Lower abdominal pain: causes of pain in men and women

If you have pain in the lower abdomen, it is more of a subjective perception than an objective sensation, so examining patients with such a complaint can be difficult.

If you have pain in the lower abdomen, you need to understand that there are a great many reasons for pain in this epigastric region, and they can be divided, so to speak, by gender - typical male symptoms and signs of pain that are characteristic only of the female body. In addition, there are general symptoms that are inherent in both men and women, old people and children.

Lower abdominal pain, causes of pain in men

Representatives of the stronger sex also suffer from pain in the lower abdomen, however, somewhat less often than women, who may sometimes have it monthly. If a man has a very painful lower abdomen, most often they courageously endure the pain in the lower abdomen, despite the possible serious dangers that lie behind this symptom. And the causes of pain in the lower abdomen can be the following:

• Inflammatory processes in the gastrointestinal tract, gastric ulcer or duodenal ulcer. Pain, usually aching in chronic diseases and sharp, cramping during exacerbation of the disease.
• Inflammation of the vermiform appendix, which is localized in the lower right part of the abdomen, near the large intestine. The pain can be varied in nature, and does not always manifest itself in the right epigastric region. One of the characteristic signs of appendicitis is acute pain in the lower abdomen, nausea, vomiting, and increased body temperature.
• Diverticulitis, in which pain in the lower abdomen can be localized in the left lower abdomen. In addition to pain, inflammation of the diverticulum is accompanied by nausea and subfebrile temperature.
• An inguinal hernia, which is a rather serious pathology, can become strangulated and cause acute pain in the lower abdomen, nausea, vomiting and even loss of consciousness. This condition requires emergency surgical care.
• Inflammatory process in the kidneys, pyelonephritis or stones are also a provoking factor causing pain in the lower abdomen in men.
• An inflammatory process in the testicles (orchitis) or appendages can also cause painful sensations in the groin.

Fortunately, a rare cause of lower abdominal pain is an oncological process in the intestines. Pain may appear already at a late stage of the disease, when the tumor reaches large sizes and presses on nearby organs.

Lower abdominal pain in men is also caused by chronic, often asymptomatic at the initial stage of development, diseases of the genitourinary system. If it is chronic cystitis, then its first signal is a urination disorder, which gradually turns into an acute stage up to urinary retention. An overfilled inflamed bladder causes initially dull, and then severe pain in the lower abdomen. In addition to cystitis, prostatitis can be the cause of lower abdominal pain in men. The inflammatory process in the prostate gland develops, as a rule, slowly, often without obvious symptoms. When clinical signs appear, we can say that prostatitis is moving into the acute stage. The pain usually begins with a pulling sensation, which the man tries to patiently endure. If prostatitis is not treated, the pain in the lower abdomen becomes more pronounced, radiating to the groin and testicle area, especially severe pain accompanies the process of urination. In addition to the fact that the man's health condition can hardly be called good, he suffers from constant pain in the lower abdomen, and his sexual activity is also impaired. Prostatitis, not detected in time, can aggravate the course of another serious disease - prostate adenoma. Pain in the lower abdomen with adenoma is characteristic, it appears due to severe narrowing and compression of the urethra, as a rule, painful sensations are constant and provoke the urge to urinate frequently at night and during the day. Adenoma is accompanied by a significant deterioration in the patient's condition, urinary retention often leads to renal pathologies, and sexual function decreases.

All conditions that cause persistent chronic pain or acute, sharp pain accompanied by nausea and a drop in blood pressure require medical attention, often emergency care.

Why do women have lower abdominal pain?

Common physiological causes for women are premenstrual pain, painful menstrual cycle, pressure from the uterus on the bladder, which may also be overfilled. Lower abdominal pain often occurs during menstruation - this is the most common complaint of lower abdominal pain in gynecological practice. Family troubles, physical and sexual violence, alcohol abuse, drug abuse and other stressful effects can also be realized in the form of painful sensations. Among the factors causing pain in the lower abdomen, one can name an overflow of the colon and diverticulosis, spasms of an empty stomach, the first three months of bearing a child, when the muscles and ligaments of the abdomen stretch. Also, pain in the lower abdomen in women can be caused by pathological reasons, among which the following are most common:

An inflammatory process, acute or chronic, in the female reproductive organs - the ovaries, the body of the uterus, the vagina or the fallopian tubes. Often a woman has pain and a pulling sensation in the lower abdomen due to an ovarian cyst that has grown to a large size or due to chronic adnexitis, pain can be caused by colpitis or adhesions, endometriosis or a benign formation in the myometrium of the uterus - fibroids. Most often, in addition to pain, these diseases are accompanied by fever, discharge, weakness. Analytical studies of blood serum show an increased level of leukocytes, confirming the inflammatory process.

Why do women have lower abdominal pain if the cause is clearly not gynecological? Factors that provoke lower abdominal pain can be various inflammatory processes of the urinary organs such as cystitis, pyelonephritis or kidney stones. Blood tests also show an increase in the level of leukocytes, both leukocytes and erythrocytes are found in the urine, the urine itself darkens, becomes cloudy, often with inclusions of purulent elements. In addition to pain in the lower abdomen, the above diseases can cause an increase in body temperature, pain when urinating, severe swelling.

Pathological processes in the pelvic organs can also provoke pain in the lower abdomen in women. These can be hernias of various sizes, diverticulosis of the colon. Constant constipation is a functional disease called megacolon, in which the walls of the colon hypertrophy, and the intestine itself constantly thickens. In addition to the fact that the lower abdomen hurts a lot, diseases are often accompanied by poor appetite, general fatigue, flatulence, hemorrhagic thrombosis of the veins of the rectal part of the digestive system.

If the lower abdomen hurts, the causes may be more serious - these are oncological diseases such as tumors - cancer of the uterus and ovaries.

All diseases that require urgent surgical care can also cause pain in the lower abdomen, although these conditions are most often accompanied by characteristic symptoms, which in surgical practice are called "acute abdomen". This is appendicitis, protrusion of the wall (diverticulum) of the ileum - Meckel's syndrome, which in addition to pain is manifested by vomiting and blood in the feces. Often, a woman's lower abdomen hurts due to volvulus of the sigmoid colon, torsion of the ovarian cyst stalk, rupture of the cyst, perforation of the ulcer and ectopic, tubal pregnancy, torsion of the subperitoneal uterine fibroid. Each of these serious diseases can end badly if timely medical care is not provided. In addition to the fact that the temperature rises, acute pain in the abdomen occurs, these conditions are characterized by a sharp drop in blood pressure, nausea, severe weakness to the point of loss of consciousness.

The causes may also include infectious diseases, including intoxication. In addition to painful sensations in the epigastric region, a woman often has diarrhea, vomiting, and an increase in body temperature.

Pain in the lower abdomen can be caused by extragenital factors, but most often the pain symptom is a sign of gynecological disorders, among which the most common are the following:

• Apoplexy, rupture of the ovary. In this case, there may be bleeding into the peritoneum or the capsule may rupture without bleeding, but both types of apoplexy are accompanied by severe pain.
• A congenital pathology that interferes with the normal development of the genitals and interferes with the outflow of blood.
• Primary or secondary menalgia or algomenorrhea is severe pain during the menstrual cycle.
• Pathological inflammatory processes in the pelvic organs, progressing to an acute stage.
• Torsion of the pedicle of various types of cysts or uterine appendages.
• Rupture of a large purulent or simple cyst.
• Hyperstimulation of ovarian function due to taking hormonal drugs.
• Termination of an ectopic or tubal pregnancy is a condition that requires emergency surgical care.
• A uterine fibroid that is increasing in size.
• Inflammation of the endometrium, adnexitis, parametritis.
• Necrosis of myoma tissue or its torsion - this concerns myomas growing towards the peritoneum (subserous formations).
• The development of a myoma growing in the submucosal tissue towards the uterus is a submucosal formation.
• Threat of miscarriage in the early or late stages of pregnancy.
• Mechanical injuries to the peritoneum and uterine walls (blow, fall, accident, etc.).
• Iatrogenic trauma during minor surgery, including perforation of the uterus during termination of pregnancy – abortion.
• Tuberculosis of the pelvic organs.
• Adhesions.
• Fusion of the cervical canal and disruption of blood outflow during menstruation – atresia.
• Accumulation of fluid secretion in the abdominal cavity, cyst - serocele.
• An intrauterine device that is inserted incorrectly and causes pain.
• Varicose veins, pathological expansion of the venous system of the pelvis.

Also, a woman has severe pain in the lower abdomen with diverticulitis, perforation of a stomach or intestinal ulcer, or strangulation of an irreducible hernia. In addition, pain in the lower abdomen can be associated with advanced cystitis, pyelonephritis in the acute stage, granulomatous enteritis (Crohn's disease), and an oncological process.

If your lower abdomen hurts a lot?

Regardless of who suffers from pain, a man or a woman, there are common signs of emergency conditions and rules of behavior in such cases.

My lower abdomen hurts a lot. What should I do and what should I never do under any circumstances?

The condition, which in clinical practice is characterized as "acute abdomen" is a serious threat not only to health, but also to life, accompanied by the following symptoms and signs:

• Sharp, unbearable pain that lasts for an hour.
• Significant increase in pain with the slightest strain or cough, when turning over or any movement.
• Pain in the lower abdomen that does not change in intensity when the patient changes position or posture.
• If there was no bowel movement for 24 hours before the pain appeared, the abdomen is tense and swollen, this may indicate acute intestinal obstruction.
• My stomach not only hurts a lot, it's tense.
• Pain in the lower abdomen is accompanied by increased heart rate, sweating, pale skin, decreased blood pressure, and even fainting and loss of consciousness.
• If the pain is accompanied by defecation, in which blood clots are observed in the stool (the stool is black or of an unusual color).

In any case, it is almost impossible to independently diagnose and differentiate a serious, life-threatening disease from others that do not require emergency care. Therefore, in case of severe pain that does not go away within an hour, high temperature, weak pulse, nausea and vomiting, you need to call an ambulance.

Before the arrival of specialists, the following independent actions are permissible:

• The patient needs complete rest, silence, a ventilated room and a horizontal position.
• You can put something cold on the abdomen - a heating pad with ice, a chilled bottle of water, a cold compress. The cold should not be kept for more than 20-25 minutes, cold compresses should be changed to avoid warming the abdomen.
• Of the medications, it is permissible to take No-shpa, no more than two tablets. All other medications can only be prescribed by a doctor after examination and preliminary diagnosis.
• If signs of internal bleeding appear - fainting, bluish complexion, increased heart rate, and there is a medical worker nearby, you can put in an intravenous drip with sodium chloride solution.

The lower abdomen hurts a lot, the following actions are unacceptable:

• You cannot choose and take painkillers on your own. At a minimum, this "blurs" the clinical picture and complicates the correct diagnosis, at a maximum - it provokes an even greater exacerbation of the underlying disease.
• You cannot warm your stomach to avoid the development of extensive sepsis; only cold is allowed.
• You cannot take medications from the laxative series; enemas are not allowed.
• You should not eat or drink anything. If your mouth is very dry, you can wet your tongue and lips.

These are recommendations that apply to both men and women, and it is especially important to be attentive to pain symptoms in children who are not yet able to correctly describe their feelings. At the slightest alarming signs of illness in a child, you should immediately seek medical help.

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Lower abdominal pain during menstruation

This type of pain is most common in young women whose hormonal system has not yet stabilized. Menstruation itself is not a disease, it is a natural physiological condition that ensures a woman's reproductive function. If all of a woman's organs and systems are functioning perfectly, the menstrual cycle should not cause discomfort. Some pain may occur in the first two or three days of the cycle and then disappear. The lower abdomen usually hurts during menstruation due to a dissonance between different types of sex hormones - prostaglandins and progesterone. The uterus produces substances that ensure its contractile function - prostaglandins. If there are too many of them, contractions become intense, and pain increases accordingly. Excess prostaglandins can also provoke headaches, nausea, and even vomiting. An increased level of contractile hormones is typical for young women who have not yet given birth. If the lower abdomen hurts during menstruation in women who have given birth, this may be evidence of more serious pathologies - endometriosis, uterine fibroids, adnexitis, inflammatory process in the ovaries, in the fallopian tubes and many other diseases. In addition, an unsuccessfully selected intrauterine device can also provoke painful sensations during menstruation. Pain in the lower abdomen can also be accompanied by other symptoms, among which the most common are the following:

• Pain radiating to the lumbar region.
• Heaviness and pain in the legs.
• Nausea, vomiting.
• Disturbance of defecation, diarrhea or constipation.
• General weakness.
• Irritability, tearfulness, often increased aggressiveness.

Urgent medical care is needed for pain during menstruation if the following symptoms appear:

• The pain becomes intense as the bleeding increases. The test is a sanitary pad that overflows in one hour.
• In addition to pain, the woman feels an increase in body temperature, a feverish state, and sweating.
• The pain is accompanied by severe aching in the joints.
• Pain in the lower abdomen is accompanied by dizziness and loss of consciousness.

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After menstruation, my lower abdomen hurts

This is typical for conditions caused by excess levels of prostaglandins, which are responsible for the contractile function of the uterus. During the cycle, the uterus must contract to remove blood clots; after the end of the cycle, contractions become less active. However, if a woman's hormonal system is not functioning properly, there is a hormonal imbalance, pain may occur after the menstrual cycle. Often, women aged 30-35 experience increased estrogen production, which leads to pain in the lower abdomen during the cycle, which can also change and go wrong. As a compensatory response, the uterus begins to actively produce prostaglandins, which continue the contraction of the organ after the end of menstruation. Postmenstrual pain in the lower abdomen is often caused by stress or depression. As a result of a difficult cycle, the thyroid gland, which controls the hormonal balance, is disrupted. A kind of vicious circle is obtained, in which one pathological factor provokes another. In addition, after menstruation, the lower abdomen often hurts due to a congenital anomaly of the uterus - underdevelopment or its incorrect position. Any inflammatory process - adnexitis, salpingitis can cause prolonged postmenstrual pain. An intrauterine device can also interfere with normal contraction of the uterus, irritating the walls and cavity of the uterus. In situations where the pain after the cycle does not stop for two or three days, you should not worry, this is most likely a normal physiological hormonal "jump". If after menstruation the lower abdomen hurts for four or more days, especially if there is discharge and elevated body temperature, you need to see a doctor to rule out a serious inflammatory process in the pelvic organs.

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After ovulation, lower abdominal pain

This is also a common phenomenon in gynecological practice, women often complain of pain in the lower abdomen during the period of follicle maturation and uterine contraction. Surprisingly, even women who have given birth sometimes do not know what ovulation is and how the fertilization process is connected with it.

Ovulation is the period when a mature follicle “releases” a single egg into the abdominal cavity, ready for fertilization. This process begins with the first menstrual cycle and gradually fades away during the climacteric period. If a couple is planning to have more children, then the ovulation days are the most favorable days for conceiving a baby. The ovulation period is individual for each woman and depends on the length of the monthly cycle. The boundaries of the ovulation period vary from 22 to 33-35 days. Ovulation is often accompanied by painful symptoms, in addition, during this period, fertility (attraction) to the opposite sex increases significantly, which is evidence of the natural predisposition of these days to conception. Pain both during and after ovulation is most often of medium intensity and is an acceptable physiological norm. Rarely, the pain becomes severe, cramping, but, as a rule, it does not last long. If the pain alternates from the left side to the right, this indicates the maturation of the follicle in the left and right ovaries. Painful sensations after ovulation are very rare, and if they appear, this may indicate the following conditions:

• Exacerbation of chronic, latent inflammation in the ovaries.
• The completion of conception.
• Pregnancy, which may be associated with some inflammatory processes in the ovaries.
• Pathological processes in the pelvic organs that are not associated with the maturation of follicles and the release of the egg.

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Lower abdominal pain and discharge

This is a sign of an inflammatory process that is entering the acute stage. Often, pain in the lower abdomen, accompanied by milky discharge, is a symptom of a common disease - thrush or candidiasis. In fact, this is also an inflammation of the vagina, but it is usually caused by Candida albicans - specific yeast-like organisms, fungi. The reasons why the lower abdomen hurts and the discharge becomes abundant, characterized by its curdled consistency, are very diverse. Among the most common are the following:

• Pathology of the endocrine system – hyperthyroidism, hypothyroidism.
• Diabetes mellitus, in which the blood sugar level is elevated, and accordingly, in vaginal discharge. The acidity of the excretory secretion decreases, which creates a favorable, comfortable environment for the reproduction of Candida albicans.
• Metabolic disorders, obesity or anorexia.
• Long-term use of medications - antibiotics, hormonal agents.
• Physiological changes in the body – climacteric period.
• Long-term use of contraceptives.
• Diseases of venereal etiology.
• Infectious diseases of the pelvic organs - mycoplasmosis, chlamydia, ureaplasmosis.
• A consequence of surgical intervention, as a result of which the body goes through an adaptation process.
• A change in climate zone, especially often provokes pain in the lower abdomen and discharge, moving to hot countries.
• General decrease in the protective functions of the immune system.
• Avitaminosis.

Thrush is not a health-threatening disease, but its chronic course can provoke an erosive process in the cervix, which is considered a rather serious pathology.

This is also a sign of an inflammatory process in the appendages. Inflammation of the appendages can manifest itself as painful sensations on the left or right side, radiating to the thigh or sacral region of the lower back. Discharge during inflammation is mucous, often with pus. The body temperature may rise, a feverish state may occur, which indicates an exacerbation of the process.

Also, pain in the lower abdomen may be regular, but not severe, discharge may be scanty, but these symptoms also cannot be ignored in order to prevent exacerbation and more serious problems that may require emergency surgical care.

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Lower abdomen hurts after sex

This is evidence of pathological processes that may be hidden in the body, but often such pain is provoked by psychogenic factors.

Lower abdominal pain after sex is also a symptom of standard gynecological problems that require diagnostics and treatment. Lower abdominal pain after sexual intercourse may indicate a ruptured ovarian cyst, a ruptured ovary itself, or a threat of miscarriage in the early stages of pregnancy. In addition, the cause of pain may be purely mechanical, when sexual intercourse was too rough, intense, and caused trauma to the vaginal wall, damaged the mucous membrane of the cervix. If your lower abdomen hurts after sex and there is bloody discharge, you should urgently seek medical help, especially if the bleeding is intense.

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My lower abdomen has been hurting for a week

Such constant abdominal pain is called chronic abdominal pain. Patients describe the sensations very differently – from a burning sensation to constant pressure and heaviness. Quite often, the reason for the lower abdomen hurting for a whole week is an elementary violation of the diet, the gastrointestinal tract is simply unable to work rhythmically in a normal mode. However, chronic, persistent pain in the lower abdomen can often indicate developing gallstone disease, pancreatitis, an inflammatory process in the large intestine. The pain can be truly constant, but it can also be cramping. As a rule, if a person suffers from pain in the lower abdomen for a whole week, the pain is quite weak and does not differ in intensity. It is important to note how the pain is associated with food intake, whether it occurs before or after eating. Also, chronic pain in the lower abdomen can be a symptom of a psychosomatic disease, more associated with neurology than with gastroenterology. In clinical practice, such pain is called neurotic.

The stomach actually hurts, although there are no objective external or internal reasons. This is due to a psycho-emotional factor, which may be an unloved job, intense study and fear of exams, family troubles. Also, the cause of constant pain may be vegetative-vascular syndrome, which is also a neurological disease. One of the causes of chronic, recurring pain is helminthic invasion. Chronic pain is diagnosed using a comprehensive examination, the more complete it is, the more accurate and effective the treatment will be. The standard diagnostic complex includes the following procedures:

• Collection of anamnestic information, including family information.
• Palpation of the abdominal region.
• Fibroesophagogastroduodenoscopy – FGDS.
• A comprehensive clinical blood test, including a white blood cell count.
• A biochemical blood test that determines the level of enzymatic activity of the liver and pancreas.
• Ultrasound examination of abdominal organs.
• Analysis to determine helminthic invasion, coprogram.

If your lower abdomen hurts a lot

However, there are conditions that require immediate medical attention, these are all severe pain sensations that do not go away within an hour.

Severe pain in the lower abdomen is one of the most typical symptoms presented in gastroenterological and gynecological practice. The abdomen most often hurts intensely, since there are thousands of nerve endings and pain receptors in the gastrointestinal tract. The nature of the pain can be different: pulling, sharp, aching, cutting, etc. The pain symptom in the abdominal area is not specific, since many diseases are accompanied by painful sensations.

Women experience severe pain in the lower abdomen during the menstrual cycle; in men, pain in the lower abdomen can be a sign of urological pathology.

Some of the main reasons why women experience severe pain in the absence of signs of pregnancy are the following:

• An ectopic pregnancy, in which the egg does not reach the uterine cavity and begins to implant in the fallopian tube. There may be no signs of pregnancy, but after three to four weeks, the egg begins to grow and destroy the tissues of the fallopian tube. This process is accompanied by severe pain, nausea, dizziness and loss of consciousness. This condition requires immediate surgical intervention.
• Apoplexy, ovarian rupture. Rupture can be caused by trauma, intense physical activity or sexual contact. Symptoms are very similar to those of ectopic, tubal pregnancy. Pain can radiate to the lumbar region, accompanied by vomiting, weakness and loss of consciousness. Treatment is urgent, surgical.
• Torsion and obstruction of blood outflow through the veins in the ovarian cyst stalk. The cyst begins to grow rapidly, presses on nearby organs, often fusing with them. The pain in the lower abdomen is aching, quite strong, but transient and recurrent. Treatment is surgical.
• Inflammation of the appendages, which occurs quite often after an abortive termination of pregnancy, after childbirth. The pain is diffuse, severe, intermittent. If the diagnosis is not made in time, the spread of the infection can lead to peritonitis. In the acute stage, adnexitis causes severe pain in the lower abdomen radiating to the groin. The temperature is elevated, the abdominal muscles are very tense. Treatment in the initial stage of adnexitis is medicinal, conservative, in the acute stage with the threat of peritonitis, surgical intervention is possible.

In addition, the lower abdomen hurts a lot with ureaplasmosis, pathological diseases of the urinary system. In men, acute pain in the lower abdomen is a typical sign of inflammation of the urethra, acute stage of prostatitis, strangulated hernia.

All conditions associated with severe pain require immediate medical attention.

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My lower back and lower abdomen hurt

This is a description of the so-called pelvic pain. Pelvic pain is considered to be all painful sensations in the lower abdominal area, accompanied by pain in the sacrum, lumbar region. Often such pain in men is given (irradiated) to the rectum or vagina - in women. Pain in the lower back and lower abdomen is a non-specific symptom that can indicate various diseases, such as gynecological, proctological, vascular or urological. The nature of pain also varies, they can be acute or chronic, long-term.

Acute lower back pain is a sudden painful sensation that lasts for two to three hours, combined with fever, nausea, weakness and a feverish state. This is how acute conditions that require immediate surgical care often manifest themselves - inflammation of the appendix, acute intestinal obstruction, an attack of cholecystitis, rupture of an ovarian cyst, purulent inflammation of the urethra, pyelonephritis and other diseases.

Chronic, long-term pelvic pain is a periodically recurring discomfort that sometimes lasts for months. Such pain indicates a developing hidden pathology that does not yet manifest itself.

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Lower back and lower abdominal pain – causes and types of diseases

Gynecological reasons:

• Endometriosis, which can have different forms:
• Hormonal imbalance, disruption of the normal anatomical structure of the uterus, thickening of the walls and deformation of tissues.
• Vulvodynia (vaginal pain) caused by endometriosis.
• An inflammatory process in the pelvic organs caused by endometriosis.
• Neoplasms (uterus, ovaries) – benign and malignant.
• Prolapse of the vaginal walls and uterus or POP (pelvic organ prolapse).

Urological causes:

• Interstitial cystitis is a disease of unknown etiology, when bacterial studies do not reveal the causative agent of the inflammatory process.
• Infectious inflammation of the urinary tract.
• Urolithiasis or urolithiasis.
• Bladder cancer.
• Adhesive causes, which often accompany surgical intervention, also adhesive disease can develop and cause pain in the lower back as a result of a closed injury.

Proctological causes:

• Hemorrhoids, which manifest as chronic pelvic pain.
• Inflammation of the mucous tissue of the rectum – proctitis.
• Intestinal tumor.

Neurological causes:

• IBS – irritable bowel syndrome.
• Radiculopathy is an inflammatory process of the spinal cord root or its infringement (radiculitis).
• Hernia, osteochondrosis or prolapse (falling out) of the intervertebral disc.

Vascular causes:

• VRVMT – varicose veins of the pelvic vein system.
• Pelvic varicose veins are an increase in the length of the veins of the small pelvis, their expansion.

Musculoskeletal causes:

• Inflammatory processes in the joints.
• Fibromyalgia is a muscle spasm that causes lower back pain.

Gastroenterological causes:

• Colitis.
• Retroperitoneal oncological process, tumors.
• Intestinal obstruction.

Psychogenic causes – depressive disorders, violence, neurotic fear of sexual contact.

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My lower abdomen hurts on the left

The lower abdomen can be divided into quadrants - the right lateral part, the umbilical part, the left lateral part, the right and left inguinal area and the pubic part. Localization of pain in a particular area is one of the important diagnostic symptoms that help to identify the cause of painful sensations.

Pain in the lower abdomen on the left is a signal of possible problems in the organs located in this abdominal part: in the left part of the intestine, in the left kidney, in the internal reproductive organs. Also, pain in the left abdominal area can be non-specific and identical in the diagnostic sense to pain in the right abdominal area, with the exception of inflammation of the appendix. If the lower abdomen hurts on the left, this may mean that the sigmoid colon is inflamed, or urolithiasis, adnexitis or diverticulitis is developing. Due to the non-specificity of the left-sided pain symptom, diagnostics include a complete examination of the abdominal organs, regardless of their location - on the right or left. A comprehensive study allows for the timely detection of diverticulitis, which is also called left-sided appendicitis. If this disease is not diagnosed in time, especially in elderly patients, it can lead to perforation of the lower part of the colon (sigmoid), which is an indication for urgent surgical intervention. Pain in the left quadrant of the abdomen may also indicate tubal pregnancy, and in addition, strangulated inguinal hernia may also signal itself in this way. Ulcerative colitis, granulomatous enteritis (Crohn's disease or terminal ileitis), and helminthic invasion may also be one of the causes of left-sided pain. Often, a renal calculus, which is localized in the left kidney, passing through to the bladder, also causes severe pain in the left side of the peritoneum.

My lower abdomen hurts on the right side

The obvious localization of pain, in a sense, is a plus for diagnosing the disease, while diffuse (widespread) pain in the lower abdomen greatly complicates diagnosis due to its non-specificity. The first thing that comes to mind with right-sided abdominal pain is appendicitis. Indeed, right-sided localization of painful sensations is a specific manifestation of appendicitis, but the lower abdomen hurts on the right side with other diseases as well. For example, an inflamed ureter or an attack of cholecystitis, liver inflammation or an acute stage of pyelonephritis can also “respond” with right-sided painful sensations. Crohn's disease, a complex inflammatory disease of unclear etiology, can also signal its development. Terminal ileitis, as Crohn's disease is also called, is a pathological lesion of the walls of the entire digestive tract, starting from the ileal region, where the first symptoms appear. However, when ileitis develops, the symptoms may move down the peritoneum. In addition, cystitis or urolithiasis, ulcerative right-sided colitis, herpetic lesion of the intestinal walls may signal and manifest themselves as pain localized in the lower right part of the abdomen.

Since the abdomen is a receptacle for many organs and systems, right-sided pain may indicate an inflammatory process, pathology or chronic course of the disease of the following organs located in this part of the peritoneum:

• A vermiform portion of the cecum or appendix, the inflammation of which most often manifests itself as pain in the right side of the abdomen - the upper or lower quadrant.
• Most of the intestinal tract, areas of which are often subject to inflammation, including infectious ones, obstruction, and an oncological process in the intestine is also possible.
• The right lower quadrant contains the right ureter, which can become inflamed and cause right-sided pain.
• The right fallopian tube, which is slightly longer than the left according to its anatomical structure. Inflammation can develop in the tube – salpingitis, endometrial polyp.

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My lower abdomen hurts and I have a fever

This is a signal that the pathological process in the peritoneum organs is already moving into the acute stage. Hyperthermia is a characteristic sign of an acute inflammatory disease, but this symptom often appears at the stage when urgent medical care is needed. Even with gangrenous appendicitis, the patient may have a relatively low body temperature, and with perforation it may even decrease. Also, hyperthermia itself cannot be a specific symptom of a viral or bacterial infection. Many severe ulcerative processes are not always accompanied by significant temperature jumps, for example, a perforated ulcer often manifests itself only with pain symptoms in the first hours.

Appendicitis, inflammation of the gallbladder (cholecystitis), diverticulitis, dysentery, adnexitis and pyelonephritis, and many other diseases may be accompanied by painful sensations and slight hyperthermia. This applies to urological pathologies, gynecological and proctological diseases, and even venereal diseases, since, for example, gonorrhea also sometimes manifests itself with abdominal pain and hyperthermia. The combination of "lower abdomen pain and fever" in clinical practice is considered a serious signal of the acute period of the disease, and a high temperature that exceeds 38-39C is a clear indication of septic damage to the body, the cause of which may be ovarian cyst apoplexy, rupture of the abdominal aorta, splenic infarction, peritonitis, rupture of the fallopian tube, infectious diseases of the kidneys or gallbladder. Both too high temperature limits and low temperature – hypothermia – are bad signs in a prognostic sense. All conditions, the symptoms of which include pain in the lower abdomen and temperature, require medical care, and if the thermometer shows 34-35 or 38-40C, you need to call an ambulance, as these are clear signs of sepsis and internal bleeding.

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Chronic pain in the lower abdomen

Chronic lower abdominal pain is persistent pain that remains the main complaint, interfering with work capacity for six months or more. The correlation between the severity of pain manifestations and the severity of abdominal pathology is usually insignificant. Chronic abdominal pain is often accompanied by mental disorders, such as depression and sleep disorders. Chronic lower abdominal pain not associated with diseases most often occurs in women who have been sexually abused. There are also statistics showing that in a third of women who underwent laparoscopy for chronic painful sensations, the cause of the disease could not be determined, which indicates a psychogenic cause of acute painful sensations. 10-20% of hysterectomies in the United States are performed annually for chronic lower abdominal pain caused by purely mental factors. Hysterectomy is highly effective in reducing the severity of pain syndromes associated with a subconscious protest against sexual contact. This reduces sexual dysfunction, lowers the level of psychogenicity and improves the quality of life of a woman, even if pathology from the uterus is not detected. There is no data on hysterectomy for psychogenic pain in our countries, it is obvious that such operations are not in demand and necessary for our women. Pain can also be a consequence of a hidden inflammatory process, infectious diseases such as chlamydia or mycoplasmosis. Any discomfort associated with sexual relations should be eliminated, perhaps not in such a radical way as is practiced in the USA. Modern gynecology has more effective means that help to identify the true cause of pain after sex and effectively eliminate it.

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Chronic lower abdominal pain due to gynecological problems

Dysmenorrhea is the most common cause of chronic painful sensations. Dysmenorrhea is called cyclical pain in the uterine region that occurs before or during menstruation. It is believed that primary dysmenorrhea is not associated with pathology of the pelvic organs, but with hyperproduction of prostaglandins by the uterus. Secondary dysmenorrhea is usually associated with the presence of acquired pathology (for example, endometriosis).

Endometriosis. The severity of pain in this disease varies from dysmenorrhea to intense, intractable chronic pain leading to loss of ability to work. The intensity of pain does not correlate with the severity of the pathology.

Adenomyosis is a common condition that is asymptomatic in most women. Adenomyosis is characterized by an enlarged, softened uterus that is slightly painful to palpation. However, adenomyosis is considered a pathological condition.

Fibromyoma is the most common benign tumor of the pelvic cavity in women. Pain in fibromyoma is caused either by compression of adjacent organs or by degenerative processes occurring in the tumor.

Ovarian sparing syndrome is characterized by recurrent pain in the uterine appendages after hysterectomy.

Prolapse of the genitals may be accompanied by a feeling of heaviness, pressure, or dull pain.

Chronic inflammatory diseases of the pelvic organs are characterized by prolonged pain, usually arising due to the presence of hydrosalpinx, tubo-ovarian cysts or adhesions in the pelvic cavity.

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Chronic lower abdominal pain due to non-gynecological diseases

Adhesions from infections or surgeries can cause chronic lower abdominal pain that is difficult to treat.

Gastrointestinal pathology, such as inflammatory bowel disease ( Crohn's disease, ulcerative colitis ), irritable bowel syndrome, constipation, fecal impaction, may be accompanied by pain. Lower abdominal pain may increase in the perimenstrual period.

Musculoskeletal conditions such as poor posture, muscle strains, and herniated discs can cause referred pain.

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Sharp pain in the lower abdomen

If you have acute pain in the lower abdomen, an active tactic is necessary, as a life-threatening condition may be present.

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Lower abdominal pain due to gynecological disease

Acute lower abdominal pain is divided into three categories: infection, rupture, and torsion.

Ectopic pregnancy. In all women of reproductive age, when examining for acute pain in the lower abdomen, it is first necessary to exclude a terminated ectopic pregnancy.

Acute inflammatory diseases of the pelvic organs are ascending bacterial infections that are usually accompanied by the following symptoms: fever, pain in the lower abdomen and pain when moving the cervix; they most often occur in women who are sexually active.

Rupture of an ovarian cyst. Acute pain in the lower abdomen most often occurs in the following conditions: intra-abdominal ruptures of a follicular cyst, corpus luteum or endometrioma. Pain in the lower abdomen can be so acute and intense that it is sometimes accompanied by loss of consciousness. The condition usually tends to self-limit with the cessation of bleeding.

Torsion of the uterine appendages usually occurs in adolescents and women of reproductive age. When twisted on a vascular pedicle, any volumetric formation of the uterine appendages (dermoid tumor of the ovary, Morgagni hydatid) can cause acute, severe pain in the lower abdomen due to a sudden disruption of blood supply. Often, in these conditions, pain in the lower abdomen intensifies and then decreases and is accompanied by nausea and vomiting.

Threatened, incomplete abortion and abortion in progress are often accompanied by painful sensations along the midline, usually of a spastic, periodic nature.

Disintegrating fibroids or ovarian tumors can cause stabbing, cutting, or aching pain.

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Lower abdominal pain due to non-gynecological diseases

Appendicitis is the most common acute surgical pathology of the abdominal organs, occurring in all age groups. In classic cases, diffuse pains with the epicenter in the umbilical region first occur, but then, after a few hours, the pain is localized in the right iliac region (McBarney point). Appendicitis is often accompanied by low fever, anorexia and leukocytosis.

Diverticulosis is more common in older women and is characterized by pain in the left lower abdomen, bloody diarrhea, fever, and leukocytosis.

Diseases of the urinary system (cystitis, pyelonephritis, urolithiasis) can cause acute or radiating pain above the pubis, a feeling of pressure and/or dysuria.

Mesadenitis often occurs in girls after an acute respiratory infection. Pain in the lower abdomen is usually more diffuse and less acute compared to appendicitis.

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My lower abdomen hurts: what should I do?

When collecting anamnesis, the nature, intensity and prevalence of pain in the lower abdomen are determined. However, pathological intra-abdominal processes are characterized by an indefinite localization of pain

The physical examination should include a complete pelvic examination, with particular attention to the reproduction of pain symptoms.

Bacteriological studies, blood chemistry, electrolyte levels, ultrasound, or other imaging studies may be indicated.

A specialized diagnostic examination is carried out taking into account the suspected diagnosis, and consultations with other specialists (anesthesiologist, orthopedist, neurologist or gastroenterologist) may be required.

The algorithm of actions in case of painful sensations depends on the organic or physiological type of causes. A physiological factor, such as the menstrual cycle, involves taking antispasmodics and observation by the attending physician in order to select adequate methods that will reduce painful sensations as much as possible. Organic causes involve either outpatient conservative treatment or emergency surgery if the disease has gone too far. This table will help you navigate the possible causes and actions when your stomach hurts:

Description of pain in the lower abdomen	List of possible reasons	Actions
Sharp, severe pain, nausea to the point of vomiting.	Intestinal infection, Intoxication, Inflammation of the vermiform part of the cecum - appendix, Intestinal obstruction.	Calling an emergency.
Sharp pain in the right side, radiating upwards	Attack of cholecystitis, Attack of hepatic colic.	Call a doctor if the temperature rises to 38-39C, call an ambulance.
Sharp pain radiating to the groin and vagina.	Renal colic.	Call an ambulance.
Increasing pain in the right or upper right quadrant.	Acute inflammation of the appendix.	Call a doctor or emergency help.
Severe pain in the lower abdomen, transient and subsiding after urination.	Inflammation of the ureter.	Call a doctor or visit a urologist yourself. Strict diet, no physical activity.
Acute, widespread pain that subsides after a bowel movement (often after diarrhea).	IBS – irritable bowel syndrome.	Independent visit to a gastroenterologist. Diet, exclusion of physical activity.
Pain on the right or left side, accompanied by diarrhea with blood clots.	Colitis (ulcerative), Crohn's disease.	Rest, diet, call a doctor to your home.
Severe pain in the lower left abdomen, increase or decrease in body temperature, decrease in blood pressure.	Possible thromboembolism (infarction) of the spleen, Rupture of the spleen capsule, Attack of renal colic.	Taking No-shpa. Urgent call for emergency care.
Aching, chronic pain on the right or left.	Cholecystitis, right-sided inflammation of the renal pelvis , left-sided pyelonephritis, stones, sand in the kidneys.	Independent visit to the doctor.
Pain that pulls downwards, dull pain on the right or left side.	Salpingitis, Inflammation of the fallopian tubes, Inflammatory process in the ovaries - salpingo-orphitis, Inflammatory process in the bladder - cystitis, Urethritis (in men), Prostatitis (in men), Vesiculitis - an inflammatory process in the seminal vesicles.	Independent visit to the doctor, full examination.
Chronic pain in the lower abdomen and lower back.	Inflammation of the renal pelvis, kidney tissue (pyelonephritis), including purulent, Oncoprocess in the kidneys, Kidney stones, Varicose veins of the pelvic organs, Tumors of the pelvic organs, Adenoma (in men).	Independent visit to a doctor, full diagnostic complex, examination of the body.

Lower abdominal pain is easiest to eliminate in the first hours of its manifestation, however, there are not many indications for independent action. The abdominal organs are very vulnerable and sensitive to various effects, both temperature and medication. An inept step, such as a heating pad on the stomach, can provoke peritonitis and sepsis, so the first rule for abdominal pain is observation for an hour. If the pain does not subside, but increases, the temperature rises, nausea, vomiting, weakness appear, you should not hesitate, but call an ambulance.