It is believed that many women have experienced lower abdominal pain at some point in their lives. The pain may be mild or severe, varying from person to person during menstruation. But did you know that lower abdominal pain or a dull ache is not always a normal part of menstruation? If it comes with chronic lower abdominal pain every day, abnormal menstrual cycles, or a dull ache that prevents you from doing daily activities, it could be a warning sign of various diseases. Lower abdominal pain can arise from many causes, both chronic and sudden, depending on the different causes. The main causes usually stem from abnormalities of the uterus, including the vagina and ovaries. Let’s take a look at what lower abdominal pain can tell women.
- Endometriosis occurs when the endometrial lining that normally sheds flows backward instead of completely exiting through the vagina. This causes the tissue to implant and grow in the fallopian tubes or ovaries, leading to inflammation and adhesions. This results in trapped blood accumulating into cysts, commonly known as chocolate cysts, causing abdominal pain and abnormally heavy menstruation.
- Uterine fibroids are the most common condition in women, mostly occurring between the ages of 30-50. It involves abnormal growth and division of muscle cells, forming lumps within the uterus. This causes heavy menstrual bleeding, abdominal pain during menstruation, fatigue, and some may experience difficulty urinating or constipation.
- Ovarian cysts are fluid-filled sacs that develop from cells in the ovary. There are two common types: cysts from the ovarian surface cells and cysts from skin cells. Early stages often show no clear symptoms but may cause intermittent abdominal pain. If the cyst enlarges, it may twist or rupture, causing sudden severe abdominal pain. If the twisting is severe enough to cause blood congestion in the ovary, the pain can be unbearable.
- Chronic pelvic pain usually starts as intermittent pain that eventually becomes constant or dull and irregular. Some experience pain during menstruation. Normally, women should not have significant pain during menstruation or only mild discomfort. Severe pain often indicates other conditions such as large uterine fibroids (which may be palpable as a mass in the lower abdomen or cause abdominal enlargement resembling pregnancy), ovarian cysts, or endometriosis. The pain usually lasts continuously for more than 3-6 months and may be accompanied by spotting, heavy or prolonged menstruation. Some may experience pain during urination or sexual intercourse and may feel a mass in the lower abdomen.
- Acute lower abdominal pain occurs suddenly and is often accompanied by nausea, vomiting, or fainting. It is caused by ischemia (lack of blood supply) to abdominal organs or damage to the affected organ. It usually results from a single cause, commonly inflammation such as uterine inflammation, pelvic inflammatory disease, intestinal inflammation, appendicitis, or bladder infection related to uterine inflammation. Symptoms may include difficulty urinating, frequent urination, and back pain.
How to know the cause of “lower abdominal pain”?
There are many causes of lower abdominal pain. If you experience symptoms, you should consult a doctor to find the cause and receive treatment. Nowadays, diagnosing abnormalities is not complicated or time-consuming, such as using high-frequency ultrasound, which allows visualization of the uterus and fallopian tubes, cystoscopy of the bladder and urethra, CT scans, or MRI.
What are the treatment options?
Once the cause is identified, treatment options start with medication such as antibiotics, anti-inflammatory drugs, or hormones. Surgery may be considered depending on symptoms, suitability, and the physician’s judgment for each patient. However, lower abdominal pain can be acute or chronic. Once it occurs, it should not be ignored. Regular health check-ups are recommended for your own well-being.
