lasts only for a moment and does not occur alongside other symptoms, it may be something minor.

However, pain is also the body’s way of warning that something is wrong. This is especially true if the pain is very intense or occurs with other symptoms.

Try to find a doctor who listens, takes one’s pain seriously, and recommends medical care when appropriate. They can help a person determine whether the cause of pain is gynecologic or something else.