Lower abdominal pain in women: possible causes

Lower abdominal pain is a sensation in the lower part of the abdomen, in the pelvic area. It can be sudden and sharp or last for months, stabbing at one point or diffuse and dull. Below is information about which organs and conditions can cause it, what the character of the sensations indicates, and when an urgent examination is needed.

Lower abdominal pain: what can be the source

The source of pain can be the pelvic organs: the uterus, ovaries, fallopian tubes, cervix, and vagina. In women and men, such pain can be a symptom of an infection or a problem with the urinary tract, lower intestine, rectum, muscles, or pelvic bones. The sensations can be constant or come in waves, localized or diffuse; severe pain interferes with everyday activities. In some women there is more than one cause at the same time, so diagnosis sometimes takes time: the symptoms resemble other common conditions.

By course, pain can be acute — sudden and sharp — or chronic, lasting six months or longer. Recurrent pain is pain that repeats over three months at least three times.

Gynecological causes of lower abdominal pain

Common causes include menstrual pain. Lower abdominal pain is also caused by conditions affecting the reproductive organs, such as an ovarian cyst or endometriosis. The sensations may appear only in certain situations: during exertion, during sex, or when urinating. Discomfort also occurs during pregnancy. Less often, it is a matter of more serious conditions — ectopic pregnancy, uterine cancer, ovarian cancer, pelvic inflammatory disease, or sexually transmitted infections.

Non-gynecological causes: intestines, bladder, lower back

The abdomen can hurt because of constipation or irritable bowel syndrome, or because of urinary tract infections. Pelvic pain often radiates to the lower back or covers the entire lower abdomen. Some causes require surgical care — appendicitis and peritonitis. That is why self-diagnosis does not work: similar sensations are caused by both harmless and dangerous conditions.

Character of the pain: stabbing, pulling, cramps, bloating

By describing the pain, you help the doctor narrow down the causes. The sensations can be as follows:

• sharp, stabbing, or burning, arising suddenly;
• increasing gradually and not going away;
• dull, heavy, like a feeling of pressure;
• twisting, knot-like;
• cramping or throbbing, coming and going.

Visceral pain comes from the organ itself, is poorly localized, is felt along the midline of the abdomen, and is often accompanied by sweating, nausea, vomiting, and pallor. Distension of a hollow organ causes spasmodic intermittent pain; bloating of the lower intestine is felt above the pubis. Pain from peritoneal irritation, by contrast, is well localized and worsens with movement.

How the doctor determines the cause: examination and workup

The conversation begins with details: where it hurts, for how long, what changes the sensations, whether there is a connection with the cycle, sex, urination, or stool. Next comes an examination, including a gynecological one, laboratory tests, and imaging, such as ultrasound of the pelvic organs and abdominal cavity; in some cases laparoscopy is used. For acute pain, a complete blood count is taken and a plain abdominal X-ray is performed, while esophagogastroduodenoscopy is done only if upper gastrointestinal bleeding is suspected. The workup plan depends on the cause found.

Warning signs: when urgent help is needed

You should make an appointment with a doctor if the pain comes and goes or does not go away, if bloating does not go away, if you are losing weight without trying, feel full quickly, or lose your appetite, or if constipation or diarrhea persists for a long time.

Seek help sooner, without waiting for a scheduled appointment, in case of difficulty urinating or passing stool, blood in the urine or stool, unusual discharge or vaginal bleeding, pain when urinating and frequent urges, very high fever and chills, vomiting and diarrhea, during pregnancy or if pregnancy is possible. If pain interferes with everyday activities, discuss it with a doctor.

Lower abdominal pain by itself is not a reason to call an ambulance; 103 or 112 — if the pain is sharp, worsening, or radiates with movement and touch, if you feel weakness, dizziness, or faint, if the tip of the shoulder hurts, it is hard to breathe, there is heavy vaginal bleeding, or sudden confusion appears.

This material is for reference: it helps to understand possible causes but does not replace an examination and consultation with a doctor.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer