Urinary, digestive, genital infection, endometriosis, ovarian cyst, ectopic pregnancy… Localized pain in the lower abdomen can have many causes. Overview of the pathologies that can cause this kind of pain with Dr. Odile Bagot, gynecologist.
Having pain in the lower abdomen is not necessarily worrying. In women it is even frequent before rules. Sometimes these pains can also reveal deeper problems such as endometriosis. List of causes of pain in the lower abdomen in women, pregnant or not, and at the man.
The lower abdomen means the pelvisotherwise called small pool, in both men and women. “In women, in the lower abdomen there is the bladder, the uterus, the ovaries and the end of the digestive tract, ie the rectum. In men, there is the bladder, the prostate and the rectum.“, explains Dr. Odile Bagot.
► At the level of the uterusone can think of menstrual pain or even to uterine endometriosis, i.e. adenopyosis. Menstrual pain associated with chronic pain or during intercourse should primarily suggest endometriosis. “There is also endometritis, that is to say an inflammation of the tissue at the level of the uterus which can occur following a gesture at the level of the uterus such as an abortion, a curettage, the installation of an IUD or after a delivery“, underlines the gynecologist. An IUD that has moved can also cause pain.
► There are all the infectious pathologies that we call upper genital infections such as salpingitis which refers to an infection in the fallopian tubes.
► At the level of the ovaries, a large cyst can be painful and if the pain is brutal and violent it can correspond to the torsion of the cyst. Micropolycystic ovaries can give a dull pain sometimes exacerbated at the time of intercourse.
► To a lesser extent, ovulation can be painfully felt by some women.
► “Pain in the small pelvis may be sequelae of infections or operation if there are adhesions in the pelvis.
► At the urinary level, cystitis can give pelvic pain but especially burning during urination with very frequent desire to urinate. There may also be kidney stones at the level of the ureter.
► At the level of the rectum, one can develop recto sigmoiditis that is to say small pockets at the end of the intestine which can become infected.
► In young women, you have to think about inflammatory bowel disease (MICI).
► Finally, there are referred rheumatological pain that is to say pain that is located at the level of the lumbar spine and the sacroiliac joints“, continues the specialist.
“You must consult a gynecologist who will perform a vaginal examination to determine if the pain comes from the urinary, digestive or osteoarticular gynecological sphere. We are going to do an ultrasound as well as a blood test to eliminate an infectious pathology, in which case the CRP, the protein of the infection, will be increased”, notes Dr. Odile Bagot.
“In the first trimester, pains similar to contractions with bleeding translate a threat of miscarriage provided you are certain that it is indeed a pregnancy implanted in the uterus (embryo seen on ultrasound). Otherwise, any pelvic pain, especially with bleeding, in the very early stages of pregnancy should bring to mind the ectopic pregnancy” explains the gynecologist. There is also urinary tract infection, although during pregnancy it does not give many signs but it can have serious consequences like a premature delivery.
The other pains, from the second trimester, are often muscle and ligament pain.
The other pains, from the second trimester, are often parietal pain that is, muscles and ligaments, of the abdominal wall. The uterus has doubled in size so the anterior abdominal wall will be put under tension. Later in the pregnancy, as the length of the muscle fibers will increase in length paradoxically, with a bigger belly, the woman will have less feelings of tension. In the third trimester, wall pain may correspond Lacome syndrome, a kind of tendonitis of the rectus abdominis muscles. “Outside of pregnancy and during, you have to think about appendicitis in case of pain on the right. There is also renal colitis which cause pain mainly on the right because the urethra is dilated on the right during pregnancy”, notes the gynecologist.
Pain in the lower abdomen in men can be a sign of different pathologies: appendicitis, rectosigmoid diverticulosis and acute prostatitis which corresponds to the equivalent of salpingitis in women with chlamydia, gonococci with inflammation and prostate pain.
“You have to think about the hemorrhoidal flare-up and you always have to be vigilant and think about the differential diagnosis of anal cancer“, observes the specialist.
It is necessary to consult when the intensity of the pain is important, that with a simple analgesic it does not pass, if you have a fever, if you have other signs such as doubtful vaginal discharge, bleeding, burning at the time of the urination or pain on ejaculation in men.
If it’s just contractions, you can take paracetamol or Spasfon®, it’s not dangerous. Beyond that, the treatments are etiological, ie depending on the cause.
Thanks to Dr. Odile Bagot, gynecologist.