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What is it about ?
Pain in the lower abdomen is very common. Most often, they are caused by a problem with the intestine. In women, they can also come from a disease of the internal genital organs (vagina, uterus, ovaries).
The possible causes are infections, conditions of the ovaries, tumors and cysts, ectopic pregnancy, birth defects of the uterus, hormonal disorders and endometriosis.
Some women experience severe pain in the lower abdomen on the day of ovulation (ovulatory pain) without having another problem.
How to recognize them?
Symptoms can vary depending on whether or not you have your period (already).
You haven’t had your first period yet
Pain can be caused by a buildup of menstrual blood in the vagina or uterus. This blood may not flow normally due to a unperforated hymen or a congenital anomaly of the uterus. After a period of recurring mild cyclic pains, you suddenly feel severe pain in your lower abdomen.
Pain can also be caused by twisting or rupture of an ovarian cyst. In the case of a twist, the cyst rotates around its axis, cuts off the blood supply and threatens to necrosis. In the event of a rupture, the cyst bursts and its contents are released into the belly. In both cases, the pain comes on suddenly.
You’ve already had your first period
The pain can be related to an infection.
It may be an infection of the endometrium (endometritis). The endometrium is the lining that lines the inside of the uterus. The condition usually occurs after childbirth, miscarriage, or a procedure such as an abortion or the placement of an abortion. IUD. In addition to pain in the lower abdomen, you also have fever, chills, headache, muscle pain, fatigue, and a general feeling of being unwell.
It may or may not be endometritis with or without infection of the fallopian tubes and ovaries (pelvic inflammatory disease), usually caused by a sexually transmitted infection (STI).
If it is a ectopic pregnancy, you have stomach pain and bleeding after a period of irregular or missed periods.
If you experience sudden pain in your lower abdomen around the middle of your menstrual cycle, it may be ovulation-related pain (ovulatory pain). This usually goes away on its own within 24 hours.
The torsion or rupture of an ovary or ovarian cyst usually causes sudden, severe pain that radiates throughout your stomach. This is because the contents of the cyst flow into the belly and irritate the peritoneum.
the ovarian hyperstimulation syndrome (OHSS) occasionally occurs in women undergoing fertility treatment. Two to three days after hormonal stimulation of ovulation, stomach pain, fluid retention, nausea, and sometimes shortness of breath occur.
Uterine myomas are benign tumors of muscle cells in the lining of the uterus. It happens that these myomas are linked to the wall with a kind of foot (pedicled myomas). If this foot rotates around its axis, it cuts off the blood flow and the myoma necroses (torsion and necrosis of a pedicled uterine myoma). This phenomenon is characterized by recurrent cyclic pain, which occurs in flare-ups, such as contractions during childbirth.
The malignant tumors may be accompanied by stomach pain and bleeding, but often do not cause complaints early in their development. Sometimes you can feel a lump in your lower abdomen. In advanced tumors, the belly may be swollen and filled with fluid.
Pain in the stomach can also herald the start of childbirth. Sometimes the woman (or her parents) doesn’t even know (know) that she is pregnant.
You are postmenopausal
THE’endometritis can also occur during menopause, often after treatment for cervical cancer. It is associated with pain, fever, bleeding, and purulent, sometimes smelly vaginal discharge.
A malignant tumor may be accompanied by pain and bleeding.
Chronic pain in the lower abdomen
Chronic pain in the lower abdomen usually stems from a chronic condition, such asendometriosis, a tumor, a chronic condition of the cervix, varicose veins of the ovaries, or premature syndrome (PMS).
How is the diagnosis made?
The doctor always begins with a normal pelvic examination, which he may supplement with a smear. In the event of purulent discharge, he takes a sample and sends it to the laboratory to identify the germ that causes the infection (pathogenic germ). The presence of irregular bleeding also warrants a pregnancy test and a test for sexually transmitted infections (STIs). If the diagnosis is not yet clear, the doctor may refer you to the gynecologist for a ultrasound.
What can you do ?
Most women recognize the discomfort associated with normal ovulation or menstruation very well. In these cases, it is usually sufficient to apply local heat to the stomach and, if necessary, to take an anti-inflammatory such as ibuprofen.
Any purulent or bloody vaginal discharge should be examined by a doctor. Don’t let it drag on, it could be something serious. Ask your sexual partner (s) if they also have any symptoms. Use a condom.
What can your doctor do?
If you have an infection, your doctor will prescribe antibiotics, often even a combination of different antibiotics. If you need large doses of antibiotics, they should preferably be given during a hospital stay.
Ectopic pregnancies, twists or ruptures of cysts or myomas, tumors and birth defects of the uterus usually require surgery.
Want to know more?
- Anatomy of the vagina (image) – Larousse
- Anatomy of the uterus (image) – Larousse
- Anatomy of the ovaries (image) – Larousse
- Non-steroidal anti-inflammatory drugs – CBIP – Belgian Center for Pharmacotherapeutic Information
- Ibuprofen – CBIP – Belgian Center for Pharmacotherapeutic Information
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