Associated symptoms
Depending on the cause, different accompanying symptoms can occur. Inflammatory diseases can be associated with fever and fatigue. Inflammations of the female genitals are also often associated with increased discharge and pain during sexual intercourse.
In addition, there is often a urinary tract infection, which usually manifests itself as pain or burning sensation when urinating and a frequent urge to urinate. Uterine polyps usually do not cause any symptoms, but can cause bleeding in postmenopausal women and bleeding disorders in premenopausal women. Myomas are typically accompanied by bleeding disorders.
Depending on where they occur in the uterus, they can also cause discomfort during bowel movements, back pain or the need to urinate. The absence of menstruation in acute pelvic pain can be an indication of a pregnancy outside the abdominal cavity. Malignant tumors are often accompanied by a combination of fever, night sweats (to such an extent that the pyjamas may have to be changed several times a night) and unwanted weight loss of more than 10% of the body weight in the last 6 months.
These symptoms are also referred to by the doctor as “B symptoms“. Tumors of the female reproductive organs often cause rather unspecific symptoms. Caution is advised with bleeding after the menopause. These can be the first symptom of a malignant tumor of the uterus and should be clarified by a gynecologist as soon as possible.
Pain localizations and situations
Uterine pain, which occurs mainly when sitting, can have various causes. When sitting, there is increased pressure on the abdomen. Inflammatory changes or other irregularities can become more painful.
Often, however, abdominal pain when sitting does not come from the uterus itself, but from other organs in the lower abdomen, such as the ovaries. Ovarian cysts, ovarian inflammation or even ectopic pregnancy can be very uncomfortable when sitting. A bladder infection is also usually very painful when sitting and is easier to bear when lying down.
Actual abdominal pain emanating from the uterus when sitting can occur in the case of endometriosis, a disease of the lining of the uterus. It is not uncommon for the intestine to be the cause of such complaints, for example in the context of appendicitis or diverticulitis, in which small protuberances of the intestinal wall become inflamed. Persistent or worsening complaints should therefore always be clarified by a doctor.
Pain during sexual intercourse is summarized under the term “dyspareunia”. Diseases of the uterus, such as endometriosis, can be a cause of pain during sexual intercourse. For women who suffer from chronic lower abdominal pain, sexuality is a particularly problematic issue.
Many women feel an increased pain during sexual stimuli or during sexual intercourse and experience this as a great strain. Often there is a strong psychological component. The fear of feeling pain during sexual intercourse and the shame of not being able to enjoy something that is actually “pleasurable” increases the pressure of suffering even more.
If the cervix hurts after penetrating too deeply during intercourse, positions that do not penetrate as deeply can be discussed with the partner and solutions can be found that allow pain-free intercourse for both partners. What else you can do about pain during sexual intercourse, you can read in our article Dyspareunia – pain during sexual intercourse! Pain in the abdomen, which occurs on the right or left side, can come from the uterus.
This hurts especially during menstruation, because it then contracts and expels the previously built up mucous membrane.However, in the case of unilateral localized pain, the uterus is often not the direct cause of the symptoms. The pain is often caused by the ovaries. Cysts or other changes in an ovary can cause pain on the corresponding side.
The same applies to an ectopic pregnancy, which can cause very severe pain. During pregnancy, unilateral abdominal pain can also occur when the ligamentous apparatus of the uterus is stretched. Benign growths of the lining of the uterus (myomas) or malignant tumors (uterine carcinoma) can also potentially cause such abdominal pain.
How you can tell if your symptoms are due to cysts is explained in our article Uterine cyst – dangerous or harmless?localized pain at the cervix can have many different causes. Often the pain is not only felt at the cervix, but also affects the adjacent structures. A possible cause of cervical pain can be cervical cancer.
In early stages, it is often painless, but in advanced stages it can be accompanied by pain radiating to the lower back. In addition to the malignant changes, there are also benign diseases, such as inflammation of the internal reproductive organs, which can cause pain in this region. Inflammation of the cervix (cervicitis) is associated with discharge and minor bleeding rather than pain, but inflammation of the vagina or the lining of the uterus can cause pain which, due to its proximity to the cervix, can also be felt there.
In addition to the inflammation, mechanical irritation of the cervix can also cause pain. An example is the routine cancer screening (PAP smear) at the gynaecologist. In this examination, a smear is taken from the cervix.
After this examination, pain may occur due to irritation of the mucous membrane. Another conceivable mechanical irritation occurs for example during sexual intercourse with deep penetration and can also cause pain. One of the most common malignant tumors in women worldwide is the so-called cervical carcinoma, also called cervical cancer.
Often an infection with certain types of human papillomavirus (HPV) is the cause of this tumor. Cervical cancer does not cause any pain or symptoms in the early stages. Only when the tumor is more advanced does it produce a flesh-colored, sweet-smelling discharge, irregular bleeding and contact bleeding during sexual intercourse.
If cervical cancer remains untreated, it grows into the bladder, rectum and other structures in the pelvis, damaging or destroying them. It is usually only at this very advanced stage that abdominal pain occurs. For this reason, it is important to visit your gynaecologist regularly in order to detect and treat cervical cancer at an early stage.
Vaccination with an HPV vaccine also reduces the risk of developing cervical carcinoma (cervical cancer), as infection is prevented by the two most common high-risk viruses. In the early stages of cervical cancer, the complete removal of the altered tissue by taking a cylindrical tissue sample (conisation) may be sufficient. In more advanced stages, removal of the uterus with surrounding structures and sometimes other organs may be necessary.
However, other tumors in the area of the lower abdomen or metastases of malignant tumors from other organs (metastases) may also cause pain in the uterus. For this reason, it is important to consult a doctor early on if the symptoms persist for a longer period of time. Pain in the area of the uterus very often occurs in the course of a pregnancy.
The pregnancy leads to stretching and growth of the uterus. This can lead to pulling pain in the abdomen. This is usually harmless stretching pain of the uterine ligaments, muscles, uterus and tendons.
However, a gynaecologist should be consulted immediately if the pain persists or there is discharge or bleeding. Under certain circumstances, an imminent premature birth may also be indicated by pain in the area of the uterus.Persistent pain may also be due to premature labor, signs of a placental disorder or a ruptured uterus. In case of doubt, pregnant women should always consult their gynaecologist or midwife in case of unclear abdominal pain in order to rule out serious causes for the pain.
If there is a possibility of pregnancy, an ectopic pregnancy (tubal pregnancy) should also be considered if there is acute pain in the uterus. This involves implantation of the embryo in the mucous membrane of the fallopian tube instead of in the uterus. If this is not detected in time, an ectopic pregnancy may eventually rupture and cause severe internal bleeding with circulatory failure and shock.
- Pain on the mother ligaments
- Pulling the mother tapes
The uterus is exposed to extreme stress during birth. During pregnancy, the uterus becomes extremely large in order to provide sufficient space for the growing child. During birth, it contracts strongly to push the baby out of the birth canal.
Accordingly, the muscles of the uterus and the birth canal are severely overstrained after birth and have to regenerate. This can be accompanied by severe pain, especially in the days immediately after birth. In addition, the placenta also comes off, leaving a bleeding wound in the uterus, which must now first heal.
The pain in the abdomen is also perceived by some women as abdominal pain. During this time, the menstrual flow decreases, which makes regular intimate hygiene important. After the first birth, such regression pains are more frequent.
Especially when breastfeeding the newborn, many women complain of sudden onset of pain caused by the contraction of the uterus. Once the uterus has contracted sufficiently, the pain subsides. As a result of pressing during a natural birth, many women also suffer from haemorrhoids that protrude from the anus.
These are vascular cushions in the mucous membrane of the rectum, which are enlarged and pressed out by the pressure load. This usually also recedes over time. A caesarean section is a burden for the mother that should not be underestimated.
During the operation, a relatively large abdominal incision is made and then the uterus is prepared. This is also opened with an incision to bring out the newborn. This leaves wounds that are sutured, but the body still needs time to heal.
Therefore, pain for several weeks after a caesarean section is not unusual. The duration of the pain also depends on how long the woman was in labor before the procedure. The longer the period of labour, the more pain can be expected.
Normally, the pain at the scar and also in the area of the uterus subsides on its own. However, if other symptoms occur, such as fever or chills, and the scar area changes color, an infection must be considered. This can also be painful and requires further treatment.
- Abdominal pain after a caesarean section
- Pain at the scar of the kaiz-cut
In the acute phase of a hysterectomy, pain can often occur. Since this is a surgical procedure, it is considered quite normal. As the wounds heal, the pain will subside after not too long.
However, between 15 and 30% (depending on the literature) of women suffer from chronic pain, which can persist for months after the operation. Women who already suffered from lower abdominal pain before the operation, women who had more intense pain in the acute phase after the operation compared to other women, or women who had previously undergone pelvic surgery, such as a caesarean section, seem to be at particular risk. The fact that many hysterectomies are performed in a so-called minimally invasive procedure through the vagina is intended to minimize the pain.
