Sometime the pain would be so excruciating that I would curse God for making me a woman.

Most women experience pain in the lower abdomen (below the belly button) time to time. It may be associated with their periods.


Pain may be severe and steady or it may be intermittent, dull and aching type or may be felt just as a pressure sensation deep within. Some women may have pain during sexual intercourse.


Causes originating from the reproductive system-

  • Endometriosis (This is a painful condition where tissue that is similar to the lining of the uterus grows outside the uterus.)
  • Simple spasmodic dysmenorrhea (excessive cramping pain during periods)
  • Pelvic inflammatory diseases
    (Infections of the lower pelvic organs can lead to scarring and abdominal pain)
  • Pelvic congestion
    (Large veins around your uterus and ovaries, similar to varicose veins, may cause pelvic pain)
  • Fibroids, which may cause a deep, dragging pain
  • Ovarian remnants
    (Some women experience pain even after removal of the uterus. This may be due to a small piece of ovary left inside in which painful cysts could develop.)
  • Ovarian cysts could cause pelvic pain, especially sharp or sudden if they get ruptured or twisted Causes originating from the gastrointestinal system, for example
  • IBS (Irritable Bowel Syndrome)
  • Ulcerative Colitis

Causes originating from the urinary system Bladder inflammations or urinary infections can all lead to symptoms of pelvic pain.

Pregnancy related causes

  • Ectopic pregnancy (pregnancy outside the uterus)
  • Abortions


Work up will depend upon the history, clinical examination etc. Apart from routine lab blood and urine tests, a pelvic ultrasound is of great help. Laparoscopy is considered as the gold standard in identification of the cause of the pain.


Treatment is directed at the identified cause and laparoscopy affords a greater advantage over open surgery because of greater magnification and better identification of pathology.