Is Lower Abdominal Pain Cramping Your Style?

Why more women need to prioritize taking care of discomfort

For busy women with caregiver responsibilities, seeing a doctor for a nuisance like lower abdominal pain can sit on the back burner. Whether it’s pain that comes and goes or a constant discomfort, there’s no reason to suffer from a problem your doctor can help you address.

 “Something that bothers you for years may not be life-threatening, but it does play a big role in your quality of life. That shouldn’t be overlooked. We women need to stop suffering in silence,” says Morgan Allyn Sendzischew Shane, M.D., MSCTI, a gastroenterologist with the University of Miami Health System’s Comprehensive Women’s Health Alliance.

Sometimes, a common barrier to relief from lower abdominal pain is finding the right doctor to diagnose your problem and recommend appropriate treatment. “It’s not hard to get a good diagnosis if you have somebody who considers all of your presenting symptoms,” says Dr. Shane.

 The problem, for many women, is finding time to address the problem in the first place.

Easier access to care can help women make time for medical appointments earlier

Women who work and also are caregivers can struggle to find time to navigate complicated health systems and attend appointments during business hours. Making it easier to access care is essential to improving women’s health.

As director of the UHealth Comprehensive Women’s Care Alliance, Dr. Shane says women in Miami are finding it easier to connect to care with a central nurse navigator who coordinates appointments among several women’s health specialists. Patients don’t have to determine who to call and how to get to a specialist. 

A primary care provider (PCP) plays the quarterback in a patient’s care journey. That’s why Dr. Shane’s first question to all her patients about their last primary care visit. “That’s your person who’s going to look at everything from a bird’s eye view and recommend any specialist you do or don’t need to visit,” says Dr. Shane.

Symptoms of lower abdominal pain in women

Dr. Shane sees an increasing number of women of all ages dealing with lower abdominal pain in her role as an adult gastroenterologist. This isn’t necessarily because it’s more prevalent. It’s more of an indication of more women taking time to address a consistent problem and finding better access to care.

Lower abdominal pain –– caused by various health issues –– underscores why women’s care coordination matters. “Many organs are packed in a small area of a woman’s lower abdomen. It could be a benign GI issue like constipation or IBS, or it could be a gynecologic issue, like an ovarian cyst or endometriosis,” says Dr. Shane.

In many cases, women with abdominal pain can’t pinpoint an exact location of pain. It can move sides or occur across the lower abdomen. Some women experience pain, while others complain of general discomfort. “The thing with abdominal pain, in general, is that it can be a little bit sneaky, and the symptoms in women are maybe not your typical symptoms.” 

Common symptoms associated with abdominal pain include the following:

• Constipation
• Diarrhea
• Bloating
• Cramping during menstruation or ovulation
• Food triggers

How to prepare for an abdominal pain specialist appointment

While many women struggle to pinpoint a location for lower abdominal pain, you may be able to notice patterns and triggers.

 Let your physician know about some of the following possible issues and when they occur:

• Changes in your bowel habits
• More pain or relief after a bowel movement
• Pain during menstruation or another point in your monthly cycle
• Identifiable trigger foods that cause lower abdominal pain

 Chronic or intermittent abdominal pain that you’ve dealt with for a decade is unlikely to be life-threatening, says Dr. Shane. But, you should see your doctor immediately if any “alarm features” accompany lower abdominal pain.

You should make an appointment right away with your doctor if you experience any of the following issues: 

• Unintentional weight loss
• Consistent fever, chills and sweats
• Profound fatigue
• Rectal bleeding
• Abnormal vaginal bleeding
• Acute changes in your bowel habits

 Some of these “alarm features” can be a symptom of colorectal cancer, so speak to your doctor if you have concerns.

Possible diagnoses for lower abdominal pain in women

Diagnosing the cause of your lower abdominal pain is the first step to finding relief. Pain can be gastrointestinal, gynecological or a combination of both.

Some common GI diagnoses for consistent lower abdominal pain include the following: 

• Irritable Bowel Syndrome (IBS): A large intestine disorder that causes cramping, abdominal pain, bloating, gas, diarrhea and/or constipation.
• Inflammatory Bowel Disease (IBD): Chronic inflammation of the digestive tract, such as in Crohn’s disease and colitis.
• Diverticulitis: Inflammation due to infection of benign bulges in the colon, causing pain, fever and digestive trouble.
• Food sensitivities, such as lactose
• Abdominal migraines
• Central abdominal pain syndrome

Some common gynecological diagnoses for lower abdominal pain include the following: 

• Endometriosis: Tissue similar to the lining inside the uterus grows outside it, causing pelvic pain, especially during menstruation and sex.
• Uterine fibroids: Benign uterine growths that can cause heavy or prolonged periods and discomfort.
• Pelvic inflammatory disease (PID): A reproductive organ infection, often caused by sexually transmitted infections, leading to pain that may worsen during sex.
• Ovarian cysts

Because there are so many causes for lower abdominal pain in women, you should see a physician for a diagnosis. “It could be a couple of different things, and it’s really important to identify your symptoms with the help of a provider who’s going to be that champion for you to find the answer you need to feel better,” says Dr. Shane.

 Most importantly, women with any consistent pain should make the time to address it, even when it doesn’t seem serious. “If there’s a meaningful way to improve your quality of life, there’s no reason not to pursue it,” says Dr. Shane.

 The gastroenterology department at UHealth’s Comprehensive Women’s Health Alliance provides specialized care for women’s digestive health at all ages. Call 855-3-4-WOMEN (96636) or request an appointment online.

Wendy Margolin is a contributor to UHealth’s news service.

Tags: abdominal pain, Comprehensive Women's Health Alliance, Dr. Morgan Allyn Sendzischew Shane, lower abdominal pain, Miami gastroenterologist