Differences between men and women

In addition to various causes, which can cause pain symptoms in the pubic bone area in equal parts for both sexes, there are also gender-specific triggers. Among the most important male diseases that can lead to painful, burning / piercing / stabbing / pulling discomfort behind the pubic bone are certain prostate disorders. These can also cause pulling in the testicles.

Inflammation of the prostate (prostatitis), which affects about 10% of all men once in a lifetime, can – whether acute or chronic – in addition to painful and frequent urination, lead to just such a pain in the pubic and/or groin area, which can be intensified by urinating, ejaculating or during bowel movements. The most frequent causes of this inflammatory prostate disease are the Gram-negative rod bacteria Escherichia coli, which ascend to the prostate via the urinary tract. In addition, however, a permanent, abacterial inflammation of the prostate (abacterial prostatitis; protatodynia) can also occur, which usually leads to a chronic pain syndrome in the pelvis.

This clinical picture mainly affects men between the ages of 25 and 45 and is classified as a psychosomatic disease. The symptoms are similar to those of bacterial prostatitis, the cause of the development of these diseases is not yet clear. However, traumatic damage to the prostate gland in the past is suspected, which leads to inflammatory and swelling changes.

Gender-specific pubic pain in women primarily includes so-called symphyseal pain, which can occur mainly during an existing pregnancy and is caused by the loosening of the pubic symphysis. The pubic symphysis is a cartilaginous joint that holds together the front part of the pelvic ring and reacts to hormonal changes in the woman during pregnancy. Under the rising level of estrogen and relaxin in the blood, this cartilage structure and the ligaments surrounding it loosen and soften, which results in the widening of the pubic symphysis and thus also in the widening of the pelvic diameter in the context of preparation for childbirth. The pain over the pubic bone is mainly motion-dependent, worsens in the lateral position and can radiate into the sacrum or the thighs.