Why Does My Lower Abdomen Hurt? - Step To Health

Why Does My Lower Abdomen Hurt?

Pain in the lower abdomen has several possible causes that require medical evaluation to decide the best course of action. Learn some of the possible causes in this article.
Why Does My Lower Abdomen Hurt?

Last update: 06 January, 2022

When our lower abdomen hurts, we often feel discomfort in both the lower abdomen and pelvic area. The causes are usually related to the organs located there, which include the bowel, bladder, appendix, and urethra.

In addition, these include the uterus and ovaries in women and the testicles in men. However, it’s possible that the condition is located elsewhere and it turns into lower abdominal pain, as well.

Let’s take a closer look.

The possible causes of lower abdomen pain

There are multiple organs involved in this area, so there are several possible reasons for why a lower abdomen may hurt. In most cases, immediate medical attention is required, as this pain may be a manifestation of serious condition or require surgical resolution.

In the medical literature, this type of pain is described as abdominal and pelvic pain.

However, there are also other causes that are important to bear in mind.

Dysmenorrhea or menstrual cramping

The term dysmenorrhea refers to pain in the lower abdomen caused by menstruation. Menstrual cramps can occur from 1 to 3 days before the onset of bleeding.

It’s described as severe pain in the lower abdomen or legs. Sometimes, it’s accompanied by headache, nausea, constipation or diarrhea, and a constant desire to urinate.

It’s usually most severe in the first 24 hours and may continues 2 to 3 days after the onset of menstruation. If your menstrual cramps are of strong intensity, do not improve, or are associated with other symptoms (heavy bleeding), you should go to a gynecologist for treatment.

We think you’ll like to read this article, too: The Most Common Period Myths and Misconceptions

Dolor por cólicos menstruales.
The pain associated with menstruation can be disabling, affecting the quality of life of many women.

Ectopic pregnancy

Ectopic pregnancy is one of the most common gynecological emergencies that can lead to serious complications. This refers to a pregnancy in which the fertilized egg implants outside the uterus. This usually occurs in the fallopian tubes.

Although an ectopic pregnancy can manifest itself without symptoms or only with the absence of a period of 6 to 7 weeks, it’s common for the woman to feel pain in the lower abdomen. At some point, it’s usually accompanied by bleeding through the genitals.

Ovarian cysts

Cysts are abnormal growths with fluid content. They can form inside the ovaries due to a failure of the egg to mature. When found in large numbers, this type of growth is called an ovarian cyst or polycystic ovary.

Ovarian cysts cause pain in the lower abdomen when they’re large. In addition, a rupture can occur, producing pain in the lower abdomen that’s very strong. This is more common on the right side.

There may be bleeding through the genitals when there’s a presence of ovarian cysts.

Pain in the lower abdomen: Ovarian torsion

Pain in the lower abdomen associated with ovarian torsion is rare and is often linked to the presence of cysts, pelvic infection, or some condition in the fallopian tubes. It’s the result of the torsion of the organ on its own axis, causing a decrease in blood flow.

Its most common clinical manifestations are as follows:

  • Pain in the lower abdomen on the affected side
  • Nausea
  • Vomiting


Endometriosis is the presence of endometrial tissue outside the cavity of the uterus. Usually, it manifests with chronic lower abdominal pain, especially severe during menstruation or ovulation.

There’s often also pain with intercourse, bleeding through the genitals, chronic fatigue, and bowel symptoms. It’s usually diagnosed when fertility problems occur.

Pelvic inflammatory disease

Pelvic inflammatory disease is due to an infection of the female sexual tract (uterus, tubes, and ovary) that can cause involvement of adjacent pelvic organs. It’s a sexually transmitted disease in most cases. It may last only a few days or become chronic.

Its symptoms tend to occur as pain in the lower abdomen, which can be very intense. The discomfort is usually on both sides of the abdomen and worsens during sexual intercourse.

In addition, there are symptoms of inflammation of the urinary tract with a recurrent urge to urinate in some cases. Vaginal discharge is usually discolored and very foul-smelling.

Possible causes of lower abdomen pain: Urinary tract infections

A urinary tract infection is caused by bacteria from the intestinal flora that reach the urinary system through the urethra. There are other causes, but this is the most frequent. In fact,  Escherichia coli (E. Coli) is almost always the germ involved.

The symptoms are as follows:

  • Burning or pain when urinating
  • Dark or foul-smelling urine
  • A feeling of incomplete emptying of the bladder
  • Frequent urination and short urination

However, patients may also feel their lower abdomen ache intermittently. Sometimes, there’s also a feeling of heaviness in the bladder.


Diverticula are small pouches that form from the wall of the large intestine. They’re more common on the left side and can become inflamed, perforated, or even torn.

Diverticulitis refers to the infection and inflammation of the diverticulum. It manifests with pain in the lower abdomen, fever, and chills. It’s also associated with changes in bowel habits and bloating.

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Diverticulitis is one of the possible causes of pain in the lower abdomen.

An inguinal hernia

Inguinal hernias are more common in men. This involved the presence of a mass in the inguinal region caused by weakness in the wall of the abdominal muscles.

This causes a part of the intestines to protrude through this weakness, generating pain in the lower abdomen. It’s treated surgically and can progress to tissue strangulation and death.


Appendicitis is inflammation of the vermiform appendix. It’s caused by a non-specific infection, usually from bacteria of the intestinal flora.

It manifests with pain in the lower abdomen, cramping, and strong intensity on the right side. Sometimes it starts around the navel. It’s usually accompanied by fever, nausea, and vomiting.

The evolution of appendicitis is rapid and can lead to perforation of the organ. It’s resolved surgically.

What should you do when your lower abdomen hurts?

Most causes of lower abdominal pain require immediate medical attention. However, many resolutions are surgical.

Don’t hesitate to call for assistance if you have persistent pain in this region. Evaluate the accompanying symptoms and discuss them with your doctor to find a quick solution.

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