Dull pain in the lower abdomen in women. Why does the lower abdomen feel tight? Causes for men and women. Pain localized on the left side

Almost every woman knows what pain in the lower abdomen is. Pain may be intermittent or episodic, severe or mild, or combined with other symptoms. The source of pain is irritation of the nerve endings, which are located in the internal organs and surrounding tissues. There are enough such structures in the lower part of the abdominal cavity (pelvic area). These are the internal genital organs, the bladder with the urethra, parts of the large intestine, and the peritoneum. Therefore, various pathological processes that can affect these organs, in most cases, occur with pain.

How to differentiate pain in different diseases

The same inflammatory or somatic process, in which irritation of nerve endings occurs, is perceived differently by the body of different women. This depends not only on its intensity or the area of ​​damage to healthy tissue, but also on the patient’s pain threshold. As a result, pain during menstruation, for example, may be perceived by one woman as minor and well tolerated. Another patient cannot tolerate it and is forced to use painkillers.

Therefore, it is very important for diagnosing diseases of the pelvic organs in women to subdivide the pain syndrome into:

• functional;
• pathological.

It is the first type that includes characteristic pains, aching and periodic, sometimes spastic, that accompany the monthly renewal of the uterine mucosa in women of reproductive age. On the other hand, their intensification or very high intensity may no longer be considered functional or physiological. In these cases, it is possible to detect pathologies or anatomically incorrect location of the uterus and appendages. For example, when the angle between the cervix and the fundus of the uterus changes.

Pathological pain syndrome is called for a variety of diseases or conditions that affect the organs of the lower abdomen. In order to carry out its differential diagnosis, that is, to determine what pathology it accompanies, it is very important to take into account all the additional characteristics of pain and the symptoms with which it is combined.

Depending on what kind of pathological process is taking place, the pain syndrome can be noted by the patient as acute or aching, dull or severe, constant or periodic, clearly localized or widespread (radiating). In addition, additional signs of diseases are of great importance for diagnosis. They may be as follows:

• nausea, vomiting, loss of appetite, heartburn, diarrhea or constipation;
• bleeding from the genital tract;
• symptoms of intoxication (fever, weakness, lethargy);
• phenomena of dysuria (frequent or painful urination, changes in the properties of urine);
• drop in blood pressure to the point of fainting.

If the pain in the lower abdomen is accompanied by dyspeptic symptoms (nausea, vomiting) or changes in stool, which can become frequent and liquid with impurities or, on the contrary, rare, then the doctor will suspect a pathology of the intestine, small or large. Further examination will help identify either an infectious process (enteritis, colitis, diverticulitis), or an ulcerative lesion, or a neoplasm.

Vaginal bleeding, accompanied by pain, especially during pregnancy, is considered quite dangerous and requires urgent diagnosis and treatment. They may indicate an incipient miscarriage or placental abruption. If pain and bleeding are combined with intoxication syndrome, then infectious damage to the reproductive organs is possible.

Pain in the abdomen, occurring with an increase in body temperature, severe malaise, headache and loss of appetite, may indicate an infectious process that has developed in any pelvic organ. For example, if the pain is characteristically localized in the right zone of the lower abdominal cavity and is combined with fever, then the doctor will primarily suspect appendicitis. Further urgent examination (clinical blood test) will help make an accurate diagnosis and prompt surgical intervention.

Drawing, aching or sharp pain in the middle part of the lower abdomen indicates inflammation of the bladder, or cystitis. If the disease manifests itself for the first time, then, as a rule, the pain is acute and is combined with frequent and very painful urination. At the same time, the amount of urine produced becomes less, it may become cloudy due to the admixture of pus and mucus, or pinkish due to blood getting into it. In the chronic course of cystitis, the pain syndrome is less severe and manifests itself during periods of exacerbation.

There are also emergency situations that require urgent medical attention. So, if there is a cystic formation on a woman’s ovaries and there is either a rupture or torsion of the base, then the pain is characterized by suddenness, clear localization to the right or left in the lower abdomen and extreme strength. Painful shock causes a sharp decrease in blood pressure, which leads to fainting or collapse. The causes of this condition are irritation of the peritoneum and internal bleeding.

What diseases in women occur with pain in the lower abdomen?

There are many such pathologies, they have an infectious or somatic, sometimes traumatic origin and are characterized by certain symptom complexes. The most common diseases in clinical practice include the following:

• gynecological;
• urological;
• colono- and proctological.

Gynecological pathologies include inflammation of the uterus and appendages, endometriosis, and ectopic pregnancy. At adnexitis, or inflammation of the uterine appendages, the localization of pain depends on whether the left or right ovary is affected by infection or both appendages. The intensity of pain is determined by the severity of the process. So, with acute right-sided adnexitis, the pain is severe, sometimes spastic, localized in the right zone of the lower or middle part of the abdomen and accompanied by intoxication syndrome. If adnexitis enters the chronic phase, the pain becomes dull or aching.

Endometriosis, or the growth of the endometrium of the uterus outside of it and its spread to other internal organs, is also characterized by pain. Its typical symptom is its severity and appearance during menstruation, which at the same time becomes longer and more abundant. In addition, pain may radiate to the lumbar or sacral area.

At ectopic pregnancy, often encountered in gynecological practice and considered a critical condition, the localization of pain also depends on where the fertilized egg stops and begins its development. In most cases, this occurs in the left or right fallopian tube, which leads to its inevitable rupture and the release of all contents into the abdominal cavity. The pain is unbearable, localized in the lower or middle zone of the abdomen and often leading to shock and the subsequent formation of peritonitis.

Urological diseases that occur with pain in the lower abdomen include cystitis, often in combination with urethritis(inflammation of the urethra). These pathologies can be caused by both nonspecific microflora (enterococci, staphylococci, E. coli) and specific microorganisms (trichomonas, gonococci, mycoplasma). In the latter case, the signs of cystitis and urethritis will be combined with the characteristic symptoms of sexually transmitted infections, that is, the pain syndrome will be supplemented by vaginal discharge, as well as manifestations of intoxication.

Pathologies of the sigmoid or rectum can also be a source of acute or dull pain in the lower abdomen in women. Inflammatory processes, acute or chronic, benign or malignant tumors, ulcerative lesions, polyps or diverticula - all these conditions at certain stages can manifest as pain of varying intensity.

What to do if you experience pain in the lower abdomen

The formation of a sharp and sudden pain syndrome, which is characterized as an “acute abdomen,” requires an urgent call for an ambulance and immediate treatment. In the emergency room of the hospital, the patient is examined by a surgeon, gynecologist, urologist, undergoes the necessary tests and undergoes additional diagnostic procedures. Depending on the final diagnosis, she is operated on or undergoes conservative therapy.

If the pain is dull, aching, and not severe, then in any case you should not endure it. The woman should go to the clinic and be examined. After ruling out functional pain, the doctor should refer the patient for blood and urine tests, a vaginal smear, ultrasound diagnostics of the pelvic organs, and, if necessary, laparoscopy. Once an accurate diagnosis is made, appropriate therapy begins.

It is possible that the patient will be prescribed surgical treatment in combination with conservative methods (for tumors, for example). If an inflammatory process is diagnosed, then a course of antibacterial drugs, painkillers, and restoratives is necessary. In some cases, hormonal therapy is required, combined with laparoscopy (for endometriosis).

It should be noted that no self-medication for abdominal pain is allowed. Unauthorized use of various pills or thermal procedures can greatly complicate a woman’s condition and threaten her life.

Body problems are often signaled by uncomfortable sensations in various parts of the body and are diverse in nature.

If a woman’s lower abdomen hurts, this is a serious reason to see a doctor.

Causes

Pain in the lower abdomen is associated with organic and functional causes. The first include inflammatory processes in the female organs with the possible occurrence of neoplasms, the use of contraceptives, damage to neighboring organs, and pathologies associated with pregnancy. Functional reasons are associated with menstrual irregularities.

Pathology of the genital organs

According to statistics, every second woman experiences pain in the lower abdomen, the cause of this is the inflammatory process of the female organs, endometriosis (growth of the inner layer of the uterine wall beyond its limits), an infectious disease transmitted through sexual contact, the development of uterine fibroids (benign neoplasm).

Gynecological pathologies are characterized by pain during sexual intercourse, menstruation, emptying the bladder or rectum.

Pregnancy or its complications

Women may experience pain in the lower abdomen when carrying a child. During the first three months, the muscles adapt to changes in the body and undergo the necessary stretching.

The cause of severe obsessive pain with bleeding, a tense state of the abdomen during pregnancy can be placental abruption, indigestion, constipation, appendicitis, pancreatitis (inflammation of the pancreas).

An ectopic pregnancy is characterized by severe pain in the abdomen and back, blood pressure drops sharply, temperature rises, and loss of consciousness is possible.

Natural pain is considered to be sensations after an abortion, but if they do not go away within a day, then this indicates an inflammatory process or end-to-end damage to the walls of the uterus.

Pathology of the urinary tract

If the reasons are not related to gynecology, then why does the lower abdomen hurt? Inflammation of the genitourinary system provokes the development of cystitis, pyelonephritis, and kidney stones. Pathologies may be accompanied by fever, discomfort when urinating, and swelling.

Congenital pathology

Abnormal development of the female genital organs often causes abdominal discomfort. Congenital pathologies include: a violation of the structure of the genitals, the absence of an organ or part thereof, an undeveloped canal or opening, non-compliance with the norms of size, shape, proportions, the presence of neoplasms.

The intestines, diseases and symptoms of which are manifested by uncomfortable sensations in the lower abdomen, may be completely or partially inflamed. In this case, a functional failure is observed, internal bleeding and fainting are possible.

Pathologies of the organs of the peritoneal cavity include diverticulosis (bulging of a certain section of the intestinal wall), appendicitis, pathologies of the stomach, gallbladder, spleen, as well as intestinal overcrowding and the occurrence of cramps in an empty stomach.

Menstrual cycle pain

As mentioned above, pain that precedes menstruation and occurs during this period is associated with functional causes and is not a deviation from the norm.

Other factors

In addition to the above reasons, discomfort in the abdominal area is felt under the following circumstances:

• adaptation after surgery;
• climate change;
• decreased immunity and vitamin deficiency;
• viral diseases, hypothermia;
• menopause;
• long-term use of contraceptives, antibiotics;
• some pathologies: problems with the endocrine system, diabetes, metabolic disorders, obesity, anorexia;
• pinched hernia;
• after sexual intercourse;
• stress, rape;
• alcohol abuse, drug taking;
• oncological problems.

Types of pain, their symptoms

Pain in the abdominal area can be different: throbbing, constant, paroxysmal, localized in a certain part, radiating to the lower back, anus, clavicle area, left hypochondrium.

Pulsating

Pain of this nature is present with increased pressure in the hollow organs, ovarian abscess, and the formation of purulent fluid in the fallopian tube.

Permanent

Dull, continuous pain occurs against the background of:

Pain of this nature cannot be delayed, so you need to urgently seek help from a doctor. Diseases can be different, such as:

• disruption of the gastrointestinal tract;
• ectopic pregnancy;
• appendicitis;
• rupture or torsion of the tumor;
• thrush;
• placental abruption during pregnancy;
• myomatous node in the wall of the uterus;
• intestinal obstruction.

Bottom left. Chronic inflammation of the appendage creates aching pain in the lower left abdomen in women, and in advanced cases causes infertility. A benign tumor in the form of an overgrown cyst compresses neighboring organs and tissues, causing pain. As for an oncological tumor, sharp pain is felt immediately at an early stage.

Failure of the functions of the sigmoid colon, which is responsible for the functioning of the digestive tract, causes pain in the left side of the abdomen, especially after a long walk, driving over potholes, or before bowel movements. Discomfort is also felt with the development of the inflammatory process of the lower part of the colon, intestinal disorder, and disease of the genitourinary system.

Pain in the lower abdomen on the left is also associated with stomach disease, the development of a hernia in the diaphragm. With an infectious pathology in the pelvic area, the left lower abdomen hurts; severe nagging discomfort does not stop for several hours.

If there is pain in the left lower abdomen, then to determine the specific disease you should pay attention to the intensity and type of sensation.

Left and right. A twisted leg of an ovarian cyst and inflammation of the appendages are signaled by very severe pain on both sides.

In the middle. The lower abdomen may hurt in the center in case of endometritis (inflammation of the uterine mucosa), endometriosis (proliferation of the uterine mucous tissue into other organs). Similar sensations are caused by problems with the pancreas, sending pain to the left and right lower parts.

On right. Persistent pain indicates inflammation of the appendix.

Gives to the lower back

These symptoms of the postpartum period may indicate injury to the intervertebral discs, urinary tract disease, pathologies in the field of proctology, urology, and vascular medicine.

Give to the anus area

Symptoms of ectopic pregnancy that occur in the first trimester (up to 12 weeks) when the tube ruptures.

Spread to the clavicle area and left hypochondrium

Acute pelvic inflammation can lead to active production of purulent fluid, which causes localized pain. The same symptoms are present as additional signs of rupture of the fallopian tube.

These include discomfort conditions:

• during the period of ovulation (possibility of fertilization);
• within a week after a successful birth;
• during menstruation.

If the pain bothers you greatly, you should consult a doctor.

Associated symptoms

There are a number of additional signs that accompany the development of various diseases:

• general weakness, chills;
• nausea, vomiting;
• bleeding between menstrual cycles;
• bleeding after sexual intercourse or during pregnancy;
• the presence of blood or cloudy inclusions in the urine;
• purulent discharge;
• frequent urination;
• vascular collapse (acute heart failure against the background of low vascular tone, which leads to a drop in pressure and loss of consciousness);
• temperature increase.

How to help yourself

For severe pain

It is required to turn to emergency services, before the arrival of which you should lie down carefully, while the room should be ventilated, and the woman should be provided with peace and quiet. An ice heating pad or bottle is placed on the stomach for 20-25 minutes, changing periodically. It is permissible to take no more than two tablets of no-shpa. You cannot eat or drink, give enemas, or warm your stomach.

For constant moderate pain

It is recommended to undergo an examination: ultrasound of the abdominal cavity and pelvic organs, donate blood and smears. If you are worried about the stomach during urination, then before visiting the doctor, you can temporarily remove the pain symptoms with an infusion of aspen buds, which is taken 5 times a day, 2 tablespoons.

You should also see a gynecologist, traumatologist, urologist, proctologist, nephrologist to confirm or exclude the diagnosis. If inflammation of the urinary tract is detected, the doctor prescribes anti-inflammatory drugs with minimal side effects, drugs that correct immunity, vitamin injections, physiotherapy procedures.

Endometriosis is treated with hormonal drugs, too much pain during menstruation is eliminated by anti-inflammatory drugs recommended by the gynecologist. Relief comes from acupuncture and electrophoresis. To get rid of discomfort, exclusion from the diet of milk, fresh vegetables and fruits, black bread, and spices can help.

Pain prevention consists of observing hygiene rules, a healthy lifestyle and proper nutrition, doing physical exercises, strengthening the immune system.

The immediate appeal of a woman to a doctor in the event of pain in the lower abdomen always has its advantages, as it leaves more chances for a full recovery.

It is generally accepted that representatives of the beautiful half of humanity most often suffer from pain symptoms in the lower abdomen ... However, this statement is not entirely true. Often, urologists turn to male patients who suffer precisely from pain localized in the lower abdomen. They can be caused by a number of pathological conditions, and the doctor's task is to identify their etiology and develop a treatment plan. If you often hurts in the lower abdomen, You need professional medical help. Once and for all, the specialists of the multidisciplinary CELT clinic will help you forget about this symptom, which causes so many unpleasant minutes (and often hours). They will determine the reason for the nagging or sharp pain in the lower abdomen and individually develop a plan to eliminate it.

Lower abdominal pain: etiology

Etiology pain in the lower abdomen in women in the vast majority of cases it is associated with the anatomy of a woman’s body and the physiological processes that occur in it at different stages of life. At the same time, such clinical manifestations do not always depend on gender and can appear due to a number of pathological conditions: disruptions in the functioning of the gastrointestinal tract or urinary system, systemic diseases and pinched nerves.

Pain in the lower abdomen in men

The causes of pain in the lower abdomen in the male population may be associated with pathological conditions of the reproductive and urinary systems. You can see them in the table below:

Pain in the lower abdomen in women

As already mentioned, pain in the lower abdomen on the right, on the left or on both sides at the same time, can arise due to the structural features of the female body and the processes characteristic of it. They are presented in our table:

Pain during pregnancy

Pregnancy is a period during which it is important for the patient to pay special attention to her health and the reactions of her body. Painful symptoms at this time may be an indicator of pathological processes that pose a threat to the health and life of the fetus and mother, or may be a natural reaction of the body to changes. Its reasons are given in the table below:

Other reasons

Not all pain in the lower abdomen is associated with the physiological characteristics of the male or female body. Their reasons are presented in our table:

Pain in the lower abdomen: diagnosis

Since the reasons that cause pain symptoms in the lower abdomen can be different, if they occur, you need to contact different specialists. This could be a gynecologist, urologist, gastroenterologist, therapist, surgeon, infectious disease specialist, venereologist, nephrologist, who will prescribe appropriate diagnostic tests to identify the exact cause of the disease. Their list depends on the accompanying symptoms and may include the following.

Any woman has encountered such an unpleasant symptom as pain in the lower abdomen. Most of the fair sex try to cope with this problem on their own, taking painkillers and antispasmodics. In fact, this symptom can be triggered by various reasons: both physiological and pathological. And if in the first case treatment is not necessary, then pathologies require immediate medical intervention. That is why you should not ignore this discomfort, and if pain recurs periodically, you should immediately seek help from a gynecologist.

Premenstrual pain is familiar to many. Complaints of discomfort in the lower abdomen during menstruation are quite common in gynecology. Factors that can cause abdominal discomfort also include stressful situations, physical and sexual abuse, excessive alcohol consumption and drug use. A crowded large intestine and a spasm of an empty stomach often cause abdominal cramps in women.

In addition, in the first months of pregnancy, the expectant mother may experience pain caused by stretched abdominal muscles and ligaments.

What pains are considered pathological?

In addition to physiological pain, a woman may also be bothered by pathological pain, which can be caused by ailments of the female genital organs or disruption of the functioning of body systems. Inflammatory diseases of the fallopian tubes, uterus, ovaries, and vagina can cause pain and colic in the lower abdomen. For example, a large ovarian cyst or endometriosis, colpitis and adhesions, fibroids can not only cause pain in the lower abdomen, but also provoke a sharp rise in body temperature and discharge from the genital tract.

Inflammatory diseases of the urinary tract (pyelonephritis, cystitis and others) are also accompanied by colic in the lower abdomen. In addition, women in this case experience an increase in temperature, swelling, and pain when urinating.

Disorders in the pelvic organs, such as hernias, diverculosis and others, are often accompanied by pain. Inconstant stool and frequent constipation can cause intestinal hypertrophy and lead to thickening of the intestine; in addition to pain in the lower abdomen, this disease provokes a decrease in appetite and causes flatulence.

Oncological diseases, for example, cancer of the cervix, uterine body, and ovaries, can also cause abdominal pain in women.

There are many diseases that are accompanied by abdominal pain and require urgent surgical intervention. Appendicitis, ectopic pregnancy, rupture of a cyst, torsion of uterine fibroids, perforation of an ulcer and other dangerous diseases can end in failure if the woman is not promptly provided with qualified medical care.

Infectious diseases and intoxication of the body may be accompanied by stool upset, vomiting, and abdominal pain.

This symptom may indicate many gynecological disorders:

• ovarian rupture (may be accompanied by bleeding or occur without hemorrhage, but in any case, severe abdominal pain is typical for such a situation);
• varicose veins - dilation of the veins in the pelvis can be accompanied by unpleasant sensations and even quite severe pain;
• proliferation of uterine fibroids;
• tuberculosis of the genital organs;
• congenital pathologies of the genital organs;
• algodismenorrhea - painful periods;
• inflammatory processes of the genital organs in the acute stage;
• ovarian hyperstimulation, usually while taking hormonal drugs;
• adhesions;
• incorrectly installed uterine device;
• threat of miscarriage at various stages.

Pain in the lower abdomen on the right

As a rule, with abdominal pain, it can be quite difficult to independently determine the exact location of its localization. Diffuse colic in the lower abdomen significantly complicates the diagnosis.

The first thing that comes to mind when it comes to abdominal pain on the right side is inflammation of the appendix. But there are many other diseases that are characterized by similar manifestations.

If a woman experiences discomfort on the right side, this may indicate pathological damage to the walls of the digestive tract. As a rule, at the beginning of the disease the pain is localized in the iliac region, but later the symptoms can descend to the lower abdomen.

Discomfort on the right side can also occur with:

• right-sided lesions of the ovary, appendages, uterus;
• right-sided lesion of the fallopian tube;
• inflammation of the ureter,
• cystitis,
• urolithiasis,
• cholecystitis,
• pyelonephritis,
• liver inflammation,
• intestinal inflammation,
• ulcerative right-sided colitis.

Sharp pain in the lower abdomen indicates an acute process, in this case, first of all, it is necessary to exclude pathologies that require immediate intervention by a surgeon (termination of a tubal pregnancy, appendicitis, etc.).

Cramping pain on the right side are characteristic of renal colic and tubal pregnancy. With renal colic, pain can radiate to the lower back, groin, and inner thigh. With gynecological problems, pain radiates to the sacrum and rectum.

Many diseases can manifest themselves in this way, so it is important to note the nature, intensity of pain, and their frequency, so that it is easier for the doctor to establish a diagnosis and make a decision about the upcoming treatment.

Pain in the lower abdomen on the left side

Such worries are symptomatic of several diseases. A woman needs to pay attention to the nature of the pain and its intensity.

The main causes of discomfort:

• inflammatory process in parts of the large intestine. This disease is also accompanied by stool disorder or constipation, bloating and nausea. Usually, if you follow a diet, such pain disappears after a couple of days, but if the pain only intensifies, then you should consult a doctor.
• diseases of the genitourinary system. Localization of pain on the left side is also possible with some gynecological diseases (adnexitis, inflammation of the ovarian cyst, etc.).
• pain in the lower abdomen on the left side may be a symptom of an ectopic pregnancy. The pain seems to roll from right to left and is in the nature of contractions. If this pathology is suspected, a woman needs urgent hospitalization and the help of a surgeon to avoid rupture of the fallopian tube.

In order to accurately determine the cause of colic and pain in the abdomen on the left, it is necessary to undergo a comprehensive examination, since all diseases that are characterized by pain on the right side can also cause pain on the left (of course, except for inflammation of the appendix). In addition, radiating pain on the left can appear with a heart attack, acute pancreatitis and other diseases.

Before the onset of menstruation

Quite often, women experience pain in the lower abdomen before the onset of menstruation. In general, menstruation should not be accompanied by pain; it is allowed only in the first days of the cycle.

The main reason for discomfort in the lower abdomen before the onset of menstruation is hormonal changes in the blood. This is a physiological reason associated with the individual structure of a woman’s body.

But there are also pathological reasons for the appearance of this disease before menstruation. Severe pain or colic in the lower abdomen before menstruation should alert a woman and become a reason to see a doctor, as it may indicate hormonal imbalance, uterine fibroids, endometriosis, inflammation of the ovaries and fallopian tubes, as well as a number of infectious diseases of the reproductive system.

Abdominal discomfort before menstruation can be a concern for women who have recently had a termination of pregnancy; as a rule, it occurs for several cycles and then goes away.

Stressful situations, depression, and thyroid dysfunction can lead to pain before and after menstruation. The unpleasant sensations that occur before menstruation are usually pulling or aching, sometimes they radiate to the lower back or legs.

In the middle of the cycle

Such pain can bother a woman due to slight bleeding from the ovary. The blood irritates the wall of the abdominal cavity, causing it to become inflamed - this is the cause of pain.

If a woman is bothered by her lower abdomen in the middle of her cycle, it is usually caused by diarrhea, which is a normal physiological process. But, in addition, pain can also be caused by pathologies, such as fibroids, inflammation of the appendages, and infections of the genitourinary system.

In order to clarify the exact cause of pain in the lower abdomen in the middle of the cycle, it is necessary to take tests and undergo a gynecological examination.

After intercourse

Intimacy should bring joy and satisfaction, but sometimes women face a very unpleasant problem when the lower abdomen begins to hurt after sex.

Such sensations may indicate hidden pathological problems in a woman’s body, and pain may also arise due to psychological factors.

Gynecological problems that may cause discomfort after sex:

• rupture of an ovarian cyst or the ovary itself;
• reproductive system disorders;
• the presence of a tumor of the pelvic organs;
• congenital anatomical abnormalities;
• cystitis;
• threat of early pregnancy loss.

Discomfort can also occur in the event of rough sexual intercourse, when the walls of the vagina are injured and the mucous membrane of the cervix is ​​damaged. The appearance of pain and blood only after the first sexual intercourse is considered normal. In other cases, if after sex there is pain in the lower abdomen or bleeding begins, you should immediately go to the hospital, where the woman will receive the necessary medical care.

Pain + discharge

Such symptoms indicate an exacerbation of the inflammatory process. Pain in the lower abdomen combined with milky discharge may indicate that you have an illness such as thrush. The most common causes of pain in the lower abdomen and copious discharge from the genitals with a cheesy consistency are pathologies of the endocrine system, metabolic disorders, diabetes mellitus, long-term use of medications, vitamin deficiency, pelvic organ infections and others.

In addition, similar symptoms may appear in women during menopause.

It is worth noting that thrush does not threaten a woman’s health, but chronic thrush can cause a rather serious pathology - an erosive process of the cervix.

Pain in the lower abdomen, combined with mucous discharge mixed with pus, indicates inflammation of the appendages. During an exacerbation of the disease, the temperature may rise and a fever may begin.

In any case, regardless of the nature of the pain and discharge, at the first such symptoms you should visit a doctor to rule out serious diseases of the reproductive system and get rid of unpleasant sensations.

Cutting in the lower abdomen and pain in the lower back

When a woman has pain in the lower abdomen and lower back at the same time, we are talking about pelvic pain. Quite often, such pains can radiate into the vagina. They are nonspecific and can indicate various diseases: vascular, gynecological, proctological, urological. The nature of the pain can also be different.

Prolonged pain in the lower abdomen and lower back indicates the development of some pathology.

Acute, sharp pain in the lower back and lower abdomen, accompanied by fever, fever, nausea - a rather dangerous syndrome, indicating the progression of some kind of pathology. For example, such a condition can be observed with rupture of the ovary, pyelonephritis, cholecystitis, inflammation of the appendix and other acute conditions requiring surgical intervention.

Causes that can cause pelvic pain

Gynecological:

• various forms of endometriosis;
• hormonal imbalance;
• inflammation of the genital organs caused by endometriosis;
• benign and malignant tumors of the uterus, ovaries and appendages;
• uterine prolapse.

Urological reasons:

• urinary tract infections, including cystitis;
• urolithiasis disease,
• adhesions;
• malignant tumors of the bladder, etc.

Proctological causes that provoke pain in the lower back and lower abdomen:

• haemorrhoids;
• intestinal tumor;
• proctitis

Vascular causes:

• varicose veins of the small pelvis.

Gastroenterological reasons:

• intestinal obstruction;
• colitis;
• retroperitoneal tumors.

In addition, neurological, musculoskeletal and psychogenic causes can cause pelvic pain. For an accurate diagnosis, it is necessary to undergo a thorough examination, which will help to identify the real cause of the pain.

During menopause

During the period of extinction of the menstrual cycle, the production of female sex hormones gradually decreases, menstruation disappears. As a rule, the occurrence of discomfort in the lower abdomen during menopause is associated with fluctuations in the amount of estrogen in the blood.

The feeling of pain and colic in the lower abdomen during menopause can indicate intestinal diseases, problems of the genitourinary system, and disorders in the reproductive organs.

If a woman is bothered by discomfort, she should immediately consult a doctor to rule out life-threatening diseases.

After an abortion

Pain after artificial termination of pregnancy can be caused by both physiological and psychological reasons. If more than a day has passed after the abortion and the pain persists, you should consult a doctor to rule out inflammation and perforation of the uterine walls.

Common causes of pain after abortion:

• contraction of the uterus;
• the occurrence of complications after surgery (an inflammatory process that can provoke endometritis);
• incomplete removal of the fertilized egg;
• sex after abortion;
• excessive physical activity.

Pain that persists for more than a day increases, and there is discharge - a rather alarming symptom that requires immediate consultation with a doctor. This condition can pose a real threat to a woman’s life.

In addition, we should not exclude the psychological aspect of the occurrence of pain after an abortion, since many women after an abortion often experience mental discomfort and even become depressed.

During pregnancy

As mentioned above, pregnant women may experience physiological pain in the lower abdomen in the first three months of pregnancy, which is associated with the introduction of the fertilized egg into the endometrial cavity, stretching of the ligaments and muscles of the abdomen, and changes in hormonal levels. However, such pain can often occur due to pathological reasons.

It is basically impossible to determine on your own whether the pain is natural or whether it threatens pregnancy. That is why, if an expectant mother is bothered by unpleasant sensations in the lower abdomen, it is best to immediately contact a gynecologist so that the doctor can help determine the cause of the pain.

Pathological reasons due to which the lower abdomen may hurt during pregnancy:

• ectopic pregnancy;
• corpus luteum cyst;

In addition, abdominal pain during pregnancy can also occur for other (non-gynecological) reasons. Pain can be caused by diseases such as inflammation of appendicitis, cystitis, pyelonephritis, intestinal diseases, etc.

You should not immediately panic when pain appears; you should note their nature and intensity and inform your gynecologist about it as quickly as possible.

What to do if you have pain?

If you experience acute, sharp pain in the abdomen, you should immediately lie down and try to relax. Try to adequately determine the location of pain, its nature, intensity and frequency. If the pain is very sharp, then you should not delay, you should immediately call an ambulance.

In general, if you are periodically bothered by pain in your lower abdomen, it is recommended to undergo a full examination. Mandatory in this case is an ultrasound examination of the abdominal cavity and pelvic organs, donation of blood and urine for a general analysis. If gynecological diseases are suspected, it is necessary to donate blood for hormones and smears for infections. In addition, depending on the causes and nature of the pain, the doctor may prescribe additional tests.

There are a great many reasons why the lower abdomen may hurt. Among them are gynecological, proctological, vascular, gastroenterological, proctological, neurological, and psychogenic.

You should not ignore pain, because sometimes it is a symptom of quite dangerous pathologies.

Recommended for viewing: If you are concerned about pain and specific discharge

Gynecologists believe that pain in the lower abdomen in women is the most common reason for referral. However, based on the nature of the symptom, it is not immediately possible to confidently name the cause. Most often, an examination with palpation of the internal genital organs is necessary. Sometimes a consultation with a surgeon or neurologist is required.

The lower abdomen reflects the manifestations of physiological changes and diseases of both the reproductive organs, the bladder, and intestines. Correct treatment can only be prescribed after a complete examination.

Mechanism of pain

The causes of pain in the lower abdomen in women may be associated with changes in a dense (parenchymal) organ, such as the ovaries, or due to hollow formations (bladder, fallopian tubes, uterus, intestines). Accordingly, the mechanism of pain syndrome is different.

Diseases of the ovaries are accompanied by enlargement of the organ, stretching of the capsule supplied with nerve pain endings. In hollow organs, the main role is played by spastic contraction of the muscle layer or its overstretching (atony).

Therefore, in the first version, the nature of the patient’s pain is described as aching, dull, constant, gradually increasing as the appendages enlarge. And in the second - more often as cramping, periodic, intensifying with excitement, movement, physical activity. Bursting pain causes a rapid increase in the size of the organ due to swelling and inflammation.

With a slow increase, women experience dull heaviness and pressure in the pathological area. Another mechanism of pain is associated with the adhesive process and overstretching of the surrounding ligaments. Adhesions are formed as a result of chronic inflammation with effusion into the peritoneum, as a complication after surgical interventions.

Adhesions do not have nerve endings, they consist of scar tissue, but, soldered at the end to the hollow organs, they cause their displacement, narrowing of the lumen

Adhesive pain accompanies intestinal peristalsis, sexual activity, and defecation. The ligamentous apparatus fixes muscles and organs in a sedentary state. A sprained internal ligament feels like a nagging pain.

Another type of pain causes irritation of the peritoneum and local inflammation. At the same time, the pain is quite strong, but it is constantly in one place and does not radiate anywhere. If a girl has pain in her lower abdomen, then in the absence of signs of inflammation this is associated with increased tone and tension of the uterus. The pain is combined with menstruation (algomenorrhea).

The nature of the pain syndrome is felt and endured differently by women at a young and mature age, who have given birth and those who have not given birth. The pain threshold of sensitivity allows some to endure acute pain, while others are haunted by occasional pain in the side. The subjective assessment is supplemented by other symptoms and examination results. Let's look at what can hurt in this area.

Pain emanating from the digestive organs

Pain in the lower abdomen in both women and men can occur due to intestinal dysfunction. On the right is the projection of the appendix, the ileocecal angle, formed by the connection of the jejunum and cecum.

This is where an appendix called the vermiform appendix emerges. The wide and short cecum descends below the crest of the iliac pelvic bone. The skinny one is close to her from behind. The left iliac region contains the sigmoid and rectum portions of the large intestine.

Attack of appendicitis

Appendicitis is a paroxysmal inflammatory disease with local damage to the appendix. In a chronic course, it spreads to neighboring areas of the intestine and the adjacent part of the peritoneum.

The disease can be caused by:

• chronic digestive disorders with stagnation inside the appendix;
• adhesive changes in the abdominal cavity, adhesions with other organs;
• intestinal atony with prolonged constipation;
• specific effect of infection in typhoid fever, tuberculosis;
• abdominal trauma;
• obstruction of patency in case of eating nuts and seed husks;
• abnormal structure.

The exit from the appendix may become clogged with fecal stones

The classic picture begins with pain in the stomach, fever, and vomiting. Reminds me of food poisoning. After 2–3 hours, the pain “descends” to the right iliac region and intensifies to a pronounced attack. Possible irradiation from bottom to top in the right hypochondrium, in the navel, lower back, anus.

Normally, the appendix has a different position, which makes diagnosis difficult. An upward deviation is characteristic of an attack in a pregnant woman. Usually, against the background of pain, there is local tenderness on palpation and tension in the abdominal muscles. Abnormal bowel movements (diarrhea or constipation).

If the pain becomes throbbing, “twitching”, then a suppurative process (phlegmonous or) should be expected. There are situations with moderate dull pain that women endure without seeking medical help.

The disease does not disappear, but becomes chronic. A restrictive “bag” of adhesions is formed around the process. It delays the formation of diffuse peritonitis. The pain recurs with varying intensity. Treatment is only surgical.

Crohn's disease

The disease has no exact cause. Pathological changes are expressed in the form of areas of granulomatous (lumpy) inflammation, alternating with normal intestinal tissue. The cecum region is the most common location.

Inflammation is characterized by through damage to the wall, the formation of rough cracks, ulcers, fistulous tracts between organs, cicatricial and suppurative processes. The disease lasts a long time with relapses even after 20 years.

A predisposition to the disease in women has been established:

• with a burdened family history (immediate relatives are sick);
• long-term “experience” of smoking and alcoholism;
• low immunity as a result of chronic infectious diseases.

Severe cramping pain in the lower abdomen on the right with ileitis indicates an active process. They intensify after eating or excitement. They may have a permanent bursting character. In addition, patients are concerned about:

• bloating;
• frequent loose stools (possibly mixed with pus and blood);
• nausea and vomiting;
• poor appetite, weight loss;
• low temperature;
• weakness.

Timely detection and treatment can achieve long-term remission.

Nonspecific ulcerative colitis

The disease begins in the rectum and “rises” further through the large intestine. The nature of the inflammation remains unclear. Ulceration of the mucous membrane does not extend to the deep layers of the wall. Women with low immunity, long-term use of toxic medications, and unfavorable heredity are more often affected.

Main features:

• cramping pain in the left iliac region and side, aggravated by eating, defecation, and physical activity;
• tendency to diarrhea;
• impurities of pus, mucus and blood in the feces;
• moderate increase in temperature;
• weight loss, weakness.

The most common complication is intestinal bleeding. In therapy, strong anti-inflammatory drugs, hormones are used. Surgery may be needed in an emergency.

Diverticulosis

The disease is caused by a broken structure of the intestinal wall. The cause of nagging pain in the lower abdomen is inflamed saccular protrusions. They are formed:

• in elderly women with atony and a tendency to constipation;
• with a lack of water and fiber intake;
• in overweight people with low physical activity;
• in case of anomalies in the development of the intestinal wall;
• with a pronounced atherosclerotic process in the arteries of the abdominal cavity with intestinal atrophy.

The most common location of diverticula is the sigmoid colon

Diverticula can cause intermittent aching pain in the area of ​​projection onto the abdominal wall. Severe spasms occur when these formations become inflamed and twisted, causing partial intestinal obstruction to form. Therapy includes intensive anti-inflammatory drugs. If there is a threat of peritonitis and obstruction, surgery is performed to remove diverticula.

Colon cancer

Adenocarcinoma most often affects the sigmoid and rectum, so differential diagnosis is carried out when it is unclear why the lower abdomen hurts in women in the left iliac region. Cancer can be detected at an early stage only by indirect signs, since it does not cause severe pain.

Patients consult a doctor with complaints:

• for constipation;
• bloating;
• unknown temperature;
• weight loss

As the tumor grows, constant pain appears in the left iliac region and in the side of a dull nature, independent of nutrition and physical activity. Therapy includes the use of a combination of cytostatics with irradiation of the cancer area and nearby lymph nodes. The issue of surgical treatment and the extent of intervention is decided by a commission.

Pain and impaired urination

Inflammation of the bladder and urethra (cystitis and urethritis) is more common among women than men. This is caused by the peculiarity of its structure and location: the urethral canal is short, wide, and lies close to the anus and vagina.

Infection is caused by E. coli, disturbed vaginal flora (especially in sexually transmitted diseases)

If a woman’s lower abdomen hurts simultaneously with pain when urinating, frequent urges, then one should think about inflammation in the lower urinary tract. Usually the pain is nagging, constant, exhausts the patient, and causes insomnia.

Severe inflammation is accompanied by flakes of mucus in the urine and bloody streaks. If pain radiates to the right or left side of the lower back, pyelonephritis should be excluded. Inflammation of the renal pelvis is also accompanied by dysuria, a burning sensation in the very bottom of the abdomen.

Treatment is usually long-term. Combines herbal remedies that flush the bladder, drinking a significant amount of fluid and antibacterial agents. It cannot be done without consulting a gynecologist. Inflammation of the genital organs and bladder often combine and support each other.

Pain due to disorders in the genital area

Gynecologists divide lower abdominal pain in patients into functional (physiological) and organic. Functional reasons are caused by temporary underdevelopment of the genital organs in girls, associated with menstruation, pregnancy. They are associated with excitement, hypothermia, and the onset of sexual activity.

Organic causes always manifest themselves in acute or chronic pathology of the uterus and appendages. The pain varies in nature and may be accompanied by uterine bleeding and vaginal discharge.

Differences between physiological pain and organic pain:

• lack of a clear connection with the previous action, spontaneous onset and disappearance;
• short-term nature;
• moderate intensity;
• relatively satisfactory health.

Secondary dysmenorrhea, which depends on the pathology of the uterus and appendages, must be distinguished from physiological causes.

Physiological pain in women

To figure out why a girl’s lower abdomen hurts before and during each menstruation, gynecologists will need to study the patient’s hormonal levels and regimen. Primary algodismenorrhea is associated with functional disorders caused by underdevelopment of the endocrine and nervous systems.

In girls, the production of prostaglandins and estrogens increases, which increase uterine contractions. It is often observed with overload in studies, little physical activity, poor diet (coffee, sandwiches, chips), and emotional stress.

In 75% of cases, the diagnosis is defined as “premenstrual syndrome”. In addition to pain, a few days before menstruation, the following occur:

• headache and nausea;
• dizziness and fainting;
• vomit;
• The mammary glands swell and hurt.

During pregnancy, painful sensations are caused by stretching of the ligamentous apparatus. Most often they bother primiparous women over the age of 25 with poor physical fitness.

It is impossible to exclude the occurrence of an acute disease or an exacerbation of a chronic disease during pregnancy, therefore every expectant mother is obliged to closely monitor her well-being and inform the doctor about any changes.

Ovulation pain occurs on days 14–15 of the normal menstrual cycle. Lasts for several hours or days. Women experience regular nagging pain in the lower abdomen that intensifies during sexual intercourse. They are caused by hormonal changes with increased blood supply to the ovary. Usually unilateral. Women require observation by a gynecologist.

Pain due to pathology of the genital organs in women

Organic pain, depending on pathological changes in the uterus and appendages, is provoked by: hypothermia, heavy physical work, sports, increased nervous tension, and the use of intrauterine contraceptives.

Adenomatosis (endometriosis) is caused by the proliferation of epithelium from the inner layer of the uterus into the muscular layer. The most affected are nulliparous women over 30 years of age and those suffering from infertility. Symptoms are associated with constant nagging pain above the pubis, prolonged menstrual bleeding, and brown vaginal discharge.

The epithelium forms “pockets”. Menstrual blood gets into them and puts pressure on the surrounding tissue. Therefore, during menstruation, the pain intensifies, radiating to the groin and lower back.

Hormonal drugs are used for therapy.

During pregnancy, a woman with endometriosis is constantly monitored to exclude placental rejection.

Inflammatory diseases (endometritis, adnexitis) are accompanied by bursting or cramping constant pain. With adnexitis (inflammation of the ovary), the pain is one-sided. Irradiation to the sacrum and lower back is observed, and the general condition worsens.

The risk of inflammation is highest in women:

• who have undergone diagnostic curettage and abortion;
• refusing long-term therapy.

Additional signs include:

• weakness, dizziness;
• muscle pain;
• temperature increase;
• unpleasant odor from vaginal discharge due to an admixture of pus;
• insomnia;
• irritability.

In 60% of women, inflammation is caused by a sexually transmitted infection. Treatment must include a temporary cessation of sexual intercourse and examination of the partner.

Congenital and acquired anomalies - in girls they are detected during a painful first menstruation (contamination of the vagina, cervix). The accumulation of blood in the cavity causes expansion and constant pain. In adult women, blood retention is facilitated by the curvature of the uterus (retrodeviation) and fusions in the cavity (synechia).

Girls need to be shown to a gynecologist and examined urgently. Special exercises are selected for women, and if the situation cannot be corrected, surgery is performed.

Tumors of the genital organs in women have benign growth and a malignant course. Benign ones include cysts and fibroids. As they grow, they stretch the organ and cause bursting pain. At the same time, stretching of ligaments and adhesions (in case of chronic inflammation) takes part in the mechanism.

Manifestations can be an acute attack due to cyst torsion or rupture. In this case, the pain is one-sided, accompanied by dizziness and nausea, and shock is possible. With fibroids, the pain is accompanied by severe uterine bleeding and signs of anemia.

Malignant tumors of the appendages are accompanied by bilateral localization, intensity in stages II–III. Signs of cancer intoxication appear:

• nausea;
• lack of appetite;
• weight loss;
• hormonal disorders;
• weakness.

Unilateral pain is caused by fallopian tube cancer. Early symptoms include intermittent, profuse, watery discharge. Uterine sarcoma is detected during examination for uterine bleeding. The tumor is characterized by rapid growth, increased pain and metastasis.

Tubal pregnancy with rupture - accompanied by sudden pain on one side of the abdomen, severe dizziness, and possible loss of consciousness caused by internal bleeding. A woman has a delay in menstruation, secondary signs of pregnancy.

Why is a gynecologist examination necessary?

For any pain in the lower abdomen in women, specialists should rule out changes in the genitals. Therefore, women are referred to a consultation, and a doctor looks at the hospital on site.

A vaginal examination is carried out with both hands, so the internal genital structures are pinched between the fingers, their size and density are determined, and the left and right ovaries are compared

With inflammation of the appendages, palpation is sharply painful on one side, one of the organs is enlarged, and the tissue is pasty. Endometritis is indicated by an enlarged and softened uterus and pain on palpation. When the fallopian tube ruptures with internal bleeding, a bulging of the posterior vaginal vault is detected.

Assessing the condition of girls and young women with lower abdominal pain is important for resolving the issue of preparation for conception, the course of pregnancy, and the birth of healthy offspring. For older women, timely exclusion of pathology guarantees ability to work and an active life after menopause.