Female abdominal pain is very common and often easy to manage, and there are lots of different reasons girls and women might experience it. By ‘lower abdomen’, we usually mean the lower tummy, below the level of the belly button (navel). Pain in that area might also be referred to as pelvic pain, or just stomach ache.
Most lower abdominal pain isn’t a sign of a dangerous condition, but occasionally that kind of pain can be a clue to something more serious. If you’re worried about lower abdominal pain, it’s probably fine. But paying attention to the area of the tummy that hurts can be a good way to know what’s causing the pain, and how to manage it.
Central lower abdominal pain
The main organs in the middle of a woman’s lower abdomen are the bladder, the uterus (womb) and part of the bowel. Here are some of the potential causes of pain in that area.
Period pain is usually a crampy, dull or tight pain in the middle of the lower abdomen, sometimes radiating outwards or into the lower back. It can be very uncomfortable, but many people find that they can manage it with a hot water bottle and/or ibuprofen.
Urinary tract infection
A water infection, or a UTI can cause some lower abdominal pain in women, as well as urinary symptoms like burning when you pee, or needing to go to the toilet very frequently or urgently.
Mild urinary tract infections like cystitis often clear up on their own if you drink plenty of fluids, but more persistent UTIs might need a short course of antibiotics, which a GP can prescribe. More severe UTIs can affect the kidneys, and might cause lower back pain on either or both sides, and make you feel generally unwell, sometimes with flu-like symptoms. It’s important to consult a doctor as soon as possible if your symptoms are more severe. If you have recurring UTI symptoms, this should also be checked out by a GP.
Pelvic inflammatory disease
Infections in the reproductive system can affect the uterus, fallopian tubes and ovaries. An untreated infection in the reproductive tract can become very serious and lead to long-term problems, so needs to be treated by a doctor. These kinds of infections are often caused by an underlying sexually transmitted infection, so if you’re a woman who’s sexually active, make sure you have regular sexual health screening.
Pain during sex, unexpected vaginal bleeding or discoloured, smelly discharge might all accompany a sexually transmitted disease, or infection of the reproductive system.
Pain in the lower left abdomen
Any of the causes of one-sided abdominal pain listed above can affect the left side, but there are some reasons that the pain might be only on the left – particularly because the bowel on the left is closer to the end of the digestive system. Trapped wind and bloating might particularly affect the left side.
Polyps or diverticular disease
Diverticular disease can also affect the lower left side, or can cause more generalised pain. Polyps are small wart-like lumps in the bowel, and diverticular disease is a condition where the bowel has tiny pockets coming off it. When those small pockets get inflamed we call it diverticulitis, and it can be painful.
Diverticulitis and polyps can both cause diarrhoea and sometimes bleeding in the bowel, and if you notice blood mixed into your poo, or if your poo looks black and tarry, it’s important to see a doctor straight away.
Pain in the lower right abdomen
The right lower abdomen contains the part of the bowel where the small intestine meets the large intestine. The appendix is a small part of the bowel which is found near that join, which can become inflamed, swollen, and infected. This is appendicitis. Appendicitis is usually very painful, and causes lower right abdominal pain – though the pain might also be felt in the central lower abdomen as well.
General lower abdominal pain
Muscular pain accounts for some cases of lower abdominal pain. A strained muscle from exercise or an injury can be very painful, and can affect one or both sides, or be more generalised across the lower abdomen. Sometimes it’s possible to work out why or when muscular pain started, and it’s usually manageable with simple painkillers and rest.
Lower abdominal pain in pregnancy
Pregnancy causes major changes in the shape and place of lots of the organs and muscles of the lower abdomen which can cause some discomfort and strain. In the later stages, women often also experience Braxton Hicks contractions, where the muscles tense hard as they prepare for childbirth.
Remember it’s always okay to ask your named midwife or prenatal team for advice if you have any concerns about your health in pregnancy. There are some serious causes of lower abdominal pain in pregnancy, so severe unexplained pain,or pain alongside unusual vaginal discharge or bleeding should be treated as an emergency.
Problems with one ovary or fallopian tube can result in lower abdominal pain which might just cause pain on one side or the other. These conditions can also cause general or central lower abdominal pain, and the pain is usually very severe. Ectopic pregnancies affect around 11,000 people in the UK every year.
When to see a doctor
Occasional lower abdominal pain isn’t unusual for women, and period pain is a particularly common cause. Some pain can be managed at home with simple painkillers, hot water bottles, and rest or gentle exercise depending on the cause.
Very severe or unmanageable pain, which doesn’t have an obvious cause or which has other worrying symptoms, should be checked out by a doctor urgently. It isn’t always easy to pinpoint a cause yourself, but it’s useful if you can identify any urinary symptoms, problems with your bowels, or whether the pain is linked to your period. Recurring pain should also be checked out by a GP.