6 tummy pains women should know about

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Causes of tummy pain in women

Authored by Dr Aifric Boylan on 15.08.2017
Medically Reviewed by Dr Richard Bennett
Last updated on 20.06.2023

We all get abdominal aches and pains now and then- most of the time it’s nothing much to worry about and gets better by itself. However, certain causes of tummy pain can indicate a serious underlying problem and shouldn’t be ignored:

Ectopic Pregnancy

An ectopic pregnancy is when a fertilised egg implants outside the uterus- in a fallopian tube, ovary or elsewhere in the abdomen.
As the pregnancy grows, it can cause serious complications including internal bleeding- which, if not diagnosed quickly, can lead to death.
The pain tends to be sharp and located low in the tummy, often to the left or the right side.
There may be abnormal vaginal bleeding, but usually not.
A woman may be a few days late for a period, but not necessarily.
Any woman who is sexually active and develops lower abdominal pain that is not settling should see a doctor as soon as possible- particularly if her period is late, the pain is sharp or getting worse, or if she is feeling weak and unwell.
Quick diagnosis of ectopic pregnancy is extremely important. Treatment can involve medication or surgery.

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Pelvic Inflammatory Disease (PID)

PID is caused by sexually transmitted infections such as Chlamydia and Gonorrhoea, which are caught by having sex without a condom.
Symptoms include pelvic pain which can be dull or sharp.
In some women it comes on suddenly- fevers, chills and general unwellness.
There may be abnormal or smelly vaginal discharge, unexpected vaginal bleeding and pain during sexual intercourse.
In other women, it may present less suddenly- there might just be pelvic aches and pains for weeks or months, with or without the other symptoms mentioned above.
It’s very important to diagnose PID as soon as possible, as it can lead to complications such as infertility due to scarring in the pelvis and fallopian tubes, and a higher risk of ectopic pregnancy.
Your GP can perform an examination, and may perform vaginal swabs and a urine test.
Antibiotics can clear the infection, but cannot get rid of scarring that has already happened.

Pyelonephritis

Women are generally more prone to urine infections as they have a shorter urethra, so it’s easier for bacteria to travel up to the bladder.
In pyelonephritis, bacteria spread from the bladder to the kidneys. This leads to pain in the middle part of the back- on one or both sides, around the lower part of the ribcage. It can be quite severe.
There may be fevers, chills, sweats, nausea or vomiting.
There may also be urinary symptoms such as a burning sensation when passing urine, passing urine more frequently than usual, and sometimes there may be blood in the urine.
Treatment involves antibiotics, but if a person is very unwell, hospital admission may be needed for pain relief and antibiotics through a drip.
Again, pyelonephritis can be very serious, as infection can spread to the bloodstream (sepsis)- so early diagnosis and treatment is essential.

Gallstones

Women are more likely than men to get gallstones. These stones form in the gallbladder, which is located in the upper right part of the tummy, near the liver.
If stones get stuck in the opening of the gallbladder, it can cause spasms of severe pain- also known as “biliary colic”. This pain may spread around the side, into the back. In some people it seems to be triggered by eating fatty foods.
In other cases, the presence of stones can lead to infection in the gallbladder, known as “acute cholecystitis”. This tends to cause a more continuous type of pain in the upper right part of the abdomen, and may be accompanied by fevers, chills and general unwellness.
These conditions often require hospital admission, for pain relief, and in the case of cholecystitis, antibiotics. Ultimately, surgery to remove the gallbladder may be required.

Endometriosis

Endometriosis is a condition that affects about 1 in 10 women, most commonly between the ages of 25 and 40.
If a woman has endometriosis, the kind of tissue that lines the uterus (womb) starts to grow outside the uterus, in places where it shouldn’t normally be- most commonly on and around the ovaries, the fallopian tubes, and occasionally the bowel or other locations.
The trouble is, this tissue tends to bleed each month when a woman has her period, leading to inflammation, pain and scarring. The most common symptoms are pelvic pain and painful periods- and these tend to worsen over time.
In addition, women may experience pain during sex, pain when passing urine or bowel motions (often worse during a period), constipation, diarrhoea, bloating and fatigue.
Cysts called endometriomas may form in the ovaries.
Infertility may also occur, thought to be caused by scarring in the fallopian tubes, though there may be other factors.

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Ovarian Cysts

Sometimes women can develop a cyst on their ovary.
There are several different types of ovarian cysts, and some women can be quite prone them ( e.g if they have PCOS or endometriosis).
Whilst ovarian cysts may be have no symptoms, pain can occur if they twist, rupture or get big enough to place pressure on other organs.
The pain tends to be low down in the pelvis on the affected side.
Symptoms can be quite similar to appendicitis or an ectopic pregnancy, so immediate medical attention should be sought.

Of course, there are many many other causes of tummy pain- we’ve just gone through some important types that are particularly relevant to women. If you have concerns about abdominal pain, be sure to speak to a doctor as soon as possible.

Further resources

www.nhs.uk

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