Causes of pain in the lower abdomen

Posted onJanuary 19, 2018 in Pain

The pains in the lower abdomen in women can have many different causes, connected both with female physiology and anatomical structure, as well as due to diseases, dysfunctions and pathologies that do not depend on the sex of the patient.

Most of the pain in the lower abdomen occurs with violations of the functions of the gastrointestinal tract, urinary system, reproductive organs, but can also occur as a result of a violation of the innervation of the nerves due to infringement in the lumbar spine, systemic disease (eg Crohn’s disease), overstrain of the peritoneum muscles , increased gas formation or sensitivity in ovulation and menstrual periods. How to determine the cause of pain in the abdomen?

Abdominal pain: organic causes

The pains at the bottom of the peritoneal region, with a clear and diffuse localization (right, left, at the bottom, covering the entire lower abdomen) can arise as a consequence of organic causes and physiological processes in women. The pain syndrome can also accompany physiological processes, for example, painful sensations when the intestine is opened with gases formed during digestion, or pain when adapting the musculoskeletal system to the growing volume of the uterus during the period of gestation.

The pains in the lower abdomen with organic disorders are caused by various diseases and can occur in the following cases:

  • with diseases of the organs of the reproductive system (endometritis, endometriosis, ovarian apoplexy and cystic formations in this organ, andeksitah, uterine myoma, etc.);
  • with diseases and pathologies of the urinary system, digestive tract, acute surgical pathologies (appendicitis, cholecystitis, pyelonephritis, bladder inflammation, intestinal infections, etc.);
  • the presence of a foreign body in the uterine cavity (intrauterine device, especially if the rules of use are not observed, the timing of replacement, spiral growth in the endometrium);
  • pathology of the gestation period: ectopic pregnancy, developing miscarriage, the process of premature detachment of the placenta, the consequences of medical abortion and other surgical interventions.

Pain sensations are determined by the nature of the disease or pathology and can be characterized as sharp, pulling, grasping, aching, spilling, stitching, sharp, blunt, etc.

Pain in the lower abdomen as a symptom of appendicitis

Inflammation of the appendix or appendicitis, contrary to popular belief, may be accompanied not only by pain in the iliac region to the right. The classical picture of appendicitis starts with pain in the epigastric region, most often shifts to the right, but the pain can spread to other parts of the abdominal cavity and irradiate to the lower back. Expression and a variety of sensations can be replaced from acute, cutting pains to stupid and aching depending on the severity of the inflammatory process. Appendicitis is also accompanied by an increase in body temperature, symptoms of general malaise (nausea, vomiting, chills).

Pain in intestinal infections

With the development of the intestinal infection, the pain begins with a dull, non-localized pain that covers most of the peritoneum, later concentrating in the lower abdomen with a return to the lumbar region.

Pain in infections of the urinary system

Most often, with cystitis, pyelonephritis, the abdomen is hurting in women, male patients with urinary tract diseases note a different symptom due to the different anatomical structure of the body.

Pain in infectious diseases of this type is accompanied by frequent urge to urinate, possibly the presence of bloody inclusions in the urine. In pyelonephritis, pain in the lumbar region is also noted, often – body hyperthermia, signs of general intoxication (decreased appetite, nausea, headaches, etc.).


Endometriosis, the proliferation of endometrial cells, characteristic of the uterine cavity, in the intrauterine space and beyond, is most often expressed as pulling pains that build up in the premenstrual and menstrual periods. Painful sensations differ depending on the stage of the disease and localization: the abdomen in the middle region hurts during the growth of the endometrium in the uterine cavity, with the retrocervical form of endometriosis and the proliferation of tissues in the appendages may hurt below the abdomen, in the inguinal or pubic region.

Pain as a symptom of ovarian apoplexy

Apoplexy of the ovary develops due to rupture of the ripened follicle in the ovulatory period. The condition is accompanied by damage to the ovarian vessels, a hemorrhage into the cavity of the peritoneum. To provoking factors include intense physical activity, sexual intercourse, etc.

A sharp pain on the right or left (depending on the location of the damaged ovary) in a woman during ovulation, accompanied by a drop in blood pressure, a syncope, a pallor of the skin – an occasion for an urgent call of a specialist. Apoplexy of the ovary is a condition that threatens life and requires emergency surgery.

Pain in uterine myoma

Myoma of the uterus is accompanied by pain in the lower abdomen with a formed formation of considerable size, exerting pressure on surrounding tissues and neighboring organs (aching, drawing pain), and also in the derivation of the formation: the rejecting myomatous node is accompanied by cramping pains, bleeding from the vagina. Treatment is exclusively surgical.

Ovarian cysts: pain in torsion of the legs

Ovarian cyst is a formation consisting of a body and a “leg” containing blood vessels. With physical effort, falling, abrupt movements of the trunk, gymnastic exercises, the leg of cystic education is prone to twisting due to displacement of the body’s position of the cyst. At partial twisting disturbed the outflow of venous blood from the body of the cyst, which is accompanied by drawing, aching pains from the side of the affected ovary.

Full torsion of the foot stops the flow of arterial blood, causing tissue necrosis. This process is accompanied by a clinical picture of the “acute abdomen”: strong, cramping pains in the lower abdomen on the right or left, hyperthermia, signs of poisoning the body. Urgent surgical intervention is required.

Inflammation of the appendages, uterine cavity

Antexitis, salpingoophoritis, endometritis, inflammation of the uterus and its appendages of various etiologies, depending on the form of the disease, can be accompanied by both aching, pulling pains in the lower abdomen and inguinal region, and by pronounced painful sensations accruing upon palpation of the inflamed organ.

Pain in ectopic pregnancy

Implantation of the egg after fertilization outside the uterine cavity (most often in one of the fallopian tubes, less often inside the ovary, in the peritoneum) is accompanied by a pain in the lower abdomen with a pulling, aching character, with irradiation into the lumbar region.

With the growth of the embryo, increased pressure on surrounding tissues begins, with tubal pregnancy without surgery, accompanied by rupture of the fallopian tube, severe, severe pain, internal hemorrhage. Treatment emergency, operative.

Why does the abdomen hurt in women during pregnancy?

The first trimester of the gestation period is often accompanied by painful sensations in the abdomen. Rooting lower abdomen, in the groin area may, in threatened abortion in the first months, ectopic pregnancy, accompanying bearing and sharpening his background diseases.

However, most of these nagging, aching pain are called “the tone of the uterus” and represent the physiological process of the muscle tissue and ligaments adapt to changes in the reproductive organ. In the absence of additional symptoms, such painful sensations do not require therapy or anesthesia. In some cases, drugs-antispasmodics (Papaverin, No-Shpa) can be prescribed.

Match abdomen below the second and third trimester may also because of the rising load on the ligaments, accompanied by softening ligament tissue, calcium deficiency, the pressure on the cervix. Normally, physiological pains do not need treatment and pass during relaxation, change in body position, moderate physical activity.
Sharp, severe pain in the abdomen with the localization of the low location of the placenta may be a sign of its premature detachment and require urgent medical attention. Cramping, periodic uterine voltage can be both a sign of the beginning of “training bouts” Braxton-Hicks contractions, physiologically normal and symptom of threatened miscarriage. When any new painful sensations appear, a specialist consultation is necessary.


This diagnosis is most common in the age of puberty and the formation of organs of the reproductive system. Algodismenorea is accompanied by pains before menstruation. It requires differentiation from premenstrual syndrome, endometritis, endometriosis, stagnant phenomena associated with the bending of the uterus, intrauterine inflammatory diseases, etc.

Why does the abdomen ache in the middle of the menstrual cycle?

Pain during the period of ovulation occurs in about 10% of women of reproductive age. They are usually characterized as stitching, localized from one of the ovaries (lower right or left), or pulling, accompanied by a feeling of “dense lump” in the lower abdomen.

As a rule, such feelings last no more than 24-48 hours, ending with the release of the ovum from the ovary. If you pay attention to the vaginal discharge, then on this day they will be more mucous, dense, “vitreous,” small bloody inclusions are possible.

Such pain, not accompanied by additional symptoms, does not require treatment. It is possible to take single-dose antispasmodics or pain medications as prescribed by a doctor.

Pain after sex

Most often, the pain after the end of the sexual intercourse, not accompanied by orgasmic contractions, is associated with swelling of the tissues, the flow of blood to the organs in the process of excitation. There are also painful sensations associated with traumatizing the tissues with an excessively intense sexual intercourse, and pain as a symptom of pelvic organs: adhesions, endometriosis, endometritis or undexitis in chronic form, cervicitis, tumoral neoplasms of the genital organs.

Pain is most often a sign of disorders, dysfunctions, painful processes in organs and tissues. The physiological causes of the painful sensations of the female reproductive system are limited by the menstrual cycle, ovulation, the gestation period and are manifested, as a rule, by drawing, aching pain, limited in time and arising on certain days and periods.

All other manifestations should become an occasion for examination by a specialist and a course of treatment.

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