Lower abdominal pain in women: Causes, symptoms and treatment

Lower abdominal pain is a common complaint in women, which can have many causes. It can be acute or chronic, of varying severity and location. In this article we will discuss the most common causes of lower abdominal pain in women, accompanying symptoms, diagnostic methods and treatment options.

Causes of lower abdominal pain related to the system:

Reproductive

• Menstruation (dysmenorrhea): Dysmenorrhea is one of the most common causes of lower abdominal pain in women. The pain usually occurs just before or during menstruation and is cramping.
  • Causes: Uterine muscle contractions that expel the endometrium.
  • Symptoms: Pain in the pit of the stomach, radiating to the back and thighs, nausea, vomiting, diarrhea, headache.
  • Treatment: Pain medications (e.g. ibuprofen, paracetamol), warm compresses, relaxation exercises. In severe cases, the doctor may prescribe oral contraceptives or other hormonal medications.
    
• Ovulation (mid-cycle pain): Some women experience pain in the lower abdomen during ovulation, the release of an egg from the ovary.
  • Causes: rupture of the Graaf follicle, from which the egg cell is released, can cause pain.
  • Symptoms: Brief, sharp pain in the lower abdomen on one side, lasting from a few minutes to a few hours.
  • Treatment: Usually not necessary, over-the-counter painkillers can be used.
    
• Endometriosis: This is a disease in which tissue similar to the endometrium grows outside the uterine cavity.
  • Causes: Not fully known, probably related to hormonal and immune disorders.
  • Symptoms: Chronic lower abdominal pain, worsening during menstruation, painful sexual intercourse, problems getting pregnant.
  • Treatment: Pain medications, hormone replacement therapy, in severe cases surgical treatment.
    
• Uterine myomas: These are benign tumors that occur in the uterine myometrium.
  • Causes: Not fully known, probably related to hormonal disorders.
  • Symptoms: pain in the lower abdomen, heavy menstrual bleeding, pressure on the bladder or bowels.
  • Treatment: Depends on the size and location of the myxomas, and may include drug treatment or surgery.
    
• Ovarian cysts: These are fluid-filled structures found in the ovaries.
  • Causes: Hormonal disorders, inflammation.
  • Symptoms: pain in the lower abdomen, menstrual disorders, in case of cyst rupture sharp pain.
  • Treatment: Depends on the type of cyst, and may include observation, drug treatment or surgery.
    
• Ectopic Pregnancy: This is a pregnancy in which a fertilized egg implanted outside the uterine cavity, usually in the fallopian tube.
  • Causes: Disruption of the transport of the fertilized egg into the uterus, such as as a result of endometriosis or fallopian tube inflammation.
  • Symptoms: pain in the lower abdomen, bleeding from the genital tract, in the case of rupture of the fallopian tube acute pain and internal hemorrhage.
  • Treatment: Operative or pharmacological treatment.
    
• Pelvic organ inflammation (PID): This is a bacterial infection of the uterus, fallopian tubes and ovaries.
  • Causes: Infection with sexually transmitted bacteria, such as chlamydia or gonococcus.
  • Symptoms: lower abdominal pain, fever, vaginal discharge, painful urination.
  • Treatment: Antibiotics.

Urinary

• Urinary tract infection (UTI): This is a bacterial infection of the bladder, ureters or kidneys.
  • Causes: most often an infection with Escherichia coli.
  • Symptoms: pain and burning on urination, frequent urination, lower abdominal pain, fever.
  • Treatment: Antibiotics.
    
• Nephrolithiasis: This is a disease in which stones form in the kidneys.
  • Causes: metabolic disorders, insufficient fluid intake.
  • Symptoms: Severe pain in the lower or lateral abdomen, radiating to the groin and perineum, hematuria, nausea, vomiting.
  • Treatment: Depends on the size and location of the stones, and may include drug treatment, stone-breaking procedures or surgical treatment.

Feed

• Irritable bowel syndrome (IBS): This is a functional bowel disease characterized by abdominal pain, bloating, diarrhea or constipation.
  • Causes: Not fully known, probably related to intestinal motility disorders, intestinal hypersensitivity and psychological factors.
  • Symptoms: abdominal pain, bloating, diarrhea or constipation, nausea.
  • Treatment: Diet, probiotics, smooth muscle relaxants, in some cases antidepressants.
    
• Appendicitis: This is inflammation of the appendix.
  • Causes: obstruction of the lumen of the appendix, such as by feces or a foreign body.
  • Symptoms: pain in the right lower quadrant of the abdomen, nausea, vomiting, fever.
  • Treatment: Operative treatment.
    
• Diverticulitis: This is inflammation of the diverticula, or small protuberances of the intestinal wall.
  • Causes: blockage of diverticula by feces.
  • Symptoms: pain in the lower left quadrant of the abdomen, fever, nausea, vomiting.
  • Treatment: Antibiotics, in severe cases surgical treatment.
    
• Intestinal obstruction: This is a condition in which food content cannot move through the intestines.
  • Causes: Postoperative adhesions, tumors, inflammation.
  • Symptoms: abdominal pain, bloating, lack of stool and gas, vomiting.
  • Treatment: Depends on the cause of the obstruction, and may include pharmacological or surgical treatment.

Other causes of lower abdominal pain

• Pain of musculoskeletal origin: Pain in the lower abdomen can be caused by straining the abdominal muscles, such as from intense exercise.
  
• Psychogenic pain: In some cases, lower abdominal pain can be a symptom of psychological disorders, such as depression or anxiety.

Diagnosis of lower abdominal pain

To determine the cause of lower abdominal pain, the doctor will interview the patient, examine her physically and order additional tests, such as:

• Gynecological examination
• Urinalysis
• Abdominal ultrasound
• Computed tomography
• MRI
• Laparoscopy

Treatment of lower abdominal pain

Treatment of lower abdominal pain depends on its cause. It may include:

• Painkillers
• Anti-inflammatory drugs
• Antibiotics
• Hormonal drugs
• Operative treatment
• Physiotherapy
• Psychotherapy

When should I see a doctor?

You should see a doctor if your lower abdominal pain is:

• Strong
• Sudden
• It is accompanied by other symptoms, such as fever, bleeding from the genital tract, vomiting
• Doesn’t go away after a few days
• Impedes daily functioning

Prevention

In many cases, lower abdominal pain can be prevented by:

• Following a healthy diet
• Regular physical activity
• Avoiding stress
• Regular preventive examinations

Remember that lower abdominal pain can be a symptom of a serious illness. Don’t ignore it and see a doctor if you have any doubts.