What does it mean if it pulls the lower abdomen. Deverticulitis of the ileum. Physiological causes of pain

Many diseases in women often develop secretly, without making themselves felt for years. Even such a symptom as pulling pains in the lower abdomen, if it bothers women slightly, may not alarm. However, if mild pain occurs constantly, and in a certain place, there are unusual discharges, then a visit to the doctor should not be postponed, waiting for complications. Perhaps the physiological state of the woman plays a role. But sometimes pain is a signal of a serious illness that requires urgent examination and treatment.

Content:

Factors affecting the occurrence of pain

Drawing pains occur in the lower abdomen, usually with pathological conditions of the pelvic organs, including the uterus and ovaries (organic causes) or due to physiological processes occurring in the woman's body (functional causes). To establish a diagnosis of a pathology, the symptom of which is pulling pain, it is necessary to know its exact location, intensity, whether it is constant or occurs periodically.

Organic factors contributing to pain

These factors include:

diseases of the uterus and ovaries (endometritis, ovarian cyst, uterine fibroids);
genital infections;
the use of an intrauterine device;
scar formation after surgery;
inflammatory and infectious diseases of the kidneys, bladder (cystitis, pyelonephritis), as well as intestines;
pathology during pregnancy.

Functional causes of pain in the lower abdomen

In this case, pulling pains appear in the lower abdomen due to dysfunction of the genital organs:

Algodysmenorrhea (a condition associated with an incorrect position or underdevelopment of the uterus, hypersensitivity), dysfunctional uterine bleeding and other menstrual disorders.
ovulatory syndrome. Aching pain in the lower abdomen during ovulation worries a woman for several hours after the follicle breaks and the egg leaves it. It can be on any one side (depending on which ovary, right or left, is involved in the process). Sometimes it bothers me from both sides at the same time. This happens when both ovaries produce eggs. In this case, the onset of multiple pregnancy is possible.
Curvature of the uterus, in which there is stagnation of menstrual blood.

Video: Causes of pain in the lower abdomen. Inadmissibility of self-treatment

organic factors

Aching pain in women can be a manifestation of inflammatory, infectious diseases or processes associated with deformation of organ tissues, circulatory disorders.

Diseases of the reproductive organs

Adnexitis(salpingoophoritis). Inflammation occurs due to various infections in the uterus, its tubes and ovaries. Moreover, dull aching pain in the lower abdomen appears when it becomes chronic. Only one ovary or both may be affected. Accordingly, the pain occurs on the left, on the right, or on both sides at once. The ovaries cease to function normally, which is expressed in various violations of the menstrual cycle. In addition, there are discharges with impurities of pus or blood, the woman's temperature rises. It becomes impossible for the full maturation of the egg, there is an obstruction of the tubes. The woman may become infertile. An ectopic pregnancy may occur.

Endometritis. Menstrual disorders, pain in the central part of the abdomen, below appear due to inflammation of the endometrium, the uterine mucosa, if the process becomes chronic. In this case, inflammation can easily spread to the appendages.

endometriosis- growth of the endometrium (uterine mucosa) in neighboring sections of the uterus (tubes, cervix), ovaries and even the intestines. It occurs, as a rule, as a result of hormonal disorders in the body. In addition to dull constant pain in the lower abdomen, women experience painful menstruation of an irregular nature. There may be severe bleeding, brown discharge in addition to menstruation. Amenorrhea (lack of menstruation) may occur. Adhesions or complete overgrowth of the fallopian tubes are formed, which leads to infertility, ectopic pregnancy. Usually, drawing pains in the groin or pubic region precede menstruation, become stronger during menstruation.

Ovarian apoplexy- hemorrhage in the ovary, which occurs when tissue breaks, damage to small vessels. Usually observed in the presence of cystic cavities. It can be provoked by sexual intercourse or physical activity. Hemorrhage extends into the peritoneal region. Aching pain below, in the region of the ovary, is intense. Bleeding can be eliminated only by surgery.

Polycystic ovaries- the appearance of cysts in the ovary, disrupting their normal functioning. In this case, there are pulling pains in the back, lower abdomen, menstrual irregularities, hormonal imbalance, obesity. The nature of the pain in the abdomen may change if the cyst stem is twisted (which is possible with bending, turning the torso, physical exertion). If the torsion is small (up to 90°), then the pain may be aching due to circulatory disorders. With complete torsion, the blood supply to the area of the cyst is cut off. Due to tissue necrosis, nausea, vomiting, and fever occur. Painful sensations in the ovarian region become acute, spasmodic. Urgent removal of the cyst is required.

Colpitis- inflammation of the mucous membrane covering the vagina. The causative agents are streptococci, gonococci, Trichomonas, fungi and other types of infection. The mucosa becomes thinner, papillae and vesicles appear on the surface, which causes pulling pains in the lower abdomen, profuse leucorrhoea, itching in the vagina.

Myoma- a benign tumor. Single or multiple nodes of various sizes appear both outside and inside the uterus. As the tumor grows, it begins to compress nearby vessels, causing a violation of the blood supply. Because of this, there is heaviness, discomfort in the lower abdomen, lower back. Uterine bleeding may occur. Complications of this disease are premature birth, possibly infertility. The tumor is hormone dependent. Hormonal therapy or surgery is used to eliminate it.

Video: Pain in the lower abdomen with inflammation of the fallopian tubes

Pathologies in other organs

Appendicitis. In chronic form, it causes aching pains that are felt in the stomach area. Concomitant symptoms are nausea, vomiting, weakness, fever. An urgent operation is needed, since the inflamed appendix can burst, the ingress of pus into the peritoneum leads to peritonitis.

Urolithiasis disease. As a result of the deposition of various salts in the ureters, kidneys or bladder, conglomerates are formed that prevent the passage of urine. In this case, both pulling dull pains in the lower abdomen and sharp, very strong pains in the lower back and groin area can occur. Stones are removed medically or surgically.

Cystitis- inflammation of the bladder. With this disease, there are pulling pains of varying intensity in the lower abdomen, burning in the bladder area, cramps during urination. In women, cystitis, as a rule, accompanies infectious inflammatory processes in the genital organs, since, due to the peculiarities of the anatomical structure of the genitourinary system, the infection spreads easily.

Note: Aching pains in the lower abdomen can also be felt in diseases of the digestive system (intestines, gallbladder). For example, with cholecystitis, pain occurs in the hypochondrium, as well as in the lower abdomen.

Drawing pain during pregnancy

They can occur at different stages of pregnancy. If aching pain occurs for up to 22 weeks, accompanied by bloody discharge, then the cause is the threat of miscarriage. The doctor, having assessed the condition of the woman, prescribes treatment aimed at maintaining the pregnancy. The threat of interruption arises due to an increase in the tone of the uterus, the presence of scars on it after the previous cauterization or curettage, hormonal disorders. A woman is recommended bed rest, treatment with antispasmodics and hormonal drugs.

The initiator of pain in the lower abdomen in women during pregnancy may be placental abruption for a period of less than 37 weeks. In this case, not only pain sensations appear, but also spotting, as well as signs of internal bleeding (dizziness, nausea, pallor, headache). In this case, a caesarean section is performed, otherwise the child may die from hypoxia.

Mild pain in the lower abdomen during pregnancy is normal, it is caused by muscle strain, an increase in the size of the uterus and the severity of the fetus. If there is a sharp increasing soreness with fever, bleeding, this may indicate the presence of an ectopic pregnancy, uterine ruptures and other complications.

Video: Causes of pain in the lower abdomen

Functional reasons

These include situations in which pain occurs in connection with different periods of the menstrual cycle.

Pain in the lower abdomen associated with menstruation

Drawing pains in the groin that occur before menstruation are usually associated with premenstrual syndrome (the effect of hormones on the nervous system, increased sensitivity, vegetative-vascular disorders). The cause of discomfort may be the underdevelopment of the genital organs (especially in young girls), changes in the shape of the uterus after abortion, childbirth, and operations.

If a woman has endometrial hyperplasia or inflammatory diseases of the uterus, then aching pains can remain even after menstruation. At this time, there is an increase in cystic formations associated with a change in hormonal levels.

Video: Pain in the lower abdomen during menstruation

Pain during ovulation

At the time of ovulation (the rupture of the follicle and the release of the egg from it), women may experience slight pulling pains in the lower abdomen and the appearance of traces of blood. These symptoms are normal and disappear after 1-2 days.

Significance of accompanying symptoms

When determining the cause of pain, accompanying symptoms are of great importance:

Bloody or other discharge that occurs in the middle of the cycle, not related to menstruation, indicates the presence of inflammatory diseases of the internal genital organs (endometritis, salpingoophoritis).
Abundant colored discharge with an unpleasant odor, fever, combined with pain in the lower abdomen are characteristic of infectious diseases of the genital organs (trichomoneliasis, gonorrhea, and others).
Cramping, burning, frequent urination, combined with pain in the lower abdomen, indicate the presence of pathologies in the urinary system.
Nausea, vomiting, bloating, nagging pain are signs of intestinal infections.
With appendicitis, pain is usually localized in the right lower abdomen.

Diagnosis and treatment

To establish the cause of pulling pains, an examination is usually prescribed by the following methods:

a general analysis for leukocytes and blood clotting, which allows you to detect the presence of inflammatory processes, suggest the cause of bleeding;
urinalysis for leukocytes, protein and bacteria;
Ultrasound of the small pelvis;
cytological examination of mucus from the vagina and cervix (smear);
blood tests for latent sexual infections (chlamydia, gonococci, mycoplasmas, Candida fungi and others);
biochemical blood test for antibodies to various infectious agents.

Depending on the localization of pain sensations, their nature and the assumption of the disease, other examination methods are also used: tissue biopsy, colposcopic examination of the uterus. When tumors are detected, computed tomography (CT) or magnetic resonance imaging (MRI) is used.

After clarifying the diagnosis, if necessary, the doctor prescribes antibacterial, hormonal or antispasmodic drugs. In some cases, only surgery helps to eliminate pain (curettage of the uterus, cauterization of the cervix, removal of tumors, cystic formations).

Warning: If there is a pulling pain in the lower abdomen, self-treatment is unacceptable, as it can cause great harm to health. The heating pad is strictly contraindicated in inflammatory diseases, appendicitis, as this leads to peritonitis, blood poisoning. Any delay in increasing pain in the lower abdomen, the appearance of signs of poisoning of the body or internal bleeding can be life-threatening. They occur with ectopic pregnancy, uterine rupture, damage to ovarian tissue, as well as kidney disease.

A week pulls the lower abdomen - what does it mean? Every woman at least once in her life experienced pain in the uterus and ovaries. There can be many reasons for such symptoms, but most often they do not pose any threat. Much more dangerous than pain that does not go away for several days or even a week.

If there is a delay

The absence of menstruation, coupled with painful sensations in the lower abdomen that do not go away for seven or more days, may indicate an "interesting situation." Pulls the stomach in the first weeks of pregnancy in many expectant mothers. In this case, it is necessary to consult a doctor to confirm the situation and work out further actions. These pains are explained by the preparation of the uterus for the further course of pregnancy. In addition, if the lower abdomen pulls for a week, and there are no periods - this may be a signal of an ectopic pregnancy or a threatened miscarriage, the appearance of bloody or brown discharge should cause alarm.

All sorts of hormonal disorders can cause discomfort. An experienced specialist can eliminate the problem during a comprehensive examination. Usually, various hormonal drugs and lifestyle adjustments are prescribed as therapy in this case. An endocrinologist or gynecologist-endocrinologist is engaged in the diagnosis and treatment of such pathologies.

The next reason is the most harmless, caused by an elementary violation of the cycle associated with the transferred stress. Also, do not exclude the possibility of gynecological diseases, such as colpitis, adnexitis, endometritis, endometriosis, and even the formation of cysts in the ovaries.

In addition, if a week, more than a week, 2 weeks pulls the lower abdomen as during menstruation, but there is no menstruation, the presence of non-gynecological diseases can be assumed. Pyelonephritis, cystitis, etc. can cause disruptions in the cycle and pain.

During the period of menstruation

Painful sensations during menstruation can be caused by contractions of the uterus, trying to "push out" all unnecessary (exfoliating endometrium) formed in preparation for a possible conception. In this case, various antispasmodic and painkillers come to the aid of women.

If the pulling pains intensify even after taking the pills and are accompanied by copious discharge, perhaps this is a signal of an aborted pregnancy, in other words, an early miscarriage.

Pain during menstruation may be accompanied by the development of various inflammatory processes of the genital organs or have nothing to do with them.

Another cause of painful periods may be sexual infantilism, in other words, this is the underdevelopment of the uterus. Its incorrect location can interfere with the outflow of secretions, causing discomfort. This problem is solved by medication.

The least common causes include increased nervous excitability of a woman or the presence of an intrauterine device. In any case, painful sensations are a signal of the body about possible malfunctions in its functioning.

Most often, women and girls who have not yet given birth suffer from pulling sensations during menstruation. Leading an unhealthy lifestyle, lack of moderate physical activity, promiscuous sex life and environmental degradation significantly increase the risk of various diseases, including those that can cause painful periods.

One of the most unpleasant sensations we experience if we pull the lower abdomen. In such situations, a desire naturally arises to establish the true causes of such a phenomenon. A significant part of the available information is devoted, as a rule, to those cases when the stomach pulls in women.

Quite often this is observed in combination with painful menstruation. However, it is important to understand that not always the aching lower abdomen has a connection with the female physiological process.

In some cases, pulling sensations can indicate the presence of serious diseases that are typical not only for the female half of society, but also for the male. Such cases are for the most part accompanied, in addition to the manifestations associated with the stomach, also with a number of additional symptoms, which together make it possible to establish the exact disease.

For this reason, it seems appropriate to consider the most complete list of possible diseases and other factors, the manifestation of which is, among other things, pulling the lower abdomen.

So, the following reasons are possible:

Pulling belly as a herald of pregnancy

A woman can sometimes find that there is a delay in menstruation against the background of pulling sensations in the abdomen. At the same time, she also notices her own drowsiness, excessive fatigue, increased sensitivity of the breast.

All these signs together can carry information about a great joy: pregnancy.

You should, of course, consult a doctor who will certainly establish the presence of pregnancy. However, a preliminary pregnancy test is also allowed. In the vast majority of cases, the test result will be positive.

Thus, a certain set of signs can clearly indicate that a woman is pregnant. But why does the stomach pull during pregnancy? The explanation for this is the constantly changing size of the uterus.

During the entire period of pregnancy, pulling sensations in the abdomen can occur repeatedly. And if at first they only indicate the presence of pregnancy, then in the future we are talking about a completely different meaning. Let's dwell on this issue.

What does the pulling lower abdomen during pregnancy mean?

In the course of pregnancy, situations when the stomach pulls can have a variety of reasons: from the most calm to truly dangerous. More specifically, there are a number of factors to consider:

What to do in all these situations? First of all, avoid panic and excessive emotional experiences.

Instead, you should immediately consult with your gynecologist. Based on the results of the conversation, the gynecologist will conduct an examination, during which he will identify the real causes that caused pulling sensations in the abdomen, and determine the necessary treatment.

It (treatment) involves the removal of discomfort by taking antispasmodics in the mildest cases. If there is a need for a full examination and the appointment of a thorough treatment, there is a possibility of placing a woman in a hospital.

Results

Thus, the pulling sensations that can be observed in the lower abdomen are associated with various circumstances.

Some of them are harmless and even unusually joyful (if we talk about pregnancy), but still there are a sufficient number of less pleasant factors, among which dangerous diseases occupy a large proportion. Therefore, we should not be too frivolous about the signals that the body gives us. After all, a lot depends on the timely reaction, even the life of the unborn child.

Drawing pains in the lower abdomen are of diagnostic value. To identify the cause of the disease, the doctor needs to find out the characteristics of the pain syndrome. It includes questions: when does pain appear, where is it localized, where does it give off, what sensations does it cause, what strengthens or weakens it.

If the pain is not permanent, then it is important to know how long they last and then reappear. Some diseases cause the same symptoms and do not depend on gender, others are inherent only in men or women. This explains why patients with pulling pains in the lower abdomen are always referred to a gynecologist and an andrologist-urologist. We will analyze both general and specific reasons.

Mechanism of pain syndrome

It is believed that abdominal pain can be caused by parenchymal organs (in the lower part - the uterus with appendages in women, the prostate - in men) due to the increase and stretching of the capsule. In hollow structures (bladder, intestines, fallopian tubes) - spastic contractions of the muscle layer.

Accordingly, the nature of the pain will be dull, constant, increasing as the organ enlarges, or cramping, periodic, if the muscle tone changes. In addition, the rate of development of the pathological process matters: a rapid increase (for example, in acute inflammation) is accompanied by bursting pains, and a gradual one is accompanied by pulling pains.

Another nature of pulling pain in the lower abdomen is associated with overstretching of the ligaments (large ovarian cyst, chronic adnexitis). These are the anatomical structures that fix the internal organs. With long-term chronic inflammatory diseases, adhesions from scar tissue occur.

The adhesions themselves do not have nerve endings, but they pull the organ by the capsule

Stretching adhesions can disrupt optimal localization, reduce the lumen and patency of tubular formations. Then the pain will be sharp, accompany any movement, intestinal motility, defecation, physical activity, sexual activity. Spikes at the same time irritate the sheets of the peritoneum.

Their formation is characteristic after surgical interventions, with appendicitis, Crohn's disease, diverticulitis, endometriosis in women. Physiological manifestations of sprains occur in women during pregnancy. Inexperienced future mothers often complain that they are pulling the lower abdomen.

Another significant cause of pulling pain in the lower abdomen is an increase in tone and prolonged tension of the organ. This symptom is observed with painful periods in girls and women (algomenorrhea).

The description of the clinic of the disease is influenced by the subjective assessment of pain. People experience this symptom differently. Therefore, additional manifestations, comorbidities, laboratory and hardware studies are important.

Diseases that are accompanied by the same manifestations, regardless of gender

It is possible to single out diseases in which both men and women equally often complain of pulling pains in the lower abdomen.

Chronic appendicitis

The disease develops with self-stopping of an acute attack and the absence of surgery. It doesn't stop though. There is a pronounced adhesive process. This is a defensive reaction of the body to limit the spread.

Frequent pains of a pulling type in the right region of the lower abdomen are sometimes the only sign of the disease. For a complete diagnosis, it is necessary to exclude the presence of diseases of the genital organs, urinary tract, and intestines. When the diagnosis is confirmed, a planned operation is recommended. This is the only way to get rid of pain.

Chronic ileal diverticulitis

The disease is caused by inflammation of the saccular protrusions on the wall of the ileum. They occur during the formation of the intestinal tube in the fetus or as an acquired pathology as a result of thinning of the wall.

Without inflammation, diverticula are not clinically manifested.

Ingestion of intestinal microorganisms, retention of contents, putrefaction contribute to the inflammatory reaction.

It is clinically difficult to distinguish from an attack of appendicitis: pulling or bursting pain, nausea, vomiting, headache, fever. The transition of pain into throbbing is an unfavorable sign. It indicates the formation of an encysted abscess. Complications include peritonitis, bleeding, and intestinal obstruction. Treatment is only surgical.

Intestinal obstruction

Pathology disrupts the passage of contents through the intestinal tube in whole or in part. Possible due to:

with mechanical blockage by adhesions, diverticula, tumor, fecal stones, foreign body;
damage to the motor function of the intestine by eating too heavy food after fasting;
diseases of inflammatory origin (pancreatitis, colitis, appendicitis);
uncontrolled medication, drug addiction.

The pain in the abdomen increases gradually and becomes very strong, bursting, spreading in all directions. The stool is delayed, gases do not go away, the stomach is swollen in the upper intestines, repeated vomiting occurs, false urge to defecate. According to vital indications, an urgent operation is required.

Chronic sigmoiditis

The sigmoid colon is located on the left side of the abdomen, in the side and iliac zone. Due to physiological curves, the speed of movement of intestinal contents is reduced here. The place is convenient for supporting chronic inflammation. The process causes, respectively, pulling pains to the left of the pubis with irradiation upwards, to the lower back.

A long-term disease leads to damage to the entire intestinal wall with surrounding tissues (perisigmoiditis) and lymph nodes. The pain becomes constant, aggravated by movement, after an enema, while walking. Measures of therapy often come down to a lifelong diet, anti-inflammatory treatment.

Malignant neoplasms of the colon

At the beginning of the development of colorectal cancer, pulling pains in the lower abdomen are possible. The growth of the tumor, the decay and attachment of inflammation cause severe pain in the iliac region on the left or right, in the lateral zone, bloating, constipation, signs of intestinal bleeding.

To distinguish from other diseases, endoscopic colorectal examination with biopsy cytology is necessary. Treatment is only surgical.

What diseases of men cause pulling pains in the lower abdomen?

Closest to the lower abdomen is the pelvic zone, in which an important organ is located in men - the prostate gland with seminal vesicles.

Chronic prostatitis

If a man complains that “it hurts and pulls in the lower abdomen”, then first of all there are suspicions of chronic prostatitis. Middle-aged men are more likely to get sick, especially during sedentary work (drivers, pilots). The pains are permanent, radiating to the suprapubic area, coccyx, anus, groin and external genitalia.

Typical itching in the anus, with straining, the secretion of the prostate gland drops through the urethra. Exacerbations of prostatitis are caused by hypothermia, alcohol consumption, sexual excesses.

At the same time, cramps during urination, frequent urges, urinary retention, a feeling of incomplete bladder emptying are added to the characteristic pains. A man's temperature rises, dizziness, weakness, headaches, insomnia appear. Often the character changes, in the family they notice a tendency to isolation, irritability over trifles.

benign tumor

Prostate adenoma is formed by overgrown glandular cells. The disease is more common in older men. An enlarged prostate compresses the urethra. Therefore, in the early stages, the symptoms indicate impaired urination: straining to push urine out, frequent urges without a feeling of complete emptying of the bladder.

Aching constant pain in the groin, above the pubis is painfully tolerated by patients. Further increase leads to stagnation of urine and inflammation. In men, cystitis, prostatitis, pyelonephritis are detected.

Adenoma associated with hormonal disorders

Prostate cancer

A malignant tumor of the prostate gland occurs against the background of a long course of adenoma, inflammatory processes in the genitourinary organs. The disease begins with pulling pains above the pubis and in the perineum, frequent urination, the appearance of blood in the urine. Further development of the tumor is characterized by rapid metastasis, pain in the bones (legs, spine, ribs), loss of appetite, and weight loss.

Physiological pulling pains in women

The physiological conditions of the female body (menstruation, pregnancy) may be accompanied by pulling pains in the lower abdomen. They disappear on their own.

During pregnancy

The pain is caused by a sprain of the ligaments surrounding the uterus and appendages. A dependence on age was noted (if pregnancy occurs at 25 years of age and older). With individual structural features of the ligamentous apparatus or increased sensitivity, pain is also disturbing against the background of subsequent pregnancies. Here, the interval between births of 7 or more years is considered important.

Distinctive signs of physiological pain from pathology are:

lack of connection with any action, spontaneous beginning and end;
brevity;
weak intensity;
there is no deterioration in well-being, such signs as spotting, fever.

Every woman during pregnancy should carefully monitor her condition, report any deviations to the obstetrician-gynecologist.

Usually, pulling pain is noticed by women during their first pregnancy.

At ovulation

The period of ovulation means the release of a mature egg in the ovary from the follicle. It occurs on the 14-15th day with the correct menstrual cycle. In some women, pulling pains in the lower abdomen last for several hours or days.

They are classified as low and medium intensity, amplification occurs during sexual intercourse. It has been proven that pain is caused by increased blood supply to the ovary, its temporary increase, which is associated with hormonal fluctuations. They differ in one-way flow.

Gynecologists advise women to be examined to exclude inflammation in the appendages. If pathologies are not detected, then it is recommended not to engage in physical work and sports during the period of ovulation, to exclude sexual intercourse. With severe pain, you can take antispasmodic drugs or put a rectal suppository with belladonna.

What pathology causes pulling pains in women?

Menstrual function is a physiological phenomenon and in a healthy woman it should not cause any signs of illness. But for some, intense pain occurs every month and the general condition is disturbed. A similar symptom is called algomenorrhea.

Gynecologists distinguish secondary dysmenorrhea caused by pathological changes in the uterus, appendages, impaired structure of the internal genital organs.

Adenomatosis

Drawing pains are combined with profuse uterine bleeding, prolonged brown discharge from the uterus. More often suffer nulliparous women after 30 years of age, suffering from infertility. With adenomatosis (endometriosis of the uterus), the internal epithelium grows from the uterine cavity into the muscle layer, "pockets" are formed.

With menstrual blood, the endothelial layer of the uterus is rejected, a mass of blood enters the "pockets", they expand and put pressure on the surrounding tissues. This causes intense pain radiating to the back, groin.

Hormonal preparations are used in the treatment. After conception and during pregnancy, obstetricians monitor the development of the fetus, prevent rejection. Women are observed by a doctor for a long time. Perhaps the formation of cysts, foci of endometriosis in the pelvis, in the cervix. It is believed that the pathology disappears after the onset of menopause.

Inflammatory diseases

Chronic inflammatory diseases of the genital area in women are often accompanied by pulling pains. Menstrual bleeding provokes the development of inflammation, since the blood is considered a good environment for the residence of pathological microorganisms.

Adhesions in the tube become one of the causes of infertility and ectopic pregnancy

At the same time, the general condition worsens, appear:

weakness;
headache and dizziness;
muscle pain;
temperature rise.

A change in discharge is characteristic: an unpleasant odor due to an admixture of pus. Typical neurological complaints of insomnia, stabbing pains in the region of the heart, irritability. Examination in 60% of cases reveals a sexually transmitted infection, respectively, in the diagnosis it is necessary to take into account the sexual behavior of a woman.

The risk of inflammation increases significantly in cases of:

transferred diagnostic curettage, abortion;
use of intrauterine contraceptives;
refusal and untimely termination of therapy for an acute disease.

With congenital anomalies, violation of the structure of the uterus

Drawing pains appear in a girl with a congenital anomaly during the first menstruation. If the defect consists in infection of the vagina or cervix, then the blood is not released, but accumulates and significantly expands the vagina, the uterine cavity.

Adolescent girls with painful menstruation should be shown to a gynecologist and examined. In women who have given birth, adhesions (synechia) may form in the uterine cavity as a result of the use of intrauterine contraceptives, an abortion, and endometritis. The delay in the outflow of blood causes retrodeviation of the uterus (bend).

The cause of the bend is hard physical work, improper management in the postpartum period, sudden weight loss

Primary algomenorrhea

It is not associated with gynecological diseases. The pain syndrome is explained by functional disorders in the pathology of the endocrine and nervous system, a tendency to increased synthesis by the body of prostaglandins that reduce the uterus, and an increase in estrogen levels. It is typical for girls with overload at school, at work, low mobility, malnutrition, increased emotional perception.

In 2/3 of cases, a diagnosis of "premenstrual syndrome" is made. There are pulling pains in the lower abdomen a few days before the planned onset of menstruation. Most intense on the first day. There is a combination with headache, nausea, fainting, vomiting, pain in the mammary glands.

Tumors of the internal genital organs

Benign tumors of the ovaries and uterus (cysts, fibroids) with their growth stretch the organ and contribute to pulling pains. At the same time, a ligament apparatus is connected to the process. The clinical picture is necessarily supplemented by severe uterine bleeding.

Malignant tumors of the ovaries are characterized by bilateral pain, since they affect both organs. The pain syndrome is expressed at II-III stages of oncological disease. There are other signs:

loss of appetite;
weakness;
weight loss;
nausea;
hormonal disorders;
metastases to the stomach.

In the lower abdomen, on one side, pain occurs with cancer of the fallopian tube. Its early manifestation is considered to be periodic copious watery discharge. The pain itself in this case is caused by impaired peristalsis of the tube.

The early stages of uterine sarcoma are accompanied by uterine bleeding, rapid tumor growth, intense pain, and metastases. For an experienced doctor, the importance of pulling pains in the lower abdomen is important for assessing a person’s condition and diagnosing. Patients with similar signs should be examined and specific causes identified.

Gynecologists believe that pain in the lower abdomen in women is the most common reason for treatment. However, by the nature of the symptom, it is not immediately possible to name the cause with certainty. Most often, examination with palpation of the internal genital organs is necessary. Sometimes a consultation with a surgeon or neurologist is required.

The lower part of the abdomen reflects the manifestations of physiological changes and diseases of both the genital organs and the bladder and intestines. Proper treatment can only be prescribed after a complete examination.

Mechanism of pain

The causes of pain in the lower abdomen in women may be associated with changes in a dense (parenchymal) organ, such as the ovaries, or due to hollow formations (bladder, fallopian tubes, uterus, intestines). Accordingly, the mechanism of pain syndrome is different.

Diseases of the ovaries are accompanied by an increase in the organ, stretching of the capsule, equipped with nerve pain endings. In hollow organs, the main role is played by spastic contraction of the muscle layer or its overstretching (atony).

Therefore, in the first variant, the nature of the pains of the patient is described as aching, dull, constant, gradually increasing as the appendages increase. And in the second - more often as cramping, periodic, aggravated by unrest, movements, physical activity. Bursting pain causes a rapid increase in the size of the body due to swelling, inflammation.

With a slow increase, women experience dull heaviness, pressure in the pathology zone. Another mechanism of the pain syndrome is associated with the adhesive process and overstretching of the surrounding ligaments. Adhesions are formed as a result of chronic inflammation with peritoneal effusion, as a complication after surgical interventions.

Spikes do not have nerve endings, they consist of scar tissue, but, having soldered the end to hollow organs, they cause their displacement, narrowing of the lumen

Adhesive pains accompany intestinal peristalsis, sexual activity, defecation. The ligamentous apparatus fixes the muscles and organs in a sedentary state. Stretching of the internal ligaments is felt as a pulling pain.

Another variant of pain causes irritation of the sheets of the peritoneum and local inflammation. At the same time, the pains are quite strong, but they are constantly in one place, they do not radiate anywhere. If a girl has pain in her lower abdomen, then this, in the absence of signs of inflammation, is associated with an increased tone and tension of the uterus. The pain is combined with the period of menstruation (algomenorrhea).

The nature of the pain syndrome is differently felt and endured by women at a young and mature age, who have given birth and who have not given birth. The pain threshold of sensitivity allows one to endure acute pain, while the other does not give rest if it occasionally aches in the side. The subjective assessment is supplemented by other symptoms and examination results. Consider what can hurt in this area.

Pain from the digestive organs

Pain in the lower abdomen in the body of both women and men can occur due to disruption of the intestines. On the right is the projection of the appendix, the ileocecal angle, formed by the connection of the jejunum and the caecum.

Here a process called the vermiform (appendix) departs. The wide and short caecum descends below the iliac crest of the pelvic bone. Skinny is adjacent to her from behind. In the left iliac region lies the sigmoid and rectum of the large intestine.

attack of appendicitis

Appendicitis is a paroxysmal inflammatory disease with a local lesion of the appendix. In a chronic course, it spreads to neighboring sections of the intestine and the adjacent part of the peritoneum.

The disease can be caused by:

chronic indigestion with stagnation inside the process;
adhesive changes in the abdominal cavity, adhesions with other organs;
intestinal atony with prolonged constipation;
specific effect of infection in typhoid fever, tuberculosis;
abdominal trauma;
impaired patency in case of eating nuts, seed husks;
anomalous structure.

The exit from the process can be clogged with a fecal stone

The classic picture begins with pain in the stomach, with fever, vomiting. Reminds me of food poisoning. After 2-3 hours, the pain "descends" into the right iliac region and intensifies to a pronounced attack. Possible irradiation from the bottom up to the right hypochondrium, to the navel, lower back, anus.

Normally, the appendix has a different position, which makes diagnosis difficult. An upward deviation is characteristic of an attack in a pregnant woman. Usually, against the background of pain, there is local tenderness on palpation, tension in the abdominal muscles. Violated stool (diarrhea or constipation).

If the pain becomes pulsating, "jerking", then a suppurative process (phlegmonous or) should be expected. There are situations with moderate dull pains that women endure without seeking medical help.

The disease does not disappear, but becomes chronic. A restrictive "bag" of adhesions is formed around the process. It delays the formation of diffuse peritonitis. Pains are repeated with different intensity. Treatment is surgical only.

Crohn's disease

The disease has no exact cause. Pathological changes are expressed in the form of areas of granulomatous (lumpy) inflammation, alternating with normal intestinal tissue. The region of the cecum is one of the most common localizations.

Inflammation is characterized by a through lesion of the wall, the formation of coarse cracks, ulcers, fistulous passages between organs, cicatricial and suppurative processes. The disease proceeds for a long time with relapses even after 20 years.

The propensity to the disease of women has been established:

with a burdened family history (sick next of kin);
long "experience" of smoking and alcoholism;
low immunity as a result of chronic infectious diseases.

Strong cramping pains in the lower abdomen on the right with ileitis indicate an active process. They are aggravated after eating, unrest. They can be permanently bursting. In addition, patients are concerned about:

bloating;
frequent loose stools (possibly mixed with pus and blood);
nausea and vomiting;
poor appetite, weight loss;
low temperature;
weakness.

Timely detection and treatment can achieve a long period of remission.

Nonspecific ulcerative colitis

The disease begins in the rectum and "rises" further along the large intestine. The nature of the inflammation remains unclear. Ulceration of the mucosa does not extend to the deep layers of the wall. Women with low immunity, against the background of long-term use of toxic drugs, with unfavorable heredity are more likely to get sick.

Main signs:

cramping pains in the left iliac region and side, increased due to food, defecation, physical activity;
tendency to diarrhea;
impurities of pus, mucus and blood in the feces;
moderate increase in temperature;
weight loss, weakness

The most common complication is intestinal bleeding. In therapy, strong anti-inflammatory drugs, hormones are used. Surgery may be needed in an emergency.

Diverticulosis

The disease is caused by a broken structure of the intestinal wall. The cause of pulling pain in the lower abdomen is inflamed saccular protrusions. They are formed:

in elderly women with atony and a tendency to constipation;
with a lack of water and fiber intake;
in overweight people with low physical activity;
in case of anomalies in the development of the intestinal wall;
with a pronounced atherosclerotic process in the arteries of the abdominal cavity with intestinal atrophy.

The most common location for diverticula is the sigmoid colon.

Diverticula can give intermittent aching pain in the projection area on the abdominal wall. Severe spasms occur when these formations become inflamed, twisted, which causes partial intestinal obstruction. Therapy includes intense anti-inflammatory drugs. With the threat of peritonitis and obstruction, an operation is performed to remove the diverticula.

colon cancer

Adenocarcinoma most often affects the sigmoid and rectum, so differential diagnosis is carried out when it is not clear why the lower abdomen hurts in women in the left iliac region. It is possible to detect cancer at an early stage only by indirect signs, since it does not give severe pain.

Patients go to the doctor with complaints:

for constipation;
bloating;
incomprehensible temperature;
weight loss.

Against the background of tumor growth, constant pains appear in the left iliac region and in the side of a blunt character, which do not depend on nutrition and physical activity. The therapy includes the use of a combination of cytostatics with irradiation of the cancer area and nearby lymph nodes. The issue of surgical treatment and the scope of intervention is decided by the commission.

Pain and impaired urination

Inflammation of the bladder and urethra (cystitis and urethritis) is more common among women than among men. This is due to the peculiarity of the structure and location: the urethral canal is short, wide, lies close to the anus and vagina.

Infection is caused by E. coli, disturbed vaginal flora (especially in sexually transmitted diseases)

If a woman's lower abdomen hurts at the same time as pain during urination, frequent urges, then one should think about inflammation in the lower urinary tract. Usually the pains are pulling, constant, exhausting the patient, causing insomnia.

Severe inflammation is accompanied by flakes of mucus in the urine, bloody streaks. If pain radiates to the right or left side of the lower back, pyelonephritis should be excluded. Inflammation of the renal pelvis is also accompanied by dysuria, a burning sensation in the very bottom of the abdomen.

Treatment is usually long. Combines phytopreparations that flush the bladder, the use of a significant amount of fluid and antibacterial agents. Do not do without consulting a gynecologist. Often, inflammation of the genital organs and the bladder are combined and support each other at the same time.

Pain associated with sexual dysfunction

Gynecologists divide pain in the lower abdomen in patients into functional (physiological) and organic. Functional causes are caused by temporary underdevelopment of the genital organs in girls, due to menstruation, pregnancy. They are associated with excitement, hypothermia, the onset of sexual activity.

Organic causes always appear in the acute or chronic course of the pathology of the uterus, appendages. The pains are of a different nature, may be accompanied by uterine bleeding, vaginal discharge.

Differences between physiological and organic pain:

lack of a clear connection with the previous action, spontaneous onset and disappearance;
short term;
moderate intensity;
relatively satisfactory health.

From physiological causes, it is necessary to distinguish secondary dysmenorrhea, depending on the pathology of the uterus, appendages.

Physiological pain in women

To figure out why a girl has a stomachache below before and during each menstruation, gynecologists will need to study the hormonal background, the patient's regimen. Primary algomenorrhea - associated with functional disorders caused by underdevelopment of the endocrine and nervous systems.

In girls, the production of prostaglandins, estrogens, increases, which increase uterine contractions. It is often observed with overload in studies, low physical activity, malnutrition (coffee, sandwiches, chips), with emotional stress.

In 75% of cases, the diagnosis is defined as "premenstrual syndrome". In addition to pain, a few days before the period of menstruation, there are:

headache and nausea;
dizziness and fainting;
vomit;
swollen and sore breasts.

During pregnancy, pain is caused by stretching of the ligamentous apparatus. Most often they disturb primiparous women over the age of 25 with poor physical fitness.

It is impossible to exclude the occurrence of an acute disease or an exacerbation of a chronic one during pregnancy, therefore, each expectant mother is obliged to carefully monitor her well-being and inform the doctor about any changes.

Pain during ovulation - occurs on the 14-15th day of the normal menstrual cycle. Last for several hours or days. Women find regular pulling pains in the lower abdomen with an increase during intercourse. They are caused by hormonal changes with an increase in blood supply to the ovary. Usually unilateral. Women require observation by a gynecologist.

Pain in the pathology of the genital organs in women

Organic pains, depending on pathological changes in the uterus and appendages, are provoked by: hypothermia, hard physical work, sports, increased nervous tension, the use of intrauterine contraceptives.

Adenomatosis (endometriosis) - caused by the growth of the epithelium from the inner layer of the uterus into the muscle. The most affected are nulliparous women over 30 years of age and those suffering from infertility. Symptoms are associated with constant pulling pains above the pubis, prolonged menstrual bleeding, brown vaginal discharge.

The epithelium forms pockets. Menstrual blood enters them and presses on the surrounding tissue. Therefore, during menstruation, the pain intensifies, radiating to the groin and lower back.

For therapy, hormonal drugs are used.

During pregnancy, a woman with endometriosis is constantly monitored to rule out placental rejection.

Inflammatory diseases (endometritis, adnexitis) - accompanied by arching or cramping constant pain. With adnexitis (inflammation of the ovary), the pain is unilateral. Irradiation to the sacrum, lower back is observed, the general condition worsens.

The highest risk of inflammation in women:

who have undergone diagnostic curettage and abortion;
refusing a long course of therapy.

Additional features include:

weakness, dizziness;
muscle pain;
temperature rise;
unpleasant odor from vaginal discharge due to the admixture of pus;
insomnia;
irritability.

In 60% of women, inflammation is caused by a sexually transmitted infection. In treatment, it is necessary to provide for a temporary cessation of sexual intercourse and examination of the partner.

Congenital and acquired anomalies - in girls, they are detected during the painful first menstruation (infection of the vagina, cervix). The accumulation of blood in the cavity causes expansion and constant pain. In adult women, blood retention is facilitated by the bending of the uterus (retrodeviation), adhesions in the cavity (synechia).

Girls need to be shown to a gynecologist and urgently examined. For women, special exercises are selected, if it is impossible to correct the situation, an operation is performed.

Tumors of the genital organs in women - have benign growth and malignant course. Benign cysts include fibroids. As they grow, they stretch the organ and cause arching pains. At the same time, sprains, adhesions (with chronic inflammation) take part in the mechanism.

Manifestations can wear a picture of an acute attack with cyst torsion, rupture. In this case, the pain is one-sided, accompanied by dizziness and nausea, shock is possible. With fibromyomas, severe uterine bleeding, signs of anemia are added to the pain.

Malignant tumors of the appendages are accompanied by bilateral localization, intensity in stage II–III. There are signs of cancer intoxication:

nausea;
lack of appetite;
weight loss
hormonal disorders;
weakness.

Unilateral pain causes cancer of the fallopian tube. Early symptoms include intermittent, profuse watery discharge. Uterine sarcoma is detected during examination for uterine bleeding. The tumor is characterized by rapid growth, increased pain and metastasis.

Tubal pregnancy with a rupture - accompanied by a sudden pain syndrome on one side of the abdomen, severe dizziness, loss of consciousness caused by internal bleeding is possible. The woman has a delay in menstruation, secondary signs of pregnancy.

Why is a gynecological examination necessary?

For any pain in the lower abdomen in women, specialists should exclude changes in the genitals. Therefore, women are referred to a consultation, and a doctor looks at the hospital on the spot.

Vaginal examination is carried out with two hands, thus, the internal genital structures are clamped between the fingers, their size, density are determined, the left and right ovaries are compared

With inflammation of the appendages, palpation is sharply painful on the one hand, one of the organs is enlarged, the tissue is pasty. Endometritis is indicated by an enlarged and softened uterus, pain on palpation. When the fallopian tube ruptures with internal bleeding, a bulging of the posterior fornix of the vagina is revealed.

An assessment of the condition of girls and young women with pain in the lower abdomen is important for resolving the issue of preparing for conception, the course of pregnancy, and the birth of healthy offspring. For older women, the timely exclusion of pathology guarantees working capacity and an active life after menopause.