Update: October 2018 Abdominal pain in women is the most
common cause of treatment to the gynecologist. However, such a painful
syndrome may be a sign of acute surgical or
neurological pathology. In case of pain, especially
acute, intolerable, you should as soon as possible to consult a doctor.
Why hurt the lower abdomen in women on the right, left?
Causes of pain in women can be divided into 2 groups:
organic and functional.
- diseases of the female genital organs (adnexitis,
endometritis, endometriosis, ovarian apoplexy, ovarian cyst,
torsion of the legs of an ovarian cyst, uterine myoma);
- use of intrauterine device;
- acute surgical pathology, urinary pathology
system gallbladder (appendicitis, cystitis, cholecystitis,
- woman’s health condition associated with pregnancy (symptoms
ectopic pregnancy, the threat of miscarriage, premature detachment
placenta, pain after medical abortion).
- menstrual disorders – algodysmenorrhea (see the causes
painful menstruation) and dysfunctional uterine
- pain associated with ovulation (see also transparent stretching
- menstrual blood stasis (bend of the uterus, hematometer).
Abdominal pain can have a different nature and be as acute
cutting or piercing, and dull, aching.
Inflammatory processes in the appendages and uterus
The inflammatory process in the uterus or appendages, as a rule,
begins acutely with a rise in temperature, the appearance of symptoms
intoxication and lower abdominal pain. When salpingoophoritis (adnexitis)
sore left or right side of the abdomen, and with endometritis it hurts
lower abdomen in the middle. During a vaginal examination with
inflammatory appendages are determined pasty and sharply painful
appendages, and with endometritis an enlarged, softened
uterus, painful on palpation and displacement of the neck. Chronic
salpingo-oophoritis and endometritis proceeds with aching, dull pain of the bottom
belly. In the area of the appendages, the hardness is determined, and the uterus
palpable as a dense and sensitive formation.
Treatment for inflammatory diseases of the genital organs
is to prescribe antibiotics, infusion therapy,
vitamins, anti-inflammatory candles in gynecology with
Genital endometriosis can affect the uterus, appendages and in
Posaddy space. Endometriosis – это распространение
cells similar in structure to the endometrium beyond the uterus. Pains
appear before menstruation and increase during it. With
endometriosis of the uterus pain localized midway in the lower abdomen, with
endometriosis of the appendages in the inguinal areas, with retrocervical
endometriosis behind the pubis (see endometriosis of the uterus – treatment and
symptoms). Significant adhesive process in the pelvis at a given
The disease is exacerbated by pain. In addition to the pain of a woman
disturbed menstruation, change of character
menstrual discharge and female infertility (see the uterus on
Treatment of endometriosis is hormonal, in some cases indicated
Apoplexy or hemorrhage in the ovarian tissue occurs in
intermenstrual period (mid-cycle) and is associated with ovulation.
With разрыве главного фолликула повреждаются сосуды яичника и
bleeding begins in the tissue of the organ and the abdominal cavity.
Sexual intercourse, physical activity can provoke apoplexy.
Intra abdominal bleeding is accompanied by intense pains below.
abdomen localized at the site of the affected ovary and symptoms
post-hemorrhagic anemia (paleness of the skin, falling
blood pressure, loss of consciousness). Emergency shown
Painsт низ belly у женщин при миоме матки при больших размерах
tumors and compression of neighboring organs and at birth submucosal
myoma node Pain with large sizes of fibroids wears
nagging, oppressive or dull character. With рождении миоматозного узла
pains are cramping, severe and accompanied by intense
bleeding. In both cases, surgery is indicated.
(see uterine fibroids – symptoms and treatment)
Torsion legs ovarian cysts
The leg of an ovarian cyst can twist when tilted, sharp
turns, physical work. In case the leg is twisted
90 degrees, the venous outflow in it is disturbed, the cyst swells, and
pains are aching in nature. With перекруте на 360 градусов к кисте
arterial blood does not flow and a picture of “acute” develops
belly: схваткообразные, сильные боли внизу belly на стороне
cysts, signs of intoxication (nausea, vomiting), positive
symptoms of peritoneal irritation, fever, forcing
body position of the patient. Emergency treatment – cyst removal
ovary, while the leg does not unwind (see ovarian cyst –
symptoms and treatment).
Symptoms of appendicitis in adults begins with subfebrile
temperature increases pains that are felt first in
epigastric, then shifted to the right iliac region, signs
intoxication and weakness. Possible loss of appetite, upset
stool vomiting. With отсутствии экстренного хирургического лечения
appendicitis can turn into diffuse peritonitis and end
Withмер из практики: Ночью поступает в приемный
peace is a young woman with complaints of pain below (more to the right)
belly. At first, she is watched by a surgeon who categorically denies
the presence of its pathology. Then call the gynecologist (me). I, too
I deny it. But the stomach hurts. The surgeon and I almost fell out
whose sick And since I am a young doctor, and he is experienced, and yes even the head.
Department, agreed on the fact that this is my stomach and together we go to
diagnostic laparotomy. Withдатки в норме, а вот аппендикс
pumped up (phlegmonous appendicitis). Make an appendectomy like
it is supposed to. Yes, no wonder they say that appendicitis is the monkey of all
diseases. In this case, the atypical location of the appendix was
and misled the surgeon.
The inflammatory process in the gallbladder is more common when
the presence of calculus in it. The disease is acute, with
fever, nausea and vomiting, itchy skin due to
высокого билирубина, болями в правом подреберье и болит низ belly.
Pains иррадиируют в область спины, поясницу и подключичную область и
worse after eating. The treatment is to assign
diets and preparations that improve the flow of bile, with large stones –
Inflammation of the bladder is accompanied by sharp, cutting
pain in the suprapubic region, aggravated by urination.
Pyelonephritis is characterized by pain in the lumbar region and below.
belly. Inflammation of the bladder and kidney occurs on the background
fever with urination problems and
inflammatory urine tests (see cystitis symptoms in women).
Both diseases are treated with antibiotics and
Grozny gynecological disease, which is
implantation of a fertilized egg outside the uterus (in the tube,
ovary, abdominal cavity). Disease in tubal abortion
characterized by recurrent paroxysmal pain in the inguinal
area or sharp, sharp pain when breaking a pipe. Pain gives
in the vagina, in the rectum and the supraclavicular region. Ectopic
pregnancy proceeds with severe intra-abdominal bleeding and
requires immediate surgical intervention. Distinctive
signs of disease are delayed menstruation, positive
pregnancy test and possible bleeding during
Withчины боли перед и после месячных
The main cause of lower abdominal pain
monthly is algodysmenorrhea. Algomenorrhea occurs
often in young girls and is associated with the establishment of hormonal
background and development of the genitals. Also cause lower abdominal pain
before menstruation there may be a bend of the uterus, premenstrual syndrome,
endometriosis of the uterus and inflammatory processes of the pelvic organs.
Pains после менструации появляются при эндометриозе матки, что
associated with increased blood circulation in it, with endometrioid
a cyst that increases in size after menstruation, with
Pains внизу belly при овуляции
Pains у женщин при овуляции возникают в середине менструального
cycle and do not deliver discomfort. Maybe within 1 – 2 days
the appearance of minor, weak pulling pain in the abdomen and a small
bleeding from the genital tract (in the form of 1 – 2 drops of blood). AT
treatment of such pain does not need.
Withмер из практики: У меня была молодая
girl patient who had no ovulation. She was recorded in
diagnostic center for laparoscopy for polycystic
ovaries (resection of the ovaries was planned). On the eve of departure she
поступает ночью с внутрибрюшным bleeding. We go to the emergency
operation, and we find an ovary apoplexy. In a patient, you can
To say, ovulation happened for the first time and with such an outcome. Resection
the ovaries had to be held in place, but laparotomic
Pains после полового акта
Pains внизу belly после полового акта могут быть следствием
frustrations. Pains ноющие и сопровождаются моральным
dissatisfaction. Also, pain syndrome after sex can
result from various diseases: adhesive disease
pelvic, chronic adnexitis and endometritis, cervicitis,
vaginal damage due to rough sex, endometriosis and
tumors of the genital organs (see in detail the causes of pain during sexual
Pains внизу belly при беременности
- Threatened miscarriage
With угрозе выкидыша до 22 недель возникают ноющие или тянущие
abdominal pain due to contractions of the uterus, you may experience
bleeding. The treatment is aimed at preserving
pregnancy (antispasmodics, hormones, bed rest).
- Premature detachment of a normally located placenta
This pathology is accompanied by significant pain in the area
belly during pregnancy, if the placenta has exfoliated in the lower
segment. Perhaps external bleeding from mild to
intense and internal bleeding with a gradual increase
retroplacental hematoma. Emergency delivery shown