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Lower Abdominal Pain in Women

First refer to chart 22, Abdominal pain

Several disorders specific to women can cause discomfort or pain in the lower abdomen. Many of these conditions are related to the reproductive tract (ovaries, uterus, or fallopian tubes) or to pregnancy. Abdominal pain that occurs during pregnancy should always be taken seriously.

  • Do you have pain when you pass urine?

    • Yes
      • Possible cause You may have cystitis

        Medical help See your doctor within 24 hours. Meanwhile, drink plenty of water and take a painkiller.

    • No

      Are you pregnant?

      • More than 14 weeks pregnant
        • Possible cause You could be having a late miscarriage or the placenta may have partly separated from the wall of the uterus (see Placental abruption).

          Medical help URGENT! Phone your doctor immediately! Rest in bed until you receive medical advice.

      • Less than 14 weeks pregnant
        • Possible cause Pain at this stage of pregnancy may indicate a threatened miscarriage or an ectopic pregnancy.

          Medical help URGENT! Phone your doctor immediately! Rest in bed until you receive medical advice.

      • Do not think so

        Have you had sexual intercourse in the past 3 months?

        • Yes

          Did your last period occur at the time you expected?

          • On time

            Do you have any of the following symptoms?

            • Abnormal vaginal discharge
            • Fever
            • Pain during intercourse
            • None of the above

              Have you been through the menopause?

              • Premenopausal

                Is the pain related to your menstrual cycle?

                • Occurs just before and/or during a period

                  Do you have an intrauterine contraceptive device (IUD) or intrauterine system (IUS)?

                  • IUD or IUS
                    • Possible cause These forms of contraception often cause increased period pain, particularly for the first few cycles after they have been inserted.

                      Medical help Make an appointment to see your doctor.

                  • No IUD or IUS
                • Occurs briefly in midcycle
                  • Possible cause Some women regularly have pain associated with ovulation.

                    Medical help Make an appointment to see your doctor to rule out other possible causes.

                • Unrelated
                  • If you cannot identify a possible cause for your lower abdominal pain from this chart, make an appointment to see your doctor.

              • Postmenopausal
                • If you cannot identify a possible cause for your lower abdominal pain from this chart, make an appointment to see your doctor.

          • Missed or late
            • Possible cause There is a possibility of an Ectopic pregnancy.

              Medical help URGENT! Phone your doctor immediately!

        • No

          Do you have any of the following symptoms?

          • Abnormal vaginal discharge
          • Fever
          • Pain during intercourse
          • None of the above

            Have you been through the menopause?

            • Premenopausal

              Is the pain related to your menstrual cycle?

              • Occurs just before and/or during a period

                Do you have an intrauterine contraceptive device (IUD) or intrauterine system (IUS)?

                • IUD or IUS
                  • Possible cause These forms of contraception often cause increased period pain, particularly for the first few cycles after they have been inserted.

                    Medical help Make an appointment to see your doctor.

                • No IUD or IUS
              • Occurs briefly in midcycle
                • Possible cause Some women regularly have pain associated with ovulation.

                  Medical help Make an appointment to see your doctor to rule out other possible causes.

              • Unrelated
                • If you cannot identify a possible cause for your lower abdominal pain from this chart, make an appointment to see your doctor.

            • Postmenopausal
              • If you cannot identify a possible cause for your lower abdominal pain from this chart, make an appointment to see your doctor.

Warning

Abdominal pain in pregnancy

Intermittent, mild abdominal pains are common throughout pregnancy due to stretching of the muscles and ligaments of the abdomen. Abdominal pain that occurs in early pregnancy can be due to complications, such as miscarriage or an ectopic pregnancy. In later pregnancy, pain is most commonly caused by the onset of labour. Rarely, partial separation of the placenta from the uterine wall may occur (see Placental abruption). If you develop severe pain, phone your doctor immediately.

From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.

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