Pelvic pain arising from the female reproductive system might be caused by conditions such as: 1  Adenomyosis. 2  Ectopic pregnancy (or other pregnancy-related conditions) 3  Endometriosis. Menstrual cramps (dysmenorrhea)  Miscarriage (before the 20th week) or intrauterine fetal 1  death. Mittelschmerz (ovulation 2  pain) Ovarian cancer.  Ovarian cysts.