Severe Lower Abdominal Pain: Could It Be Pregnancy or Something Else?

Persistent severe pain in the lower abdomen?

I have been experiencing persistent severe pain in my lower abdomen for the past three hours.
The pain is located below my navel and is widespread.
At times, I feel sharp, cramping pain on the left side, and at other times on the right side.
Even slight movements cause intense pain, and pressing on my abdomen is extremely painful.
Over the past few weeks, I have also had abdominal pain in various areas, including the upper abdomen and both lower quadrants.
I am unsure what is happening, but this has been ongoing for several weeks without any signs of improvement.
After lying down for three hours, I now feel very dizzy.
I have irregular menstrual cycles, ranging from 34 to 72 days.
My most recent period was from July 13 to July 17, and I had sexual intercourse on August 13 and August 15.
On August 15, I experienced brown discharge that lasted for three days, ending on August 18.
I am wondering if I could be pregnant because my symptoms seem to align with that possibility.
I have been feeling dizzy, experiencing abdominal pain, and recently had a slight fever of 37.8°C.
I vomited on the same day.
On August 22, I visited a gynecologist and had a blood test, but the report did not include an HCG test, so I am uncertain about the possibility of pregnancy.
Dr.
Huang, could you please help me understand what might be wrong? Is it possible that I am pregnant, or could this be related to another gynecological issue, or even an ectopic pregnancy? Please provide me with some answers.
P.S.
My lower abdominal pain has been persistent for a long time, sometimes intermittent but lasting for extended periods.

Niming, 10~19 year old female. Ask Date: 2018/08/30

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Persistent severe pain in the lower abdomen has lasted for 3 hours, with pain concentrated below the navel.
The entire area is very painful, with intermittent sharp pain on the left side and sometimes on the right side.
Any movement causes severe pain, and pressing on the area is extremely painful.
For the past few weeks, I have experienced widespread abdominal pain, including in the upper abdomen, lower abdomen, and both lower quadrants.
I am unsure what is happening, but this has persisted for several weeks without improvement.
After lying down for 3 hours, I now feel very dizzy.
I have irregular menstrual cycles, ranging from 34 to 72 days.
My last period was from July 13 to July 17, and I had sexual intercourse on August 13 and August 15.
On August 15, I experienced brown discharge that lasted for 3 days, ending on August 18.
I am wondering if I could be pregnant, as my symptoms seem to align with that possibility, including persistent dizziness, abdominal pain, and a mild fever reaching 37.8°C.
I vomited on the same day.
On August 22, I visited a gynecologist and had a blood test, but the report did not include an HCG test, so I am uncertain about the possibility of pregnancy.

Dr.
Huang, could you please clarify what might be the issue?
1.
Is it possible that I am pregnant, or could it be an ectopic pregnancy?
Answer: Currently, it is unclear whether you are pregnant or experiencing an ectopic pregnancy; it is advisable to take a pregnancy test first.

2.
Could there be other gynecological conditions?
Answer: Other gynecological conditions would require a pelvic examination and ultrasound.

P.S.
I have been experiencing lower abdominal pain for a long time, sometimes intermittent but with prolonged duration.

Reply Date: 2018/08/30

More Info

Severe lower abdominal pain during pregnancy can be concerning and may arise from various causes. Given your symptoms, including persistent pain in the lower abdomen, occasional sharp pains on either side, and additional symptoms like dizziness, nausea, and a slight fever, it is essential to consider several possibilities.

Firstly, the pain you are experiencing could be related to normal physiological changes during pregnancy. As the uterus expands, it can stretch the ligaments and surrounding tissues, leading to discomfort. This is often referred to as "round ligament pain," which is common in the second trimester. However, the severity and persistence of your pain, especially if it has lasted for several weeks without improvement, warrant further investigation.

Another critical consideration is the possibility of an ectopic pregnancy. This occurs when a fertilized egg implants outside the uterus, often in a fallopian tube. Symptoms of an ectopic pregnancy can include severe abdominal pain, especially on one side, and may be accompanied by abnormal bleeding or spotting. Given your history of irregular menstrual cycles and the recent sexual activity, it is crucial to rule out this condition, as it can be life-threatening if not addressed promptly.

Additionally, the presence of fever and nausea could indicate an infection, such as a urinary tract infection (UTI) or pelvic inflammatory disease (PID). Both conditions can cause significant abdominal pain and require medical treatment. The fact that you experienced coffee-colored discharge could also suggest a possible complication, such as a miscarriage or other issues related to pregnancy.

Since your blood tests did not include an HCG (human chorionic gonadotropin) level, it is essential to follow up with your healthcare provider to ensure that a pregnancy test is conducted. HCG is a hormone produced during pregnancy, and its levels can help confirm whether you are pregnant or not. If you are pregnant, your healthcare provider may recommend an ultrasound to assess the location of the pregnancy and check for any abnormalities.

In summary, while some abdominal pain can be attributed to normal pregnancy changes, your symptoms suggest that further evaluation is necessary. It is crucial to consult with a healthcare professional who can perform a thorough examination, possibly including imaging studies and laboratory tests, to determine the underlying cause of your pain. Early diagnosis and management are vital to ensure both your health and the health of your potential pregnancy. If you experience worsening symptoms, such as increased pain, heavy bleeding, or fainting, seek immediate medical attention.

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