Introduction
Pain in the lower abdomen can have a variety of causes. Often, digestive disorders or infections of the urinary tract are the cause of abdominal pain. However, pain can also originate in the uterus. One of the most common causes is uterine pain as an acute symptom during menstruation, but in most cases this is harmless.
Cause
Uterine pain can have different causes. Most often they occur during the monthly menstrual period, which is then also called dysmenorrhea. Endometriosis can also be the cause of uterine pain, a condition in which the functional lining of the uterus is disrupted outside the uterus.
Another cause of uterine pain is pregnancy. Almost every woman experiences pain in the uterus during pregnancy. This is because the growing child takes up more and more space for itself.
Other organic diseases can also be the cause of uterine pain, such as uterine inflammation or tumor diseases. Cramp-like pain during menstruation, which often radiates into the back, is a common symptom that many women suffer from. Possible causes of painful menstruation are, for example, increased production of pain-promoting messenger substances, the so-called prostaglandins, or endometriosis.
Analgesic and antispasmodic drugs can help to alleviate the symptoms. But also some home remedies, which also help with short-term abdominal pain caused by digestive problems, cramp-like flatulence, constipation or other harmless causes, can be used for menstrual pain. Heat helps, for example, to relieve cramps in the lower abdomen and uterus.
A hot water bottle, a cherry pit pillow or a warm bath can often already help alleviate the discomfort. Tea and light foods can help to calm intestinal disorders that often accompany menstrual pain. Gentle abdominal massages can provide relief from painful stinging in the abdomen.
You can also find out what else you can do about unpleasant menstrual pain on our menstrual pain page. Pain in the area of the uterus, which occurs independently of the menstrual period, can have various causes. If the pain is acute, it could be caused by a myoma, a benign tumor of the uterus, which can die by turning the uterine stalk and thus cutting off its vascular supply, leading to the acute pain.
Other causes are more common in acute lower abdominal pain, which often cannot be clearly separated from “uterine pain” in terms of its symptoms. The female reproductive organs are affected by ovarian cysts, inflammation of the ovaries and fallopian tubes and, in women of childbearing age, pregnancy outside the uterus. However, the cause of acute pain can also lie outside the female reproductive organs.
Common causes are cystitis, kidney stones, appendicitis or inflammation of diverticula in the intestine. The situation is similar with chronic pain in the lower abdomen. In the case of the uterus, the most common causes are myomas, polyps, changes in the position of the uterus or intrauterine pessaries (so-called spiral).
Furthermore, tumors of the fallopian tubes and ovaries can cause chronic pain. However, uterine tumors themselves are usually not painful. Bowel diseases, urological, neurological and orthopedic diseases can also cause chronic lower abdominal pain.
However, it should be mentioned that up to 80% of women undergoing treatment for chronic lower abdominal pain suffer from somatoform pain disorder triggered by stress, loss experiences or even sexual abuse. This is a diagnosis of exclusion, which is often accompanied by other typical psychosomatic complaints such as headaches, impaired sexuality and digestion, sleep disorders and cycle disorders. This topic might also be of interest to you: Myomas of the uterusPain in the uterus is often caused by the benign, chronic disease endometriosis.
Here, the lining of the uterus (endometrium) occurs outside the uterus and, like the normal lining of the uterus, also changes during the menstrual cycle.Bleeding occurs outside the uterus when the mucosa is shed during menstruation. This results in very unspecific symptoms such as severe pain in the abdomen, which are often interpreted by those affected (but also by the treating physicians) as normal menstrual problems. In some cases, endometriosis is the cause of infertility.
Until now, the exact cause of endometriosis could not be clarified. For this reason, there is currently no possibility of preventing or treating the cause of endometriosis. The therapy of the disease consists in the surgical removal or destruction of the falsely located uterine mucosa and a hormonal inhibition of the cycle.
This can reduce the probability of recurrence of endometriosis. On our Endometriosis page you can find out what other symptoms endometriosis manifests itself through and what you can do about it. The uterus can push itself through the birth canal.
This is initially referred to as uterine descent (Descensus uteri). In more advanced stages, the uterus inside the now inverted vagina (vaginal prolapse) may even leak outside the body. In these cases, one speaks of a uterine prolapse or a uterine prolapse.
The cause lies in the failure of the holding ligaments of the uterus. A uterine prolapse can also occur after birth. Pelvic floor exercises (especially after pregnancy) are recommended to prevent uterine prolapse.
A prolapsed uterus mainly affects older women. Complaints such as a feeling of fullness or pressure in the abdomen are frequently reported. But also increased urge to urinate and pain in the area of the uterus and in the back can occur.
Nowadays, the therapy rarely consists of a hysterectomy (removal of the uterus). Nowadays, a vaginal tightening (colporrhaphy) and a fixation of the cervix at the sacrum are performed surgically. How you can optimally train your pelvic floor muscles in order to prevent or treat a uterine prolapse is explained in our article Pelvic floor training.
In some cases, pain in the uterus can also be caused by an inflammation of the lining of the uterus. In the case of so-called endometritis, localized pressure pain in the uterus often occurs, usually accompanied by bleeding and fever. If the uterine inflammation spreads to the adnexa (ovaries and fallopian tubes), very severe pain and high fever can also occur.
This inflammation most often occurs in the postpartum. Most often, the pathogens are bacteria that have been carried from the vagina or have ascended from it. Endometritis is promoted by inflammation in the area of the cervix (cervicitis), the vagina (colpitis, vaginitis), by an intrauterine device (coil) or tumors.
The therapy of uterine inflammation of the endometrium consists of the administration of antibiotics during an in-patient hospital stay. It is also important to take appropriate pain and cramp medication. In some cases, endometritis can lead to an accumulation of pus in the uterine cavity (pyometra).
This pus has to be drained with the help of a Fehling tube, for example. After treatment and resolution of the acute inflammatory phase of the uterine inflammation, a scraping (Abrasio uteri) and pathological diagnostics are performed to rule out a tumor in the uterus. The term pelvic inflammatory disease covers various inflammatory diseases of the uterus, fallopian tubes and ovaries.
In most cases, the inflammation is caused by bacteria, but also by viruses, fungi or parasites and can lead to infertility. Symptoms such as abdominal pain, pain during sexual intercourse or irregular menstrual bleeding are frequently reported. After exclusion of pregnancy, appendicitis, ectopic pregnancy, abortion, ruptured cysts or tumors, a pelvic inflammatory disease is treated with antibiotic therapy.
You can read more about this topic, including prevention, treatment and prognosis, in our article Inflammation in the abdomen. A polyp is a protrusion of the lining of the uterus. They are usually benign, but a small percentage can also degenerate into malignant tumors.Polyps in the uterus are only painful in rare cases.
They are often noticed by chance when an ultrasound is performed at the gynaecologist. Depending on the size and location of the polyps, they can make menstrual bleeding stronger than normal or cause inter-bleeding. Pain is possible during bleeding, but it is difficult to differentiate whether it is caused by the polyps or the increased bleeding. If and when polyps in the uterus are dangerous, you will learn in our article Are polyps in the uterus dangerous?