Have you ever experienced pelvic pain and wondered whether it could be linked to systemic lupus erythematosus (SLE)? You’re not alone. Many members of the MyLupusTeam community have shared this concern and asked, “Can lupus cause pelvic pain?”

One MyLupusTeam member wrote, “I have pain in my pelvic area, and when it’s bad, it’s hard to walk. Is this common?”

Another member shared, “I have recurring pelvic pain.”

Lupus can cause several problems that lead to pelvic pain, but the pain can also come from other causes. If you have lupus and pelvic pain, it’s important to talk with your doctor to find out what’s going on.

In this article, we’ll look at six possible causes of pelvic pain — some related to lupus and others not — and share tips on how to manage it.

What Causes Pelvic Pain in Lupus?

Lupus is an autoimmune disorder. The immune system makes proteins called antibodies that help break down viruses and bacteria that cause illnesses, diseases, and infections. In autoimmune diseases, these antibodies mistakenly attack a person’s own tissues and organs.

When the body attacks its own cells, it leads to inflammation. Inflammation leads to many of the painful and uncomfortable symptoms of lupus.

Lupus treatment usually involves medications including antimalarial drugs like hydroxychloroquine, as well as corticosteroids and immunosuppressants. Following your doctor’s treatment plan can help control inflammation and may reduce pelvic pain.

Sometimes, people with lupus feel pain even when doctors don’t see signs of swelling or damage. This can happen because lupus may affect how the brain and nerves feel pain, making things hurt more than they should. Doctors call this “central sensitization.”

Some people with lupus also have fibromyalgia, another condition that causes long-lasting pain throughout the body, including the pelvic area.

There are many reasons someone with lupus might have pelvic pain. Talking with your doctor is the best way to find out what’s causing it. Here are six possible causes of pelvic pain in lupus.

1. Joint or Muscle Pain

Because lupus causes inflammation, musculoskeletal pain (pain in the muscles, joints, and bones) is a common symptom. This can include pain in the lower back, hips, and pelvic area.

The pelvic floor — a group of muscles in your pelvis that includes the levator ani and the coccygeus — supports the bladder, uterus, and bowels. If these muscles become inflamed, you may experience pain similar to other muscle aches in your body.

Pelvic pain can also come from tight muscles in the pelvic floor, even if they’re not inflamed. These muscles can stay tense or spasm, which might feel like aching or pressure. This is sometimes called pelvic floor dysfunction.

Lupus can also affect the five major bones of the pelvis — the ilium, ischium, pubis, sacrum, and coccyx — leading to discomfort.

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

Another possible cause is avascular osteonecrosis, a condition where blood flow to the bone is reduced, leading to bone damage and pain, often in the hips.

If your pelvic pain lasts or interferes with daily life, talk to your rheumatologist for further testing and treatment.

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 can feel like discomfort in your lower back or sides, but it can also show up as pain in the pelvic area.

The main function of kidneys is to filter 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 run from your lower back down to your groin, infections or problems anywhere along that path can cause pain in the pelvic area. While these may be caused by lupus, they may also come from other health conditions.

3. Pelvic Infections

People with lupus have weakened immune systems, which means they’re more likely to get infections. This may include pelvic infections and sexually transmitted infections (STIs) such as gonorrhea or chlamydia.

Pelvic infections may cause yellow discharge, itching, and fever. However, because lupus affects the immune system, your body might not show typical signs of infection.

If you think you might have a pelvic infection, talk to your doctor right away.

While lupus can make infections worse, pelvic infections usually have other causes. Talk to your healthcare provider to figure out what’s going on. Finding and treating the real cause of your pain can help you feel better faster.

4. Gastrointestinal Disease

Sometimes, pain from the digestive system can feel like it’s coming from the pelvic area. Conditions that affect your stomach, intestines, or bowels can cause this kind of discomfort.

Common gastrointestinal (GI) diseases linked to lupus include:

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

Lupus and certain treatments for the condition can also cause digestive issues.

Other symptoms related to GI issues can include:

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

GI issues can also cause bowel spasms, which may lead to pain throughout the pelvic area. GI issues can also make menstrual symptoms worse and contribute to pelvic pain from other causes. Sometimes, lupus itself can cause belly pain if it affects the intestines or the lining of the abdomen. This kind of pain can feel similar to pelvic pain.

Changes in your diet and certain medications can help with some GI-related diseases. If you’re any GI symptoms — with or without pelvic pain — talk to your doctor.

5. Reproductive Health Problems

The female reproductive organs include the uterus, uterine lining, fallopian tubes, and ovaries. Because they are located in the pelvis, problems with any of these can cause pelvic pain, sometimes quite severe.

Common causes include:

• Ovarian cysts — Fluid-filled sacs that form on the ovaries
• Endometriosis — When tissue similar to the uterine lining grows outside the uterus
• Menstrual cramps — Cramping and pain during your period
• Uterine fibroids — Noncancerous tumors in the uterus
• Gynecologic cancers — Such as ovarian, endometrial, vulvar, cervical, and vaginal cancers

If you have pelvic pain — especially with heavy or unusual bleeding — tell your gynecologist. They can help figure out what’s causing it and recommend the right treatment.

6. Prostatitis

Prostatitis is a condition in which the prostate gland — a small organ located just below the bladder in the male reproductive system— becomes inflamed. This can lead to discomfort and various symptoms.

Prostatitis can be caused by an infection, but it often develops without one. It can cause pain during urination, lower back pain, and a frequent need to urinate. Some people may also feel pain in other areas of the male reproductive system.

If you notice these symptoms, see your doctor. In some cases, prostatitis can lead to a serious infection that needs antibiotic treatment.

Strategies for Managing Pelvic Pain

There are several ways to help manage and treat pelvic pain. The right approach depends on what’s causing it. Common treatment options include:

• Antibiotics — These may be used to treat bacterial infections such as UTIs, prostatitis, or pelvic infections.
• Hormone therapy — This may help if your pelvic pain is related to problems in the menstrual cycle.
• Physical therapy — Stretching, gentle exercises, and massage can help relax the pelvic muscles and ease pain.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) — These medications can help reduce inflammation and relieve pelvic pain.

If your pain is linked to nerve sensitivity, your doctor may recommend nerve pain medications or certain antidepressants. Your lupus treatment plan may also help with pelvic pain by calming inflammation in your body.

Always talk with your rheumatologist or healthcare provider before starting new treatments for your pelvic pain to make sure they don’t interfere with your existing lupus treatment plan.

Share Details of Your Pain

No matter what’s causing your pelvic pain, it's important to discuss all of your symptoms with your healthcare provider. Try to be as specific as possible when describing your pelvic pain:

• Does it come and go or stay constant?
• Is it a dull or sharp pain?
• Does it happen only during certain activities, like sex, urination, or exercise?

The more details you can give, the easier it is for your doctor to find the cause. They may order blood tests or clinical assessments to help make a diagnosis. Together, you and your doctor can create a treatment plan that helps relieve your pain and improve your quality of life.

Join the Conversation

On MyLupusTeam, people share their experiences with lupus, get advice, and find support from others who understand.

Have you experienced pelvic pain while living with lupus? Let others know in the comments below.