Lower Abdominal Pain and Discomfort in Women

Lower abdominal pain and lower back pain?

Hello Doctor, I have been experiencing lower abdominal pain for the past few days, with the right side being more pronounced.
I also have a constant urge to have a bowel movement and my lower back feels sore.
When I feel particularly uncomfortable, I sometimes experience slight numbness in the front of my ankles.
I do not have sciatica, and I have not engaged in sexual activity.
My discharge is sometimes light white to yellow and thick, but it has no odor.
My menstrual period was from May 29 to June 3.
I visited a clinic, and the doctor did not say much, only that my ovaries looked fine and there were no cysts, but the heights on both sides were different, possibly due to muscle or ligament strain.
I would like to know if this could be a gynecological issue.
Should I go for another consultation, or could it be something else? The doctor prescribed pain relievers and muscle relaxants for me.
If it is pelvic inflammatory disease, will these medications help? Thank you.

HELEN, 20~29 year old female. Ask Date: 2020/06/10

Dr. Wu Xianghui reply Obstetrics and Gynecology

1.
Could this possibly be a gynecological issue? Do I need to see a doctor again? Abnormal vaginal discharge, itching, fever, and lower abdominal pain are common symptoms in women caused by various factors.
Treatment methods require comprehensive patient education, and it is recommended to consult a specialist in obstetrics and gynecology for evaluation.
2.
The doctor prescribed me pain relievers and muscle relaxants.
If it is pelvic inflammatory disease, will taking this medication help? No, it will not.

Reply Date: 2020/06/10

More Info

Lower abdominal pain in women can arise from a variety of causes, and understanding the underlying issues is crucial for effective treatment. Based on your symptoms, including right-sided abdominal pain, persistent urge to defecate, lower back discomfort, and occasional ankle numbness, there are several potential explanations to consider.

Firstly, the right-sided abdominal pain could be indicative of several conditions. One common cause is ovarian issues, such as ovarian cysts or even ovulation pain (mittelschmerz), which can occur around the time of ovulation. Although your recent ultrasound showed no cysts, it’s important to note that not all ovarian issues are visible on imaging. Additionally, conditions like endometriosis can cause pain that may not always be detected through standard imaging techniques.

Another possibility is pelvic inflammatory disease (PID), which is an infection of the reproductive organs. PID can cause lower abdominal pain, discomfort during urination, and changes in vaginal discharge. The absence of foul-smelling discharge is a good sign, but it does not completely rule out an infection. If PID is suspected, antibiotics are typically prescribed, and your current medications may help alleviate some symptoms, but they may not address the underlying infection if present.

Your mention of lower back pain and the sensation of numbness in your ankle could suggest a musculoskeletal issue. Muscle strain or ligamentous pain, particularly if you have recently engaged in physical activity or experienced stress, can lead to referred pain in the abdomen and back. The fact that your doctor noted a difference in the height of your ovaries could imply some muscular or ligamentous tension, which might explain the discomfort.

The gastrointestinal system should also be considered. Conditions such as irritable bowel syndrome (IBS) can cause abdominal pain and changes in bowel habits, including a frequent urge to defecate. Stress and anxiety can exacerbate these symptoms, leading to a cycle of discomfort.

Given your history of anxiety, it’s important to recognize that psychological factors can significantly influence physical symptoms. Anxiety can manifest as physical pain, and chronic stress can lead to muscle tension, which may contribute to your discomfort.

In terms of treatment, the medications prescribed—pain relievers and muscle relaxants—are appropriate for managing pain and discomfort. However, if your symptoms persist or worsen, it would be wise to follow up with your healthcare provider. They may recommend further evaluation, such as blood tests or additional imaging, to rule out conditions like appendicitis or other gastrointestinal issues.

In conclusion, while your symptoms could be related to gynecological issues, they may also stem from musculoskeletal problems or gastrointestinal conditions. If your pain continues or if you develop new symptoms, such as fever, vomiting, or significant changes in your discharge, it is essential to seek medical attention promptly. Keeping an open line of communication with your healthcare provider will help ensure that you receive the appropriate care and treatment for your condition.

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