Lower Abdominal Pain and Abnormal Bleeding in Women

Abdominal pain

Hello, doctor! I have a dull pain in my lower abdomen near the pubic bone, and I am experiencing abnormal bleeding.
The amount is not significant, but it has been going on for almost two weeks.
Recently, I felt abdominal pain during intercourse with my husband.
Please respond, thank you!

nicole, 30~39 year old female. Ask Date: 2008/10/04

Dr. Huang Jianxun reply Obstetrics and Gynecology

Please see an obstetrician-gynecologist for a pelvic examination and a Pap smear test.

Reply Date: 2008/10/04

More Info

Lower abdominal pain and abnormal bleeding in women can be concerning symptoms that warrant careful evaluation. The symptoms you describe—persistent dull pain near the pubic bone and abnormal bleeding lasting for nearly two weeks—could be indicative of several underlying conditions, some of which may require medical intervention.

First, it is essential to consider the menstrual cycle. If you are experiencing abnormal bleeding outside of your regular menstrual period, it could be due to hormonal imbalances, ovulation, or even early pregnancy complications, such as a miscarriage or ectopic pregnancy. Given that you mentioned experiencing pain during intercourse, this could also suggest conditions like pelvic inflammatory disease (PID), which is an infection of the reproductive organs that can lead to scarring and chronic pain.

Another possibility is the presence of ovarian cysts or fibroids. Ovarian cysts are fluid-filled sacs that can form on the ovaries and may cause pain, especially if they rupture. Fibroids, which are non-cancerous growths in the uterus, can also lead to abnormal bleeding and discomfort. Both conditions are relatively common and can be evaluated through imaging studies such as ultrasound.

Endometriosis is another condition to consider. This occurs when tissue similar to the lining of the uterus grows outside of it, often leading to significant pain, especially during menstruation or intercourse, as well as abnormal bleeding. Diagnosis typically involves a combination of pelvic exams, imaging, and sometimes laparoscopic surgery.

Infections, such as sexually transmitted infections (STIs), can also cause lower abdominal pain and abnormal bleeding. If you have had unprotected intercourse, it is crucial to get tested for STIs, as they can lead to complications if left untreated.

Given the duration and nature of your symptoms, it is advisable to seek medical attention. A healthcare provider will likely perform a thorough history and physical examination, followed by appropriate diagnostic tests such as blood tests, pelvic ultrasound, or even a Pap smear to rule out cervical issues.

In the meantime, managing pain with over-the-counter medications like acetaminophen (Tylenol) or NSAIDs (like ibuprofen) may provide some relief. However, it is essential to avoid self-medicating without consulting a healthcare professional, especially if you suspect an underlying condition.

In summary, lower abdominal pain and abnormal bleeding can arise from various causes, including hormonal imbalances, infections, structural abnormalities, or more serious conditions like endometriosis. It is crucial to consult a healthcare provider for a comprehensive evaluation and appropriate management tailored to your specific situation. Early diagnosis and treatment can help prevent complications and improve your overall health and well-being.

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