Health Care for Women

What Causes Lower Abdominal Pain in Females: 8 Major Causes

As we are well aware, the female body contains many more internal organs in the abdominal area than a male's body. While a man’s reproductive organs are external, the female reproductive organs are internal. So, in addition to the organs in the abdominal cavity that we all share as humans, females have a few more organs that need to be considered when addressing “abdominal pain.”

First, let’s discuss what’s considered the “abdominal area” of the human body. The abdomen is the cavity of the human body and stretches from the chest to the pelvis. The abdominal cavity is usually broken down into the upper and lower abdomen. The entire abdomen contains the stomach, the upper and lower intestines, the pancreas, the liver, the gall bladder, the spleen and kidneys, and the appendix, as well as some major blood vessels. In females, add the uterus, ovaries, and fallopian tubes to the lower abdomen.

What Causes Lower Abdominal Pain in Females?

There are many things that can cause lower abdominal pain in women. Conditions like diverticulitis, inflammation of the diverticulum in the intestines, appendicitis, inflammation of the appendix, pancreatitis, inflammation of the pancreas, or liver issues can be very serious. The stomach and intestines are major culprits for abdominal pain as well. It can be as simple as eating or drinking something that irritates the stomach or intestines or as complicated as a lesion or tumor.

In women, there are several other organs that can become inflamed or diseased. Things like menstruation, miscarriage, or reproductive complications are a few of the situations that can be the causes of abdominal pain in women. Below are some of the more common and uncommon conditions that can cause abdominal pain in women.

1. Endometriosis

This is a disorder where the tissue that is supposed to grow inside of the uterus grows outside of it and attaches to the fallopian tubes, intestines, or other organs. It can cause mild to severe lower abdominal pain in females, pelvic pain, longer menstruation cycles, nausea and/or vomiting, bowel or urinary issues, and infertility. The causes of endometriosis are still unknown. Treatments involve the use of hormonal birth control, surgery, and pain management.

2. Ectopic Pregnancy

This is a condition where a fertilized egg embeds itself in the fallopian or anywhere else instead of the uterus. As the embryo grows, if not removed, it will rupture the ovary or fallopian tube, leading to a life-and-death situation in which the patient can bleed to death. The patient will have all the signs of pregnancy at first, swollen breasts and lack of period, but soon after will start to experience cramping to severe lower abdominal pain. Ectopic pregnancies can be dissolved with medication or can be removed via surgery.

3. Pelvic Inflammatory Disease

This is an inflammation or infection of the female reproductive organs. It can affect the ovaries, fallopian tubes, or uterus and is normally caused by bacteria that migrate from the vagina or cervix to the other reproductive organs. PID can also be a complication of an STD like chlamydia or gonorrhea. Pain may be absent or mild. Some will have a foul-smelling vaginal discharge, abnormal bleeding, nausea and vomiting, fever, or painful intercourse. Untreated PID can cause scarring, which can lead to ectopic pregnancy, infertility, and abscesses. Early intervention is key.

4. Uterine Fibroids

This is a condition where benign tumors grow in the uterus. Symptoms depend on the location and the size of the tumor. They can range from a dull ache or a feeling of pressure to bleeding during intercourse, trouble with urination, and infertility. Once a fibroid outgrows its blood supply, the patient will experience sharp or chronic pelvic pain, trouble urinating, and heavy vaginal bleeding in between periods. More than 70% of women in their reproductive years suffer from uterine fibroids.

5. Ovarian cysts

These are fluid-filled sacs that grow on the ovaries. They are very common, especially during child-bearing years, and most resolve on their own with no intervention. If a cyst grows very large, it can cause lower abdominal pain, sharp pain in the breast, and heaviness in the lower back and legs. If a cyst bursts, you may spot blood or have a sudden sharp pain on one side. If the cyst doesn’t resolve on its own, medication or surgery is recommended. Women in or near menopause are at higher risk of developing a cancerous tumor on the ovaries, so they should always consult with their physician if they experience any of the symptoms above.

6. Pregnancy

Prior to knowing that you may be pregnant, you can experience belly and pelvic pain. As the baby grows in the uterus, the mom’s bones and ligaments move to make room. This can cause discomfort. Cramping and discomfort can also occur early in pregnancy. If pain is severe or disturbing, or if vaginal bleeding occurs, it warrants a call to the physician.

7. Cancer

Cancer can occur in any organ of the body. In women, lower abdominal pain can be an indicator of malignancy. The pain may be vague and, many times, is attributed to gas or constipation. However, with something like ovarian cancer, the pain will not resolve. The patient may notice belly bloating or a strong urge to urinate. They may also experience weight loss. It is important to have any abdominal pain that is constant or increasing in severity checked by your physician.

8. Ovulation and Menstruation

Ovulation occurs in women of childbearing age. This is when the ovaries release an egg. If the egg gets fertilized, the woman will become pregnant. If the egg is not fertilized, the woman will experience menstruation. Menstruation is the shedding of the lining of the uterus. During either, a woman can experience bloating, cramping, and pain. This is normal; however, if the pain is intense or feels different than in the past, it’s time to contact your physician.

These are some of the major factors that can help you learn what causes lower abdominal pain in females, but abdominal pain may be caused by something innocuous or something more sinister. If you experience belly pain and it does not resolve or is getting worse over time, contact your healthcare provider for a consultation.

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Author Profile: Laura Castricone, Respiratory Therapist

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