Lower Abdominal Pain at Night: Possible Causes and Concerns

Lower abdominal pain at night?

Hello doctor, I have been experiencing lower abdominal pain for the past two nights, which feels similar to menstrual cramps, but I just had my period on the 12th.
What could be the possible reasons for this? If it is ovulation, can it cause pain? The weather has been hot, and I have been eating a lot of cold foods, and my menstrual cycle has been irregular.
On the 11th, my boyfriend only used his fingers, but my period started the next day, so even if there was semen on his hands, it shouldn't be possible for me to be pregnant, right? If I go to a gynecologist and only have an ultrasound, will they be able to tell if I have masturbated or had sexual intercourse?

M, 10~19 year old female. Ask Date: 2008/08/30

Dr. Li Guanghan reply Obstetrics and Gynecology

Hello! 1.
It is possible to experience mild lower abdominal pain during ovulation, but the cause of your abdominal pain can only be determined through a medical examination.
2.
If semen enters the vagina, there is a possibility of pregnancy.
3.
A transabdominal ultrasound in obstetrics and gynecology cannot determine whether sexual intercourse or masturbation has occurred.
Wishing you peace and good health.

Reply Date: 2008/08/30

More Info

Lower abdominal pain at night can be concerning, especially when it mimics menstrual cramps. Given your recent menstrual cycle and the timing of your symptoms, there are several potential causes to consider.

1. Ovulation Pain (Mittelschmerz): It is possible that what you're experiencing is related to ovulation, which typically occurs about 14 days before your next period. Some women experience pain during ovulation, known as mittelschmerz, which can feel like cramping on one side of the lower abdomen. This pain can occur even if your menstrual cycle is irregular.

2. Menstrual Cramps: Since you mentioned that you recently had your period, it’s also possible that the pain is related to menstrual cramps. Even after menstruation, some women may experience residual cramping or discomfort due to hormonal fluctuations.

3. Gastrointestinal Issues: Sometimes, abdominal pain can be attributed to gastrointestinal issues, such as gas, bloating, or indigestion, especially if you've been consuming a lot of cold foods or ice, which can upset your stomach. Conditions like irritable bowel syndrome (IBS) can also cause cramping and discomfort.

4. Urinary Tract Infection (UTI): UTIs can cause lower abdominal pain and discomfort, particularly if accompanied by symptoms like a burning sensation during urination or frequent urges to urinate.
5. Pelvic Inflammatory Disease (PID): If there has been any recent sexual activity, even if it was limited to manual stimulation, there is a slight risk of sexually transmitted infections (STIs) that could lead to PID, which can cause significant abdominal pain.

Regarding your concerns about pregnancy, if your boyfriend only used his fingers and there was no direct vaginal penetration, the likelihood of pregnancy is extremely low, especially since you had your period shortly after. Sperm typically needs to be deposited directly into the vagina for pregnancy to occur.

As for your question about whether a pelvic ultrasound can detect past sexual activity or masturbation, the answer is no. Ultrasounds are used to visualize the reproductive organs and can help identify issues such as cysts, fibroids, or other abnormalities, but they cannot determine sexual history.

If your pain persists or worsens, it is advisable to consult a healthcare provider, preferably a gynecologist. They may recommend further evaluation, which could include a pelvic exam, blood tests, or additional imaging studies to rule out any underlying conditions. Keeping a symptom diary, noting the timing, intensity, and nature of your pain, as well as any accompanying symptoms, can also be helpful for your healthcare provider in diagnosing the issue.

In summary, while there are several benign explanations for your symptoms, it is important to monitor your condition and seek medical advice if the pain continues or if you develop new symptoms. Early intervention can help address any potential issues before they become more serious.

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