Pain in the lower abdomen in women: causes and when to see a doctor

Other names: Боль внизу живота у женщин, тянет низ живота, боли в малом тазу, тазовая боль, ноет низ живота, боль в яичнике, хроническая тазовая боль

In the lower abdomen of a woman, the organs of three systems at once converge: the uterus with appendages, the bladder and ureters, as well as the final sections of the intestines. Therefore, the same pain sensation can be a normal variant during ovulation, a sign of inflammation, and a reason for emergency surgery. The doctor is interested in the time of pain in relation to the cycle, its nature, temperature, discharge, connection with urination and stool. A separate task is not to miss an ectopic pregnancy, torsion or rupture of a cyst, and appendicitis. If the pain is sharp, increasing and accompanied by weakness or bleeding, emergency help is needed.

🧾 МКБ-10: R10.2 🏥 Where it is treated: 9 Gynecology, urology or intestinesThe connection with the cycle is importantSharp pain - urgent

👨‍⚕️ Which doctor

Gynecologist, urologist, surgeon, gastroenterologist

🔬 Diagnostics

Pelvic ultrasound, smears, urinalysis, hCG, blood test

💊 Treatment

Depends on the cause: anti-inflammatory therapy, hormonal treatment, antibiotics, surgery

📈 Prognosis

Usually benign, but acute conditions require emergency care

⚠️ At risk

Sexually transmitted infections, endometriosis, pelvic surgery, frequent inflammation, constipation

⏱ When to see a doctor

Planned for nagging pain; emergency for severe pain and bleeding

🚨 See a doctor urgently

With these signs do not wait for a scheduled appointment — the condition requires emergency care.

Резкая кинжальная боль с нарастающей слабостью и головокружением
Задержка менструации и боль с одной стороны — возможна внематочная беременность
Температура выше 38 °C с гнойными выделениями
Обильное маточное кровотечение
Боль с рвотой, вздутием и отсутствием стула и газов
Боль при беременности любого срока

Gynecological reasons

The largest group. A nagging pain in the middle of the cycle is typical for ovulation and usually goes away within a day. Painful menstruation can be primary or secondary when it is caused by endometriosis or fibroids. Chronic aching pain that intensifies before menstruation is characteristic of endometriosis and adhesions. Acute unilateral pain may indicate torsion or rupture of an ovarian cyst. Inflammation of the appendages and uterus causes pain with fever and discharge. A separate category is ectopic pregnancy, a condition in which delay is life-threatening.

Ovulatory pain
Painful periods
Endometriosis
Uterine fibroids
Ovarian cyst, torsion or rupture
Inflammation of the appendages and endometritis
Ectopic pregnancy
Adhesive process in the pelvis

Urinary and intestinal causes

Cystitis causes pain and pain above the pubis, frequent urge and burning sensation when urinating; in women it is common due to the short urethra. A ureteral stone causes paroxysmal pain radiating to the lower back and perineum. From the intestinal side, pain in the lower abdomen may be associated with irritable bowel syndrome, constipation, diverticulitis or inflammatory diseases. Appendicitis occupies a special place: in women it is easily confused with gynecological pathology, therefore, if there is pain on the right side, an examination by a surgeon is required.

Cystitis and urethritis
Ureteral stone
Pyelonephritis
Irritable bowel syndrome
Constipation and flatulence
Diverticulitis
Appendicitis

How to relate pain to your cycle

The diary helps the doctor more than the most detailed descriptions. Note the day of the cycle, the nature of the pain, its strength on a ten-point scale, duration, what intensifies and what alleviates, as well as accompanying symptoms: discharge, temperature, nausea, changes in urination and stool. Pain strictly in the middle of the cycle indicates ovulation, pain in the first days of menstruation indicates dysmenorrhea, constant pain with intensification before menstruation and during sexual intercourse indicates endometriosis, and pain without any connection with the cycle often has a non-gynecological nature.

Mid-cycle - ovulatory pain
The first days of menstruation - dysmenorrhea
Worsening before menstruation - endometriosis
Pain during sexual intercourse - endometriosis, adhesions, inflammation
Without connection with the cycle - urinary tract or intestines

Survey

The examination begins with an examination by a gynecologist and an ultrasound of the pelvic organs, preferably transvaginal: it shows the uterus, endometrium, ovaries, cysts and free fluid. Women of reproductive age with acute pain must have their hCG checked to rule out pregnancy, including ectopic pregnancy. Smears reveal inflammation and infections, a general urine test reveals cystitis and pyelonephritis, a general blood test shows an inflammatory reaction. If the picture is unclear, an ultrasound of the kidneys, a consultation with a surgeon, and, in difficult cases, a diagnostic laparoscopy are added.

Examination by a gynecologist
Transvaginal ultrasound of the pelvis
blood hCG
Smears for flora and infections
General analysis of urine and blood
Ultrasound of the kidneys and bladder
Diagnostic laparoscopy for unclear chronic pain

Treatment and what you can do yourself

Tactics depend on the diagnosis. Ovulatory pain and mild dysmenorrhea are relieved by warmth, rest, and over-the-counter pain relievers from the group of nonsteroidal anti-inflammatory drugs; For severe dysmenorrhea, the gynecologist may suggest hormonal therapy. Inflammation of the appendages is treated with antibiotics according to the regimen, endometriosis with hormonal drugs and, if necessary, laparoscopy, and a cyst with observation or surgery. Before being examined by a doctor, if there is severe pain, you should not apply a heating pad or take strong painkillers: heat increases inflammation, and pain relief erases the picture and interferes with diagnosis.

If there is severe pain, do not heat the stomach and call for help.
Painkillers only for an already clear reason
Antibiotics for inflammation are prescribed by a doctor
Hormonal therapy for endometriosis and dysmenorrhea
Laparoscopy for cysts, adhesions and ectopic pregnancy
Treatment of cystitis and constipation by specialized specialists

Services and prices for this diagnosis

Based on official price lists of Tashkent clinics. The exact cost is determined after examination.

🔬 Diagnostics

Первичный приём гинекологаfrom 200 000 Трансвагинальное УЗИfrom 145 000 УЗИ матки и яичниковfrom 120 000 Мазок of гениталий (3 точки)from 155 000 Общий анализ мочи (ОАМ)from 50 000 ХГЧ (хорионический гонадотропин)from 120 000

Frequently asked questions: Pain in the lower abdomen in women

When is lower abdominal pain considered normal?+

Short-term nagging pain in the middle of the cycle and moderate pain in the first one or two days of menstruation, which does not interfere with normal activities and is relieved with a simple painkiller, is usually not dangerous. If the pain is severe, lasts longer, or gets worse every month, you need to be examined by a gynecologist.

How to understand that it is appendicitis and not gynecology?+

With appendicitis, the pain often begins around the navel and after a few hours moves to the right and down, accompanied by nausea, lack of appetite and fever. These conditions can only be accurately distinguished by examination with ultrasound and tests, so if there is pain on the right side, they are treated urgently.

Can cystitis cause pain in the lower abdomen?+

Yes. Cystitis causes pain and pressure over the pubis, pain when urinating and frequent urges in small portions. The diagnosis is confirmed by a general urine test, and in case of repeated episodes, urine culture and consultation with a urologist are necessary.

What to do if there is sharp pain in the lower abdomen?+

Lie down, do not eat or drink, do not apply a heating pad, do not take painkillers and call 103, especially if there is a delay in menstruation, bleeding, weakness or fever. Such symptoms may indicate an ectopic pregnancy or cyst torsion.

Do I need to be examined for chronic pelvic pain?+

Yes. Pain that persists for more than six months requires routine examination: ultrasound, smears, assessment of bowel and bladder function. Often the cause is endometriosis or adhesions, and early treatment significantly improves quality of life.

The information on this page is for reference only and does not replace a doctor consultation. Only a qualified specialist can make a diagnosis and prescribe treatment after an in-person examination.