Frequent Urination and Lower Abdominal Pain in Women

Frequent urination with lower abdominal pain (in the area of the uterus and ovaries)?

Hello Doctor: I discovered that I have a frequent urination issue over two months ago.
I noticed that the frequency seems to occur from about a week before my menstrual period to a week after it.
I can hardly sleep at night (I usually need to urinate about three times during the night).
Additionally, I experience alternating pain in my left and right ovaries before and after my period (sometimes it's a sharp pain), which is not exactly cramping but rather a persistent discomfort that affects my mood.
I went to a gynecologist for an abdominal ultrasound (but at that clinic, they require a urine test before the appointment, and I wasn't full for the ultrasound).
The doctor said it was just ovarian inflammation and mentioned that it could be due to bacteria entering the vagina, causing the inflammation.
However, I have no sexual experience, so even though I feel something is off in my lower abdomen, the doctor couldn't perform more detailed examinations.
I also visited another gynecologist due to the frequent urination issue, but again, I wasn't full for the urine test, and they only prescribed medication for the urinary tract.
I feel like it hasn't helped, and these symptoms have persisted for about two to three months.
I'm starting to wonder if something is wrong inside me.
What should I do, Doctor? I've seen doctors for my discomfort, but the issues remain unresolved.
Due to my lack of sexual experience, I can't undergo more detailed examinations, and the main problem is the persistent alternating discomfort in my lower abdomen along with the frequent urination (not every day, but about every two to three days).

A Xin, 20~29 year old female. Ask Date: 2019/10/26

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Two months ago, I discovered that I have a problem with frequent urination.
I noticed that the frequency seems to occur from about a week before my menstrual period to a week after it.
I can hardly sleep at night (I usually wake up to urinate about three times).
Additionally, I experience alternating pain in my ovaries before and after my period (sometimes it's a sharp pain), which is not exactly cramping but rather a persistent dull ache that affects my mood negatively.

I went to a gynecologist for an abdominal ultrasound (the clinic requires a urine test before the appointment, and I wasn't instructed to have a full bladder during the ultrasound).
The doctor said it was just ovarian inflammation and mentioned that it could be due to bacteria entering the vagina, causing the inflammation.
However, I have no sexual experience, so even though I feel something is off in my lower abdomen, the doctor is unlikely to conduct more detailed examinations.

I also visited another gynecologist due to the frequent urination issue, but again, I wasn't instructed to have a full bladder, and they only prescribed medication for the urinary tract.
I feel that the medication hasn't been effective, and these symptoms have persisted for about two to three months.
I'm starting to wonder if something is wrong internally.
What should I do, doctor? I've seen doctors but haven't resolved the issue, and due to my lack of sexual experience, I can't undergo more detailed examinations.
The main issues are the persistent dull ache in my lower abdomen and the frequent urination (not every day, but about every two to three days).

Answer: Consider seeing a specialist in female urology.

Reply Date: 2019/10/26

More Info

Frequent urination and lower abdominal pain in women can be indicative of several underlying conditions, particularly when these symptoms occur cyclically in relation to the menstrual cycle. Based on your description, it seems that your symptoms are exacerbated around the time of your menstrual cycle, which may suggest a connection to hormonal fluctuations and potential gynecological issues.

Firstly, frequent urination, especially if it occurs predominantly in the week leading up to menstruation and shortly after, can be attributed to several factors. Hormonal changes during the menstrual cycle can affect bladder sensitivity and function. For instance, the increase in progesterone and estrogen levels can lead to changes in the urinary tract and bladder, potentially causing increased frequency of urination. Additionally, premenstrual syndrome (PMS) can also manifest with urinary symptoms due to fluid retention and subsequent changes in bladder pressure.

The lower abdominal pain you are experiencing, particularly if it alternates between the left and right sides, could be related to ovarian activity. Ovulation pain, also known as mittelschmerz, can occur around the middle of the menstrual cycle and may present as sharp or cramping pain on one side of the abdomen. However, since you mentioned that the pain persists before and after your menstrual period, it may be indicative of other conditions such as ovarian cysts, pelvic inflammatory disease (PID), or endometriosis.

Given that you have undergone an abdominal ultrasound which indicated ovarian inflammation, it is essential to consider that inflammation can arise from various causes, including infections or cysts. Even without a history of sexual activity, it is possible to develop infections that can lead to inflammation of the ovaries or pelvic organs. Conditions such as bacterial vaginosis or urinary tract infections (UTIs) can occur and may not always present with typical symptoms, leading to discomfort and frequent urination.

If the medications prescribed for urinary symptoms have not alleviated your discomfort, it may be beneficial to seek a second opinion or request further diagnostic testing. This could include a more comprehensive pelvic examination, additional imaging studies, or even a referral to a specialist in reproductive health. It is crucial to communicate your ongoing symptoms clearly to your healthcare provider, emphasizing the impact they have on your quality of life, including sleep disturbances and emotional well-being.

In summary, while hormonal fluctuations related to your menstrual cycle may play a significant role in your symptoms, it is essential to rule out other potential causes of your frequent urination and abdominal pain. Persistent symptoms warrant further investigation to ensure that any underlying conditions are appropriately diagnosed and managed. Don't hesitate to advocate for your health and seek the necessary evaluations to find relief from your symptoms.

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