Sudden Severe Lower Abdominal Pain: What You Need to Know

Sudden severe pain in the lower abdomen?

I experienced sudden pain in my lower abdomen, which has happened once before.
This is the second time, and it occurred because my menstrual period did not arrive on the expected date.
I thought drinking some hot water might help, and since I have not had severe menstrual cramps in the past, I did not seek medical attention.
However, I have been drinking cold beverages recently.
Initially, the pain felt like a dull ache, and I thought it was related to gastrointestinal motility, but it turned out not to be the case.
The pain intensified, and I felt very hot and dizzy, to the point where I could not stand.
Eventually, I could not sit up and had to lie down in bed.
The pain was so severe that my whole body felt weak, lasting about 30 minutes.
It felt like a sharp pain in a specific area, but I couldn't pinpoint the exact location, which is in the lower abdomen, towards the center.
I also wondered if it could be a bladder issue, as I had just woken up and had held my urine for a while.
However, my period has not arrived this month; based on the previous cycle, it should have come around the end of this month or the beginning of next month, but it hasn't, and the situation is similar to last time.
Could you please advise me on how to address my symptoms or which specialty I should consult?

Hsieh Yu-chieh, 10~19 year old female. Ask Date: 2017/08/17

Dr. Lin Manying reply Obstetrics and Gynecology

Dear Ms.
Hsieh Yu-Chieh, regarding the issue you raised, if it occurs again, we recommend that you first visit a gynecologist.
It could potentially be related to: 1.
Gynecology 2.
Urology 3.
Gastroenterology issues.
The Hualien Hospital of the Ministry of Health and Welfare cares about your health.

Reply Date: 2017/08/17

More Info

Sudden severe lower abdominal pain can be alarming and may indicate a variety of underlying conditions, some of which require immediate medical attention. Given your description of the pain, its intensity, and the associated symptoms like dizziness and a feeling of heat, it is crucial to consider several potential causes.

Firstly, one of the most common causes of sudden lower abdominal pain in women, especially in relation to your menstrual cycle, is ovarian issues. Conditions such as ovarian cysts or ovarian torsion can cause severe pain and may be accompanied by nausea or dizziness. Ovarian torsion, in particular, is a surgical emergency and requires immediate intervention to save the ovary.

Another possibility is endometriosis, a condition where tissue similar to the lining inside the uterus grows outside of it. This can lead to severe pain, especially during menstruation, and can sometimes cause pain even when menstruation is not occurring. The pain can be debilitating and may be accompanied by other symptoms such as gastrointestinal issues.

Pelvic inflammatory disease (PID) is another condition to consider, especially if there is a history of sexually transmitted infections. PID can cause severe abdominal pain and may also lead to fever and other systemic symptoms.

In addition to gynecological issues, you should also consider gastrointestinal causes. Conditions such as appendicitis, diverticulitis, or intestinal obstruction can present with sudden abdominal pain. Appendicitis typically starts with pain around the belly button and then shifts to the lower right abdomen, but variations can occur. Diverticulitis can cause pain in the lower left abdomen and is often accompanied by changes in bowel habits.

Given your symptoms of feeling faint and hot, it is essential to rule out any serious conditions such as ectopic pregnancy, which occurs when a fertilized egg implants outside the uterus, often in a fallopian tube. This can lead to severe pain and internal bleeding, which can be life-threatening.

In terms of management, if you experience severe pain that does not improve, or if you develop additional symptoms such as fever, vomiting, or changes in bowel habits, it is crucial to seek medical attention promptly. You should consider visiting an emergency department or a gynecologist for a thorough evaluation. Diagnostic imaging, such as an ultrasound or CT scan, may be necessary to determine the cause of your pain.

In the meantime, while waiting for medical attention, it may help to avoid any strenuous activities and to stay hydrated. Applying a warm compress to the abdomen may provide some relief, but be cautious about masking symptoms that could indicate a more serious condition.

In summary, sudden severe lower abdominal pain can arise from various causes, including gynecological and gastrointestinal issues. Given the potential severity of some conditions, it is vital to seek medical evaluation to ensure appropriate diagnosis and treatment.

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