What Causes Lower Abdominal Pain in Females?

Table of ContentsView AllTable of ContentsCausesDescribing PainGetting ReliefUndiagnosed Pain

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Table of Contents

Causes

Describing Pain

Getting Relief

Undiagnosed Pain

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.triocean / Getty ImagesA Note on Gender and Sex TerminologyVerywell Health acknowledges thatsex and genderare 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 FemalesMany 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 CrampsMenstrual crampingis 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 ofprostaglandinhormones that cause the uterus to contract forcefully.PregnancyAs 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 PregnancyAnectopic pregnancyoccurs when an embryo develops outside of the uterus. This typically occurs as a fertilized egg gets stuck and attaches to thefallopian 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.When Pain Could Mean Ectopic PregnancyMiscarriageAmiscarriageoccurs 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 LaborPreterm labor, orpremature 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.EndometriosisEndometriosisoccurs when tissue similar to the endometrium (the inner lining of the uterus) grows outside the uterus, usually within the pelvis and the surroundingreproductive 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.AdenomyosisAdenomyosisis 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 themyometrium, the smooth muscle tissue of the uterus. This causes the following symptoms:An enlarged uterusFeelings of abdominal fullness or heavinessHeavy bleedingIntense crampingPelvic painFibroidsFibroidsare benign growths that form within the uterus. While they are not cancerous or dangerous, they can cause symptoms like generalizedpelvic pain, heavy bleeding, and urination problems in 20% to 50% of females.Ovarian CystsAnovarian cystis 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 canrupture, 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 SyndromePolycystic ovary syndrome (PCOS)is a hormonal disorder that results from high levels ofandrogenhormones. 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 DysfunctionPelvic 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.Pelvic Floor Therapy: What to ExpectPainful Bladder SyndromePainful bladder syndrome, called interstitial cystitis, causes chronic, central lower abdominalpainand 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 DiseasePelvic 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 aschlamydiaandgonorrhea, are the most common causes of PID. Symptoms include unusual vaginal discharge and pelvic pain with urination and intercourse.Cancers of the Female Reproductive TractPelvic pain can be a symptom of several types ofgynecologic cancersthat affect the female reproductive organs. Pelvic pain, bloating, and abnormal bleeding can occur with conditions such asovarian cancer,endometrial cancer, orcervical cancer.Describing Lower Abdominal Pelvic PainLower 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 SymptomsSome at-home treatment options can be used to decrease cramping and pelvic pain. These include:Over-the-counter (OTC) pain medication:Medications likenonsteroidal anti-inflammatory drugs (NSAIDs)such asTylenol (acetaminophen),Advil and Motrin (ibuprofen), orAleve (naproxen)can help decrease pain and inflammation.Heat:Heat therapycan involve using a heating pad, hot water bottle, warm bath, or shower, which may help relax cramping and decrease pain around your abdomen.Transcutaneous electrical nerve stimulation (TENS) machine:TENS machines apply electrodes to your skin to deliver a mild electrical current for pain relief.6 Tips to Reduce Period BloatingUndiagnosed Lower Abdominal Pain in FemalesMany 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.SummaryLower 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.

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.

triocean / Getty Images

A Note on Gender and Sex TerminologyVerywell Health acknowledges thatsex and genderare 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.

A Note on Gender and Sex Terminology

Verywell Health acknowledges thatsex and genderare 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 crampingis 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 ofprostaglandinhormones 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

Anectopic pregnancyoccurs when an embryo develops outside of the uterus. This typically occurs as a fertilized egg gets stuck and attaches to thefallopian 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.

When Pain Could Mean Ectopic Pregnancy

Miscarriage

Amiscarriageoccurs 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, orpremature 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

Endometriosisoccurs when tissue similar to the endometrium (the inner lining of the uterus) grows outside the uterus, usually within the pelvis and the surroundingreproductive 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

Adenomyosisis 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 themyometrium, the smooth muscle tissue of the uterus. This causes the following symptoms:

Fibroids

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

Ovarian Cysts

Anovarian cystis 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 canrupture, 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 ofandrogenhormones. 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.

Pelvic Floor Therapy: What to Expect

Painful Bladder Syndrome

Painful bladder syndrome, called interstitial cystitis, causes chronic, central lower abdominalpainand 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 aschlamydiaandgonorrhea, 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 ofgynecologic cancersthat affect the female reproductive organs. Pelvic pain, bloating, and abnormal bleeding can occur with conditions such asovarian cancer,endometrial cancer, orcervical 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:

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.

17 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American College of Obstetricians and Gynecologists (ACOG).Dysmenorrhea: Painful periods.American Pregnancy Association.Stomach pain in pregnancy.National Health Services.Ectopic pregnancy symptoms.Hendriks E, Rosenberg R, Prine L.Ectopic pregnancy: Diagnosis and management.Am Fam Physician.2020 May 15;101(10):599-606.UpToDate.Pregnancy loss (miscarriage): clinical presentations, diagnosis, and initial evaluation.Coddington CC, Cohen R.Chapter 6: Pregnancy loss and spontaneous abortion. In: DeFranco E, Evans AT, eds.Manual of Obstetrics. Wolters Kluwer Health; 2020:105-117.American College of Obstetricians and Gynecologists (ACOG).Preterm labor and birth.Nezhat C, Vang N, Tanaka P.Optimal management of endometriosis and pain.Obstetrics & Gynecology. 2019:134(4):834-839. doi: 10.1097/AOG.0000000000003461Johns Hopkins Medicine.Adenomyosis.De La Cruz MS, Buchanan EM.Uterine fibroids: Diagnosis and treatment.Am Fam Physician.2017 Jan 15;95(2):100-107. PMID: 28084714.U.S. Department of Health and Human Services. Office on Women’s Health.Ovarian cysts.Ajmal N, Khan SZ, Shaikh R.Polycystic ovary syndrome (PCOS) and genetic predisposition: A review article.Eur J Obstet Gynecol Reprod Biol X.2019 Jun 8;3:100060. doi: 10.1016/j.eurox.2019.100060Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).Pelvic floor disorders (PFDs).National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).Interstitial cystitis (painful bladder syndrome).American College of Obstetricians and Gynecologists (ACOG).Pelvic inflammatory disease (PID).Speer LM, Mushkbar S, Erbele T.Chronic pelvic pain in women.Am Fam Physician.2016 Mar 1;93(5):380-7.Centers for Disease Control and Prevention.Heavy menstrual bleeding.

17 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American College of Obstetricians and Gynecologists (ACOG).Dysmenorrhea: Painful periods.American Pregnancy Association.Stomach pain in pregnancy.National Health Services.Ectopic pregnancy symptoms.Hendriks E, Rosenberg R, Prine L.Ectopic pregnancy: Diagnosis and management.Am Fam Physician.2020 May 15;101(10):599-606.UpToDate.Pregnancy loss (miscarriage): clinical presentations, diagnosis, and initial evaluation.Coddington CC, Cohen R.Chapter 6: Pregnancy loss and spontaneous abortion. In: DeFranco E, Evans AT, eds.Manual of Obstetrics. Wolters Kluwer Health; 2020:105-117.American College of Obstetricians and Gynecologists (ACOG).Preterm labor and birth.Nezhat C, Vang N, Tanaka P.Optimal management of endometriosis and pain.Obstetrics & Gynecology. 2019:134(4):834-839. doi: 10.1097/AOG.0000000000003461Johns Hopkins Medicine.Adenomyosis.De La Cruz MS, Buchanan EM.Uterine fibroids: Diagnosis and treatment.Am Fam Physician.2017 Jan 15;95(2):100-107. PMID: 28084714.U.S. Department of Health and Human Services. Office on Women’s Health.Ovarian cysts.Ajmal N, Khan SZ, Shaikh R.Polycystic ovary syndrome (PCOS) and genetic predisposition: A review article.Eur J Obstet Gynecol Reprod Biol X.2019 Jun 8;3:100060. doi: 10.1016/j.eurox.2019.100060Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).Pelvic floor disorders (PFDs).National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).Interstitial cystitis (painful bladder syndrome).American College of Obstetricians and Gynecologists (ACOG).Pelvic inflammatory disease (PID).Speer LM, Mushkbar S, Erbele T.Chronic pelvic pain in women.Am Fam Physician.2016 Mar 1;93(5):380-7.Centers for Disease Control and Prevention.Heavy menstrual bleeding.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

American College of Obstetricians and Gynecologists (ACOG).Dysmenorrhea: Painful periods.American Pregnancy Association.Stomach pain in pregnancy.National Health Services.Ectopic pregnancy symptoms.Hendriks E, Rosenberg R, Prine L.Ectopic pregnancy: Diagnosis and management.Am Fam Physician.2020 May 15;101(10):599-606.UpToDate.Pregnancy loss (miscarriage): clinical presentations, diagnosis, and initial evaluation.Coddington CC, Cohen R.Chapter 6: Pregnancy loss and spontaneous abortion. In: DeFranco E, Evans AT, eds.Manual of Obstetrics. Wolters Kluwer Health; 2020:105-117.American College of Obstetricians and Gynecologists (ACOG).Preterm labor and birth.Nezhat C, Vang N, Tanaka P.Optimal management of endometriosis and pain.Obstetrics & Gynecology. 2019:134(4):834-839. doi: 10.1097/AOG.0000000000003461Johns Hopkins Medicine.Adenomyosis.De La Cruz MS, Buchanan EM.Uterine fibroids: Diagnosis and treatment.Am Fam Physician.2017 Jan 15;95(2):100-107. PMID: 28084714.U.S. Department of Health and Human Services. Office on Women’s Health.Ovarian cysts.Ajmal N, Khan SZ, Shaikh R.Polycystic ovary syndrome (PCOS) and genetic predisposition: A review article.Eur J Obstet Gynecol Reprod Biol X.2019 Jun 8;3:100060. doi: 10.1016/j.eurox.2019.100060Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).Pelvic floor disorders (PFDs).National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).Interstitial cystitis (painful bladder syndrome).American College of Obstetricians and Gynecologists (ACOG).Pelvic inflammatory disease (PID).Speer LM, Mushkbar S, Erbele T.Chronic pelvic pain in women.Am Fam Physician.2016 Mar 1;93(5):380-7.Centers for Disease Control and Prevention.Heavy menstrual bleeding.

American College of Obstetricians and Gynecologists (ACOG).Dysmenorrhea: Painful periods.

American Pregnancy Association.Stomach pain in pregnancy.

National Health Services.Ectopic pregnancy symptoms.

Hendriks E, Rosenberg R, Prine L.Ectopic pregnancy: Diagnosis and management.Am Fam Physician.2020 May 15;101(10):599-606.

UpToDate.Pregnancy loss (miscarriage): clinical presentations, diagnosis, and initial evaluation.

Coddington CC, Cohen R.Chapter 6: Pregnancy loss and spontaneous abortion. In: DeFranco E, Evans AT, eds.Manual of Obstetrics. Wolters Kluwer Health; 2020:105-117.

American College of Obstetricians and Gynecologists (ACOG).Preterm labor and birth.

Nezhat C, Vang N, Tanaka P.Optimal management of endometriosis and pain.Obstetrics & Gynecology. 2019:134(4):834-839. doi: 10.1097/AOG.0000000000003461

Johns Hopkins Medicine.Adenomyosis.

De La Cruz MS, Buchanan EM.Uterine fibroids: Diagnosis and treatment.Am Fam Physician.2017 Jan 15;95(2):100-107. PMID: 28084714.

U.S. Department of Health and Human Services. Office on Women’s Health.Ovarian cysts.

Ajmal N, Khan SZ, Shaikh R.Polycystic ovary syndrome (PCOS) and genetic predisposition: A review article.Eur J Obstet Gynecol Reprod Biol X.2019 Jun 8;3:100060. doi: 10.1016/j.eurox.2019.100060

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).Pelvic floor disorders (PFDs).

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).Interstitial cystitis (painful bladder syndrome).

American College of Obstetricians and Gynecologists (ACOG).Pelvic inflammatory disease (PID).

Speer LM, Mushkbar S, Erbele T.Chronic pelvic pain in women.Am Fam Physician.2016 Mar 1;93(5):380-7.

Centers for Disease Control and Prevention.Heavy menstrual bleeding.

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