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24+ Reasons for Lower Abdominal Pain in Females – Complete Guide

Knowledge Hub

10 mins readFact Checked
Author of post icon

Written By:

Atif Riaz

Medically Reviewed By:

Mr M. Usman

lower abdominal pain in a female wearing yellow clothing standing in front of pink background

Lower abdominal pain in females is a common and distressing symptom experienced by many women, encompassing a wide range of potential causes that can vary from benign to serious.

Lower abdominal pain in females serves as a significant indicator that prompts attention and necessitates thorough medical evaluation to identify the underlying condition. Understanding the diverse array of factors contributing to lower abdominal pain is crucial as it enables accurate diagnosis, appropriate management, and alleviation of symptoms.

From menstrual cramps to pelvic inflammatory disease, ovarian cysts, endometriosis, urinary tract infections, gastrointestinal disorders, and even the possibility of ectopic pregnancy, the complex nature of lower abdominal pain in females requires careful examination and consideration of multiple factors. By delving into the origins and distinguishing features of these causes, we can enhance our comprehension of this symptom and empower individuals to seek timely medical intervention, ultimately leading to improved quality of life and peace of mind.

What are the causes of lower abdominal pain in females?

Lower abdominal pain in females is a complex symptom that can arise from a multitude of factors, ranging from minor inconveniences like gas and constipation to potentially severe conditions such as ovarian cysts and cancer.

While occasional bouts of lower abdominal pain are not uncommon among women, it is crucial to pay attention to persistent or severe pain and seek medical attention promptly. Consulting a healthcare professional when experiencing lower abdominal pain is essential to accurately identify the underlying cause and ensure appropriate treatment. It’s worth noting that the causes of lower abdominal pain in females can vary depending on the specific location within the lower abdomen, highlighting the intricacy and diversity of potential sources for this discomfort. By recognising the significance of addressing lower abdominal pain and understanding its potential origins, individuals can take proactive steps toward their health and well-being.

Common causes of pain in the lower abdomen in females

Trapped wind/bowel gas

Trapped wind can also cause pressure on surrounding organs and structures, which can also affect nerve endings and lead to abdominal pain in females. The diaphragm, a muscle separating the chest and abdomen, can sometimes also be irritated by trapped gas. This irritation can result in referred pain, which is felt in the lower abdomen but originates from the diaphragm.

abdominal trapped wind and gas a cause for abdominal pain in women
https://www.everydayhealth.com/

Accumulation of excess air or gas in the digestive system or if it gets trapped or unable to pass through the gastrointestinal tract efficiently, can lead to discomfort and pain in the abdomen.  Excessive gas in the digestive system can cause the intestines to stretch or distend. This stretching of the intestinal walls can lead to a sensation of fullness, bloating, and abdominal pain. The pain is often described as cramp-like or aching.

x-ray image showing abdominal distension
https://www.bmj.com/content/352/bmj.i1382.full

Trapped wind can also cause irregular contractions or spasms in the intestines, contributing to abdominal pain and cramping sensations.

Gastrointestinal Disorders

Conditions such as gastroenteritis, constipation, diverticulitis, and inflammatory bowel disease can cause lower abdominal pain in females. These conditions are typically accompanied by other digestive symptoms like diarrhoea, constipation, bloating, or changes in bowel habits.

Muscular pain

The muscles in the abdominal region, including the rectus abdominis, obliques, and transverse abdominis, can experience strain, inflammation, or injury, leading to abdominal pain. Common examples include muscle strain, muscle spasms, diaphragm Issues, muscle inflammation and muscle trigger points.

female abdominal muscles causing pain
https://www.womeninfocusphysio.com.au/

Menstrual Cramps

During the menstrual cycle, many women experience lower abdominal pain and cramping, known as dysmenorrhea. This is caused by the contraction of the uterus as it sheds its lining. Menstrual cramps are an extremely common cause of lower abdominal pain in females.

Pelvic Inflammatory Disease (PID)

PID is an infection of the female reproductive organs, usually caused by sexually transmitted bacteria. It can lead to lower abdominal pain in females. Other typical symptoms include abnormal vaginal discharge, fever, painful intercourse, and irregular menstrual bleeding.

Endometriosis

Endometriosis is a condition in which the tissue lining the uterus (endometrium) grows outside the uterus, commonly on the ovaries, fallopian tubes, or other pelvic organs including the bowel. It can cause chronic lower abdominal pain, heavy or irregular periods, pain during intercourse, and in some instances infertility. It can often be very debilitating for women who may also suffer from bowel problems due to inflammation.

Irritable Bowel Syndrome (IBS)

IBS is a chronic disorder affecting the large intestine, characterised by abdominal pain, bloating, gas, and changes in bowel habits. The pain is often felt in the lower abdomen and may be relieved by passing stool.

Ovarian cyst

Ovarian cysts, fluid-filled sacs that develop on or within the ovaries, are a common occurrence. Although most ovarian cysts are benign and resolve on their own, some can cause various symptoms, including abdominal pain in females.

Cysts can contribute to abdominal pain through several mechanisms, such as increased pelvic pressure, ovarian torsion (twisting of the ovary leading to compromised blood supply), or the risk of cyst rupture (bursting). These factors can result in discomfort or sharp abdominal pain, highlighting the potential impact that ovarian cysts can have on a person’s well-being. An ultrasound scan is often a useful imaging tool to diagnose ovarian cysts.

Fibroids

Fibroids are noncancerous growths that develop in or on the uterus. While many women with fibroids may not experience any symptoms, lower abdominal pain can occur depending on the fibroids’ size, number, and location.

The fibroids can cause increased pressure and distension of the abdomen if they grow large, leading to excess pressure on surrounding organs and tissues, including the abdominal area. Fibroids can also distort the womb the shape and structure of the uterus, leading to abdominal or pelvic pain in females. The abnormal positioning and enlargement of the uterus due to fibroids can cause stretching and cramping sensations. If the fibroids are very large, sometimes this can impair the blood flow to the uterus and surrounding tissues, resulting in ischemia (lack of oxygen-rich blood) and subsequent pain in the affected area.

Occasionally, some fibroids can undergo degeneration, which is a process where the fibroid tissue starts to break down. This can cause sudden and severe abdominal pain, tenderness, and swelling. Degeneration typically occurs when fibroids outgrow their blood supply.

Pregnancy

During pregnancy, the female body undergoes various changes and adapts to accommodate the growing baby.

abdominal pain in a pregnant female
Ziga Plahutar / Getty Images

Abdominal pain in females who are pregnant can be a normal part of a healthy pregnancy, but in some instances, it can also be a sign of an underlying problem.

A common cause of abdominal pain in pregnancy is round ligament pain. This is caused by the uterus expanding due to the pregnancy, which causes the ligaments that support it (round ligaments) to stretch which often causes short bouts of sharp pain or cramping in the lower abdomen. It is often more common in the second trimester

Another common cause is Braxton hicks contractions. These mild, irregular contractions can occur throughout pregnancy and are considered normal. They can cause discomfort or a tightening sensation in the abdomen, which may be mistaken for abdominal pain. However, Braxton Hick’s contractions typically do not become progressively stronger or more frequent.

Pregnancy can also cause pain caused by gas, bloating and constipation. These are common issues in pregnancy and are caused by hormonal changes that slow digestion, leading to increased gas and bloating.

Preterm labour or miscarriage are also likely to cause abdominal pain or cramping accompanied by other concerning symptoms such as vaginal bleeding or back pain. Immediate medical attention is necessary in such cases.

Ectopic pregnancy

An ectopic pregnancy occurs when a fertilised egg implants itself outside the uterus, commonly in the fallopian tubes. It can cause severe lower abdominal pain, vaginal bleeding, dizziness, and shoulder pain. Ectopic pregnancies are medical emergencies and require immediate attention.

Urinary Tract Infection (UTI)

Urinary tract infections are bacterial infections that can affect the bladder, urethra, or kidneys.

UTIs are also more common in pregnancy due to hormonal changes and the pressure exerted on the urinary system by the growing uterus. Lower abdominal pain in females is a common symptom, along with a frequent urge to urinate, a burning sensation during urination, cloudy or bloody urine, and fever.

Bladder stones

Bladder stones are hard mineral deposits that form in the bladder. Growing in size or becoming numerous can lead to various symptoms, including abdominal pain. Stones in the bladder can lead to irritation and Inflammation of the bladder wall, obstruction or blockage of the urine or infection (cystitis) all of which can cause abdominal pain in females. 

Crohn’s disease

Crohn’s disease is a chronic inflammatory bowel disease that can affect any part of the digestive tract, from the mouth to the anus. Abdominal pain is one of the most common symptoms experienced by individuals with Crohn’s disease. Chronic inflammation of the digestive tract can lead to crampy or colicky type of abdominal pain. The severity and location of the pain can vary depending on the specific area affected by the disease.

crohns disease in the bowel segments of a female
https://healthmatters.nyp.org/

The inflammation in Crohn’s disease can cause the formation of ulcers and lesions in the lining of the digestive tract, which can cause discomfort, especially when they come into contact with food or stool passing through the intestines.

Over time, the inflammation and scarring associated with Crohn’s disease can lead to the narrowing of the digestive tract, resulting in bowel obstructions and pain. In some cases of Crohn’s disease, abnormal tunnels (fistulas) develop. These tunnels connect to different parts of the digestive tract or even different organs and can cause more localised pain in the abdomen.

Additionally, abscesses, (pockets of infection or pus) can develop in the affected area, leading to more abdominal pain.

Some people with Crohn’s disease can also experience pain in the perianal area due to inflammation or abscesses around the anus. These symptoms can cause significant abdominal pain and discomfort.

Abdominal tumour

Tumours that develop in the abdominal area can lead to pain and discomfort due to tumour growth, compression of surrounding organs and structures, tumour invasion, obstruction of blood vessels and other bodily fluids, inflammation, infection and nerve impingement.

What causes pain in the right lower abdomen

Pain in the right lower abdomen in females can arise from various causes, some of which are more serious than others.

pain in the right lower abdomen in women
https://www.ligastrohealth.com/

The right lower abdomen, also called the right lower quadrant includes important structures such as the appendix, bowel, and parts of the small intestine, large intestine, and reproductive organs.

Pain in the right lower abdomen can indicate potential conditions such as appendicitis, mesenteric adenitis, ovarian cysts, gastrointestinal issues, urinary tract problems, and musculoskeletal factors. A wide range of factors can contribute to abdominal pain in this specific region. Let’s explore some of the potential underlying causes of pain in the right lower quadrant in females.

Appendicitis

Appendicitis refers to the inflammation of the appendix, a small finger-shaped organ located in the lower right abdomen. The inflammation is often due to a blockage, typically from a small piece of stool, a foreign object, or an infection.

The hallmark symptom of appendicitis is abdominal pain that typically starts around the belly button which often starts as a dull ache or discomfort then migrates to the lower right side of the abdomen and gradually becomes more localised and intense and steady. The pain will often worsen with movement, coughing, or deep breathing. Appendicitis can also cause loss of appetite, nausea, fever and elevated white blood cell counts.

Additional symptoms that may accompany abdominal pain in appendicitis include abdominal bloating, constipation or diarrhoea, difficulty passing gas, and a general sense of feeling unwell. Prompt medical attention is required.

Ovarian cyst

Women typically have two ovaries which are typically located on either side of the abdomen. One is on the right lower abdomen and one is on the left.

Ovarian cysts are sacs filled with fluid that form either on or within the ovaries. While the majority of ovarian cysts are typically benign and self-resolve, certain cysts can give rise to a range of symptoms, including abdominal pain in females. The presence of cysts can lead to abdominal pain through different mechanisms, such as the elevation of pelvic pressure, the occurrence of torsion (twisting of the ovary resulting in compromised blood supply), or the potential for cyst rupture.

Ectopic Pregnancy

An ectopic pregnancy occurs when a fertilised egg implants itself outside the uterus, commonly in the fallopian tubes but in some instances elsewhere in the abdomen. It can cause severe and worsening lower abdominal pain, vaginal bleeding, dizziness, and shoulder pain. Ectopic pregnancies are medical emergencies and require immediate attention.

Mesenteric lymphadenitis

Mesenteric lymphadenitis is an inflammation of the lymph nodes in the mesentery, the tissue that connects the intestines to the abdominal wall. It is most commonly caused by a viral or bacterial infection, similar to appendicitis. The inflamed lymph nodes can lead to abdominal pain, typically in the lower right lower abdomen.

Mesenteric adenitis can cause inflammation and swelling of the glands (lymph nodes) and cause them to become enlarged and swollen. This can result in abdominal pain that is usually localised in the lower right quadrant of the abdomen, similar to the location of pain in appendicitis.

Mesenteric adenitis can also cause referred pain as in some cases, the pain from inflamed mesenteric lymph nodes can be felt in different areas of the abdomen. It may be perceived as generalised abdominal pain rather than being confined to a specific quadrant. Mesenteric adenitis can cause additional symptoms such as fever, loss of appetite, nausea, vomiting, and sometimes diarrhoea. These symptoms may help differentiate mesenteric adenitis from other causes of abdominal pain in females.

What causes Pain in the left lower abdomen?

Pain in the left lower quadrant of the abdomen can arise from various causes some of which are more serious than others.

left lower abdominal pain in females
https://flo.health/

The left lower abdomen, also called the left lower quadrant, is an area of the body that encompasses structures such as the left ovary, fallopian tube, sigmoid colon, and parts of the small intestine. Pain can signify conditions like ovarian cysts, diverticulitis, endometriosis gastrointestinal disorders, urinary tract issues, and musculoskeletal factors. A wide range of factors can contribute to abdominal pain in females within this specific region. Let’s explore some of the potential underlying causes of pain in the left lower quadrant.

Diverticular Disease & Bowel Polyps

Females experiencing lower left abdominal pain often find its origins in the presence of polyps or diverticular disease. Polyps are minuscule growths that can develop on the inner lining of the colon, while diverticular disease refers to the formation of small pouches called diverticula within the wall of the large intestine. In both cases, inflammation and discomfort manifest in the lower left abdomen as these conditions take hold. Recognizing and addressing these potential causes with timely medical attention is crucial.

Ovarian Cysts

Ovarian cysts are fluid-filled sacs that develop on or within the ovaries. While many ovarian cysts are completely harmless and resolve on their own, some can cause various symptoms, including abdominal pain. Cysts cause abdominal pain in multiple ways such as causing increased pelvic pressure, torsion (twisting of the ovary cutting off its blood supply), and bursting (rupture of cyst). The severity and nature of abdominal pain caused by ovarian cysts can vary. Some individuals may experience mild or intermittent pain, while others may have more intense or persistent pain. An Pelvic Ultrasound Scan is often a useful imaging tool to diagnose ovarian cysts.

Ectopic Pregnancy

An ectopic pregnancy occurs when a fertilised egg implants itself outside the uterus, commonly in the fallopian tubes. It can cause severe lower abdominal pain, vaginal bleeding, dizziness, and shoulder pain. Ectopic pregnancies are medical emergencies and require immediate attention.

Muscular pain

The muscles in the abdominal region, including the rectus abdominis, obliques, and transverse abdominis, can experience strain, inflammation, or injury, leading to abdominal pain. Common examples include muscle strain, muscle spasms, diaphragm Issues, muscle Inflammation and muscle trigger points.

What causes abdominal pain when coughing?

Abdominal pain when coughing can be an uncomfortable and concerning symptom that in some instances needs medical attention. Coughing is a reflexive action that helps clear the airways, but it can also exert additional strain on the abdominal muscles and organs as the pressures inside the body change. Various factors can contribute to this type of pain, ranging from muscle strain and hernias to underlying gastrointestinal issues, urinary tract infections, or reproductive organ conditions. Let’s explore some of the potential underlying causes of pain when coughing

abdominal pain in females when coughing
https://www.prevention.com/

Muscle Strain

Coughing forcefully or frequently can strain the muscles in the abdomen, including the rectus abdominis or the muscles surrounding the ribs. This strain can lead to lower abdominal pain in females, which is typically temporary and improves with rest.

Hernia

Coughing can increase pressure in the abdominal area, potentially causing a hernia. A hernia occurs when an organ or tissue pushes through a weakened area in the abdominal wall. Coughing can exacerbate the hernia, resulting in lower abdominal pain or discomfort.

Gastrointestinal Issues

Conditions such as gastritis, gastric ulcers, or gastroesophageal reflux disease (GERD) can cause lower abdominal pain that worsens when coughing. Coughing can increase intra-abdominal pressure, leading to irritation or inflammation in the gastrointestinal tract.

Reproductive Organ Issues

Certain gynaecological conditions, such as ovarian cysts or endometriosis, can cause lower abdominal pain in females that is exacerbated by coughing. These conditions may be more noticeable or symptomatic during certain activities, such as moving in a certain way, moving into a particular position, working out or coughing.

Kidney Stones

Kidney stones are hard deposits made up of minerals and salts that form inside the kidneys. If a kidney stone is present in the urinary tract, coughing can lead to increased pressure and movement of the stone, causing pain in the side of the abdomen (loin) or lower abdominal pain.

What causes lower abdominal pain before a period

Lower abdominal pain before a period, commonly known as premenstrual abdominal pain, is a symptom experienced by many females that can significantly impact their daily lives.

The menstrual cycle involves intricate hormonal fluctuations and changes in the reproductive system, which can give rise to various physical and emotional symptoms.

Understanding the potential causes of abdominal pain in females before a period is crucial for accurate diagnosis and effective management. From the release of prostaglandins to ovulation-related discomfort, hormonal changes, and underlying conditions like endometriosis or pelvic inflammatory disease, a multitude of factors can contribute to abdominal pain in the premenstrual phase.

abdominal pain during period - image of uterus wrapped in sharp wire

Menstrual cramps

During the menstrual cycle, many women experience lower abdominal pain in females and cramping, known as dysmenorrhea. This is caused by the contraction of the uterus as it sheds its lining. Before menstruation, the body produces increased levels of prostaglandins, hormone-like substances that play a role in uterine contractions. Higher levels of prostaglandins can cause the uterine muscles to contract more forcefully, leading to lower abdominal pain in females before a period.

Ovulation

Some women experience lower abdominal pain around the time of ovulation, which occurs approximately two weeks before the start of the menstrual period. This pain, known as mittelschmerz, is caused by the release of an egg from the ovary and is usually felt on one side of the lower abdomen.

Hormonal changes

Fluctuations in hormone levels, particularly oestrogen and progesterone, during the menstrual cycle, can contribute to lower abdominal pain. These hormonal changes can affect the sensitivity of the uterus and pelvic muscles, leading to discomfort before the period.

Ovarian cyst

Ovarian cysts are fluid-filled sacs that form either on or within the ovaries. They can exhibit a range of effects on a woman’s health. While many ovarian cysts are benign and resolve on their own without causing any issues, certain cysts can lead to various symptoms, including abdominal pain.

The onset of abdominal pain from cysts can occur through different mechanisms, such as increased pelvic pressure, torsion (twisting of the ovary resulting in compromised blood supply), or cyst rupture.

The severity and characteristics of abdominal pain stemming from ovarian cysts can differ significantly among individuals, with some experiencing mild or intermittent pain while others endure more intense or persistent discomfort.

Endometriosis

Endometriosis is a condition in which tissues similar to the lining of the womb, grow outside the uterus, commonly on the ovaries, fallopian tubes, or other pelvic organs. Women with endometriosis often experience lower abdominal pain ranging from mild to extremely severe pain, which may worsen in the days leading up to their period.

Adenomyosis

Adenomyosis is a condition in which the endometrial tissue grows into the muscular wall of the uterus. It can cause lower abdominal pain, particularly before and during menstruation.

Pelvic Inflammatory Disease (PID)

In some cases, lower abdominal pain before a period may be a result of pelvic inflammatory disease (PID), an infection of the reproductive organs typically caused by sexually transmitted bacteria. PID can lead to pain and inflammation in the lower abdomen, along with other symptoms.

female lying down with abdominal pain

Lower abdominal pain in females: A quick summary

In conclusion, pain in the lower abdomen in females is a common symptom experienced by females that can arise from various causes.

Understanding and identifying the underlying factors contributing to lower abdominal pain in females is important for safe diagnosis and effective treatment. From gynaecological conditions such as ovarian cysts, endometriosis, or pelvic inflammatory disease to gastrointestinal disorders, urinary tract issues, and musculoskeletal factors, a wide range of potential causes could cause abdominal pain in some women.

Working closely with healthcare professionals to obtain an accurate diagnosis and develop a comprehensive management plan tailored to the individual and their particular needs is essential.

Google search nor an article like this, or any other article for that matter, can not and should not replace the advice from your medical practitioner/doctor. Equally, it can not replace your natural instincts. Therefore prompt medical attention for lower abdominal pain in females is always important. This could include a visit to the doctor’s office or hospital for a check-up, followed by a range of tests such as ultrasound scans or blood tests to help determine the cause of the lower abdominal pain and rule out any serious conditions.

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