What Causes Lower Abdominal Pain in Females?

Kristen Gasnick, PT, DPT
·7 min read

Conditions such as fibroids, endometriosis, and pregnancy-related disorders could be to blame

Medically reviewed by Kimberly Brown, MD

There are many different causes of lower abdominal pain, but there are unique issues that only affect females. Pain can be central, one-sided, or located on both sides of the lower abdomen. It may feel sharp, dull, or heavy. Many causes of lower abdominal or pelvic pain in females are linked to the menstrual cycle or structures of the female reproductive system.

This article will review the causes of lower abdominal pain in females and tips for symptom relief.

<p>triocean / Getty Images</p>

triocean / Getty Images



A Note on Gender and Sex Terminology

Verywell Health acknowledges that sex and gender are related concepts, but they are not the same. To reflect our sources accurately, this article uses terms like “female,” “male,” “woman,” and “man” as the sources use them.



Causes of Lower Abdominal Pain in Females

Many causes of lower abdominal pain in females are linked to the menstrual cycle or structures of the female reproductive system. These conditions are unique to females and can fluctuate depending on the stages of the menstrual cycle. Other times, pain may be worsened with activities such as urination or intercourse.

Menstrual Cramps

Menstrual cramping is commonplace leading up to and during the menstrual cycle. Menstrual cramps are typically felt throughout the entire pelvic region and can ebb and flow in intensity. "Dysmenorrhea" is the term used to refer to painful periods, which can result from high levels of prostaglandin hormones that cause the uterus to contract forcefully.

Pregnancy

As a growing fetus develops, the bones, ligaments, and muscles of the pelvis and lower abdomen need to stretch to accommodate the increase in size. A developing fetus can place a lot of pressure and strain on structures of the lower abdomen.

Ectopic Pregnancy

An ectopic pregnancy occurs when an embryo develops outside of the uterus. This typically occurs as a fertilized egg gets stuck and attaches to the fallopian tube. An embryo cannot develop and grow outside of the uterus, so an ectopic pregnancy always results in pregnancy loss. Pain with an ectopic pregnancy is located on one side of the lower abdomen.

Without treatment, an ectopic pregnancy can cause the fallopian tube or surrounding structures to rupture, which can cause severe complications or death in the mother. If an ectopic pregnancy ruptures, it is a medical emergency and can lead to severe internal bleeding.

Read Next: Nonsurgical and Surgical Ectopic Pregnancy Treatment

Miscarriage

A miscarriage occurs when a pregnancy is lost unexpectedly. Miscarriages often cause lower abdominal pain, bleeding, and passing of blood clots. Most miscarriages occur within the first trimester of pregnancy.

Preterm Labor

Preterm labor, or premature birth, occurs when the body initiates contractions and goes into labor before 37 weeks of gestation. Abdominal pain and cramping, pressure in the pelvis or lower abdomen, and uterus contractions are signs of preterm labor.

Endometriosis

Endometriosis occurs when tissue similar to the endometrium (the inner lining of the uterus) grows outside the uterus, usually within the pelvis and the surrounding reproductive organs. Endometrial-like tissue, called lesions, bleeds and causes chronic pain in the lower abdomen and pelvic regions. Complications include tissue adhering to surrounding structures, which can cause more pain and inflammation.

Adenomyosis

Adenomyosis is a condition that is similar to endometriosis, in which abnormal endometrial-like tissue grows. Instead of extending outside of the uterus, adenomyosis causes abnormal tissue to spread to the myometrium, the smooth muscle tissue of the uterus. This causes the following symptoms:

  • An enlarged uterus

  • Feelings of abdominal fullness or heaviness

  • Heavy bleeding

  • Intense cramping

  • Pelvic pain

Fibroids

Fibroids are benign growths that form within the uterus. While they are not cancerous or dangerous, they can cause symptoms like generalized pelvic pain, heavy bleeding, and urination problems in 20% to 50% of females.

Ovarian Cysts

An ovarian cyst is a fluid-filled sac that develops on one or both of the ovaries. Ovarian cysts are often harmless and painless and tend to go away on their own. But other times, ovarian cysts can rupture, causing sharp, sudden pain and heavy bleeding.

If ovarian cysts do cause symptoms, they include sharp or dull aches on one or both sides of the abdomen, pain with intercourse, and lower abdominal bloating.

Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is a hormonal disorder that results from high levels of androgen hormones. This leads to problems with the menstrual cycle, which can lead to infertility, and symptoms like the development of acne and facial hair.

Because PCOS impacts the menstrual cycle, it can cause irregular bleeding and increase the likelihood of developing ovarian cysts with associated pain and bleeding.

Pelvic Floor Dysfunction

Pelvic floor dysfunction results when the muscles that form the pelvic floor do not work properly, often resulting in pain. Pelvic floor muscles help support the core and organs of the lower abdomen.

Symptoms of pelvic floor dysfunction can vary from person to person, but typically include a feeling of heaviness, fullness, or aching in the vagina and pelvic regions, pain with urination and intercourse, and vaginal muscle pain and tightness. Pelvic floor dysfunction can result from a variety of different causes, but commonly occurs after childbirth, surgery, or chronic straining with urination or bowel movements.

Learn More: Pelvic Floor Therapy: What to Expect

Painful Bladder Syndrome

Painful bladder syndrome, called interstitial cystitis, causes chronic, central lower abdominal pain and pressure with urination. This condition is not clearly understood and is diagnosed when all other potential causes of bladder pain are ruled out.

Pelvic Inflammatory Disease

Pelvic inflammatory disease (PID) is an infection of the reproductive organs, including the uterus, ovaries, or fallopian tubes. It typically results from the spread of an infection from the vagina or cervix.

Sexually transmitted infections (STIs) such as chlamydia and gonorrhea, are the most common causes of PID. Symptoms include unusual vaginal discharge and pelvic pain with urination and intercourse.

Cancers of the Female Reproductive Tract

Pelvic pain can be a symptom of several types of gynecologic cancers that affect the female reproductive organs. Pelvic pain, bloating, and abnormal bleeding can occur with conditions such as ovarian cancer, endometrial cancer, or cervical cancer.

Describing Lower Abdominal Pelvic Pain

Lower abdominal pelvic pain in females can feel sharp or dull. Many conditions cause a feeling of pressure, bloating, or heaviness around the pelvis and lower abdomen. Pain can come and go in intense bursts or stay steady throughout the day. Pain may be brought on or made worse with urination or intercourse.

How to Relieve Lower Abdominal Pelvic Symptoms

Some at-home treatment options can be used to decrease cramping and pelvic pain. These include:

Related: 6 Tips to Reduce Period Bloating

Undiagnosed Lower Abdominal Pain in Females

Many symptoms of different causes of female pelvic pain overlap. If you experience ongoing abdominal pain during menstruation for more than two cycles, talk with your healthcare provider.

While some degree of menstrual cramping and associated discomfort is commonplace with menstruation, intense, debilitating menstrual cramping and pain that interferes with daily life and cannot be relieved with OTC medication is not normal.

You should also see your healthcare provider if you experience pain outside of menstruation, especially with urination or intercourse. This includes severe lower abdominal or pelvic pain and heavy bleeding. See your healthcare provider immediately if you experience other symptoms like nausea, light-headedness, dizziness, rapid heart rate, or fever.

Summary

Lower abdominal or pelvic pain in females can result from a variety of different conditions that affect the female reproductive organs. These include menstrual cramps, pregnancy, ectopic pregnancy, miscarriage, preterm labor, endometriosis, and more.

Pelvic pain, heaviness, and abnormal bleeding commonly occur in many of these disorders. See your healthcare provider if you experience ongoing severe lower abdominal or pelvic pain, heavy bleeding, and/or pain with urination or intercourse.

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