Right Lower Abdominal Pain: Is It Pelvic Inflammatory Disease? - Obstetrics and Gynecology

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Right abdominal discomfort and pain?


Hello Doctor: I have been experiencing persistent discomfort in my lower right abdomen.
Since my bowel movements are normal and there are abnormalities in my discharge, I suspect it might be a gynecological issue.
My most recent discharge was green, occurring two days before my menstrual period, and my intimate clothing has a stronger odor, but there is no itching.
Could this be pelvic inflammatory disease?

Jane, 20~29 year old female. Ask Date: 2007/07/21

Dr. Zhou Dali reply Obstetrics and Gynecology


It is recommended to visit a nearby gynecology clinic for an examination.

Reply Date: 2007/07/21

More Info


Right lower abdominal pain can be a complex symptom with various potential causes, and your concerns about pelvic inflammatory disease (PID) are valid, especially given your recent symptoms. PID is an infection of the female reproductive organs, which can lead to inflammation and pain in the pelvic area. However, it's important to consider other possible causes of your symptoms as well.

Based on your description, the right lower abdominal discomfort, along with the greenish discharge and the change in odor, could suggest an infection. While PID is a possibility, other conditions should also be considered. For instance, sexually transmitted infections (STIs) such as chlamydia or gonorrhea can lead to similar symptoms and may cause PID if left untreated. Additionally, conditions like ovarian cysts, appendicitis, or even gastrointestinal issues such as irritable bowel syndrome (IBS) could also manifest as right lower abdominal pain.

The fact that you mentioned your bowel movements are normal is a good sign, as it may help rule out certain gastrointestinal issues. However, the presence of abnormal discharge, especially if it is green and has a strong odor, is concerning and warrants further investigation. This could indicate a bacterial infection or another type of vaginitis, such as bacterial vaginosis or trichomoniasis, which can also cause pelvic discomfort.

It’s crucial to consult a healthcare provider for a thorough evaluation. A pelvic examination, along with laboratory tests (such as a Pap smear, cultures for STIs, and possibly an ultrasound), can help determine the underlying cause of your symptoms. If PID is diagnosed, it is typically treated with antibiotics, and early treatment is essential to prevent complications such as chronic pain or infertility.

In addition to PID, other gynecological issues such as endometriosis or fibroids could also lead to chronic pelvic pain. Endometriosis, for example, occurs when tissue similar to the lining of the uterus grows outside of it, often causing significant pain, especially during menstruation. Fibroids, which are non-cancerous growths in the uterus, can also cause discomfort and changes in menstrual patterns.

Given your history of abnormal discharge and the recent changes you've noticed, it’s essential to seek medical attention promptly. While it may not be PID, the symptoms you describe indicate that there is likely an underlying issue that needs to be addressed.
In summary, while PID is a possibility given your symptoms, it is not the only potential cause of your right lower abdominal pain. Other conditions, including STIs, endometriosis, or fibroids, should also be considered. A healthcare provider can help you navigate these symptoms and provide appropriate testing and treatment options. Remember, early intervention is key to managing any potential reproductive health issues effectively.

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