Uterine pain

introduction

Pain in the lower abdomen can have a variety of causes.
Often, digestive disorders or urinary tract infections are the cause of abdominal pain. However, pain can also come from the uterus. One of the most common causes is uterine pain as an acute symptom during menstruation, which in most cases is harmless in nature.

root cause

Uterine pain can have different causes.

Most often they occur as part of the monthly menstrual period, which is then also known as Dysmenorrhea referred to as.

Endometriosis can also be the cause of uterine pain, a disease in which the functional uterine lining outside of the uterus splinters.

Another cause of uterine pain is pregnancy. Almost every woman experiences pain in the uterus during pregnancy. This is because the growing child takes up more and more space for themselves.

Other organic diseases can also be the cause of uterine pain, such as uterine inflammation, or tumor diseases.

Period pain as a cause of uterine pain

Cramp-like pain during menstruation, often radiating into the back, is a common symptom that many women suffer from. Possible causes for the painful menstrual period are, for example, an increased production of pain-promoting messenger substances, the so-called Prostaglandins but also endometriosis.

Pain reliever and anticonvulsant medication can help relieve the discomfort. But also some home remedies that help with short-term abdominal pain caused by digestive problems, cramp-like gas, constipation or other harmless causes can be used for menstrual pain.

For example, warmth helps to relieve cramps in the lower abdomen and uterus. A hot water bottle, a cherry stone pillow or a warm bath can often contain the symptoms. Tea and light foods can help calm down the intestinal upset that is often associated with period pain. Gentle abdominal massages can provide relief from painful stinging in the abdomen.

You can also find out what you can do if you have unpleasant menstrual pain on our website Menstrual pain.

Uterine pain regardless of your period

Pain in the area of ​​the uterus, which occurs regardless of the period, can have a wide variety of causes. If the pain is acute, it could be a myoma, i.e. a benign tumor of the uterus, which can die when the stem rotates and its vascular supply is blocked, which leads to the acute pain.

Other causes are more common in acute pelvic complaints, which often cannot be clearly separated from “uterine pain” based on their symptoms. Concerning the female reproductive organs, there are ovarian cysts, an inflammation of the ovaries and fallopian tubes and, in women of childbearing age, pregnancy outside the uterus.

The cause of the acute pain can also lie outside the female genital organs.
Common causes are cystitis, kidney stones, appendicitis, or inflammation of diverticula in the intestine.

The situation is similar with chronic pain in the lower abdomen. On the uterus, fibroids, polyps, changes in the position of the uterus or intrauterine devices (so-called coils) should be thought of. Tumors of the fallopian tubes and ovaries can also cause chronic pain. However, uterine tumors themselves are usually not painful.

Intestinal, urological, neurological and orthopedic diseases can also lead to chronic pelvic problems.
However, it should be mentioned that up to 80% of women who are treated for chronic pelvic pain suffer from a somatoform pain disorder triggered by stress, loss of life or even sexual abuse. It is a diagnosis of exclusion, which is often accompanied by other typical psychosomatic complaints such as headaches, impaired sexuality and digestion, sleep disorders and menstrual disorders.

You may also be interested in this topic: Uterine fibroids

Endometriosis

Pain in the uterus is often caused by the benign, chronic disease endometriosis. The lining of the uterus (Endometrium) outside of the uterus and also changes like the normal uterine lining during the menstrual cycle. Bleeding outside the uterus occurs when the lining is shed during menstruation. This results in very unspecific symptoms such as severe pain in the abdomen, which are often interpreted by those affected (but also by the treating physicians) as normal menstrual cramps.

In some cases, endometriosis is the cause of infertility. So far, the exact cause of the development of endometriosis has not been clarified. For this reason, there is currently no way of preventing or treating the cause of endometriosis. The treatment of the disease consists in the surgical removal or destruction of the wrongly located uterine lining foci and hormonal inhibition of the cycle. This can reduce the likelihood of endometriosis recurring.

You can find out which other symptoms are manifested by endometriosis and what you can do about it on our website Endometriosis.

Uterine prolapse / depression

The uterus can push its way through the birth canal. This is initially referred to as uterine descent (Descensus uteri), in more advanced stages the uterus may even emerge from within the now enlarged vagina (Vaginal prolapse) outside the body. In these cases one speaks of a uterine prolapse or a prolapse of the uterus. The cause lies in the failure of the holding ligaments of the uterus. Uterine subsidence can also occur after birth.

Read more on the topic: Uterus subsidence after birth

Pelvic floor exercises (especially after pregnancy) are recommended to prevent a prolapsed uterus / lowering of the uterus. A prolapsed uterus mainly affects older women. Often complaints such as a feeling of fullness or pressure in the abdomen are reported. However, increased urination and pain in the uterus and back can also occur. Today, therapy rarely consists of removing the uterus (hysterectomy). Nowadays, vaginal compression (colporrhaphy) and fixation of the cervix on the sacrum are performed surgically.

You can find out in our article how you can optimally train your pelvic floor muscles to prevent or treat a prolapsed uterus Pelvic floor training.

Inflammation of the uterus (endometritis)

Pain in the uterus can in some cases be caused by inflammation of the lining of the uterus. In so-called endometritis, localized tenderness of the uterus often occurs, which is usually associated with bleeding and fever. If the uterine inflammation spreads to the adnexa (ovaries and fallopian tubes), very severe pain and high fever can also occur. This inflammation is most common during the puerperium. Most of the time, the pathogens are bacteria that have been carried away or ascended from the vagina.

Endometritis is promoted by inflammation in the area of ​​the cervix (cervicitis), the vagina (colpitis, vaginitis), an intrauterine device (coil) or tumors. The treatment of uterine inflammation of the uterine lining consists in the administration of antibiotics as part of an inpatient hospital stay. Appropriate pain and cramp medication is also important. In some cases, endometritis leads to a build-up of pus in the uterine cavity (pyometra). This pus must be drained, for example, using a Fehling's tube (drained) become. After treatment and resolution of the acute inflammatory phase of the uterine inflammation, a scraping (Abrasio uteri) and a pathological diagnosis are carried out in order to exclude a tumor in the area of ​​the uterus.

You can also find more information in our article Uterine inflammation

Pelvic inflammatory disease

Under the English term Pelvic inflammatory disease various inflammatory diseases of the uterus, fallopian tubes and ovaries are grouped together.
In most cases, the inflammation is triggered by bacteria, but also viruses, fungi or parasites and can lead to infertility.

Symptoms such as abdominal pain, painful intercourse, or irregular menstrual bleeding are commonly reported. After excluding pregnancy, appendicitis, ectopic pregnancy, abortion, ruptured cysts or tumors, a Pelvic inflammatory disease treated with antibiotic therapy.

More on this topic, including The prevention, treatment and prognosis can also be found in our article Inflammation in the abdomen.

Polyp pain

A polyp is a protrusion of the lining of the uterus. As a rule, they are benign, but a small percentage can also degenerate malignantly. Polyps in the uterus are rarely painful. They are often noticed by chance when an ultrasound is performed by the gynecologist. Depending on the size and location of the polyps, they can make menstrual bleeding heavier than normal or cause intermenstrual bleeding. Pain is possible with the bleeding, but it is difficult to differentiate whether it is caused by the polyps or the increased bleeding.

You can find out if and when polyps in the uterus are dangerous in our article Are polyps in the uterus dangerous?

Concomitant symptoms

Depending on the cause, different accompanying symptoms can occur. Inflammatory diseases can be associated with fever and fatigue. Inflammation of the female genital organs is also often associated with increased discharge and pain during sexual intercourse. In addition, there can often be a urinary tract infection, which usually manifests itself as pain or burning sensation when urinating and frequent urination.

Uterine polyps usually do not cause any symptoms, but can cause bleeding in postmenopausal women and bleeding disorders in premenopausal women. Fibroids are typically accompanied by bleeding disorders. Depending on where in the uterus they occur, they can also cause discomfort during bowel movements, back pain, or the urge to urinate. A lack of menstrual bleeding in acute pelvic pain can be an indication of pregnancy outside the abdominal cavity.

Malignant tumors are often accompanied by the symptoms of fever, night sweats (to the extent that the pajamas may have to be changed several times per night) and unwanted weight loss of over 10% of body weight in the last 6 months. These symptoms are also summarized by the doctor under the term "B symptoms". Tumors of the female genital organs often cause rather unspecific complaints.

Care should be taken with postmenopausal bleeding. These can be the first symptom of a malignant tumor of the uterus and should definitely be checked by a gynecologist as soon as possible.

Read more on this topic: B symptoms

Pain locations and situations

Pain in the uterus when sitting

Uterine pain, which occurs mainly when sitting, can have different causes. When sitting, there is increased pressure on the abdomen.
Inflammatory changes or other irregularities can become more painful as a result. Often, abdominal complaints when sitting do not come from the uterus itself, but from other lower abdominal organs, such as the ovaries.
Ovarian cysts, inflammation of the ovaries or even an ectopic pregnancy can be very uncomfortable when sitting. A cystitis is usually very painful when sitting and is easier to bear when lying down.

Seated abdominal pain actually emanating from the uterus can occur in endometriosis, a disease of the lining of the uterus. It is not uncommon for the intestines to be the cause of such complaints, for example in the context of appendicitis (appendicitis) or diverticulitis, in which small protrusions on the intestinal wall become inflamed. Persistent or worsening symptoms should therefore be clarified by a doctor.

Painful intercourse

Pain during sexual intercourse is summarized under the term "dyspareunia". Uterine disorders, such as endometriosis, can be a cause of painful intercourse. For women who suffer from chronic pelvic pain, the topic of sexuality is a particularly problematic topic.

Many women experience increased pain from sexual stimuli or during intercourse and experience this as a great burden. Often there is a strong psychological component. The fear of feeling pain during sexual intercourse and the shame of not being able to enjoy something actually "enjoyable" increase the level of suffering even more.

In the event of pain in the cervix after too deep penetration during sexual intercourse, positions can be discussed with the partner that do not penetrate as deeply and solutions can be found that enable pain-free intercourse for both partners.

In our article you can find out what you can do about pain during intercourse Dyspareunia - painful intercourse!

Uterine pain left and right

Abdominal pain that occurs on the right or left side may come from the uterus. This is particularly painful during the menstrual period, as it then contracts and expels the previously built up mucous membrane.
However, when pain is localized on one side, the uterus is often not the direct cause of the symptoms. The pain often comes from the ovaries.

Cysts or other changes in one ovary can cause pain on that side. The same applies to an ectopic pregnancy, which can cause very severe pain. During pregnancy, unilateral abdominal pain can also occur when the ligamentous apparatus of the uterus is stretched.

Benign growths of the uterine lining (Fibroids) or malignant tumors (Uterine cancer) can potentially cause such abdominal discomfort.

In our article you can find out how you can tell whether your symptoms are due to cysts Uterine Cyst - Dangerous or Harmless?

Pain in the cervix

Localized pain in the cervix can have a variety of causes. Often the pain is not only felt in the cervix, but also affects the neighboring structures. Cervical cancer can be a possible cause of pain in the cervix. It is often pain-free in the early stages, but in advanced stages it can be accompanied by pain that radiates to the lower back. In addition to the malignant changes, there are also benign diseases, such as inflammation of the internal genital organs, which can cause pain in this region.

Inflammation of the cervix (Cervicitis) is more associated with discharge and minor bleeding than with pain, but inflammation of the vagina or the uterine lining can cause pain that can also be felt there due to their proximity to the cervix.

In addition to inflammation, mechanical irritation to the cervix can also cause pain. One example is routine cancer screening (PAP smear) at the gynecologist. During this exam, a smear is taken from the cervix. After this examination, pain may occur due to irritation of the mucous membrane. Another conceivable mechanical irritation occurs, for example, during sexual intercourse with deep penetration and can also cause pain.

For more information on the symptoms and treatment of cervical inflammation, also read our article on the Cervicitis!

Tumor pain in cervical cancer

One of the most common malignant tumors in women worldwide is so-called cervical carcinoma (cervical cancer), also known as cervical cancer. Often an infection with certain types of the human papillomavirus (HPV) is the cause of this tumor. Cervical carcinoma (cervical cancer) does not cause any pain or symptoms in the early phase, only when the tumor is more advanced does a flesh-colored, sweet-smelling discharge, irregular bleeding and contact bleeding occur during sexual intercourse.

If left untreated, cervical cancer will invade, damage, or destroy the urinary bladder, rectum, and other structures in the pelvis. In most cases, pain in the abdomen only occurs at this very advanced stage. For this reason, it is important to be able to recognize and treat cervical cancer at an early stage through regular visits to the gynecologist. Vaccination with an HPV vaccine also reduces the risk of developing cervical cancer because the two most common high-risk viruses prevent infection.

In the early stages, cervical cancer can be sufficient if the changed tissue is completely removed by taking a cylindrical tissue sample (conization). In more advanced stages, it may be necessary to remove the uterus with surrounding structures and sometimes other organs. However, other tumors in the lower abdomen or colonization of malignant tumors from other organs (metastases) can lead to pain in the uterus. For this reason, it is important to consult a doctor at an early stage if the symptoms persist.

Read more about this under: Vaccination against cervical cancer

Uterine pain in pregnancy

Pain in the uterus is very common during pregnancy.
Pregnancy causes the uterus to stretch and grow. This can lead to drawing pain in the abdomen. As a rule, this is harmless stretching pain in the uterine ligaments, muscles, uterus and tendons. However, a gynecologist should be consulted immediately if the symptoms persist or if there is a discharge or bleeding. Under certain circumstances, the threat of premature birth can be announced by pain in the uterus.

If the pain persists, it may include labor pending premature birth, signs of placental disorder (placental disorder) or a ruptured uterus (uterine rupture). If in doubt, pregnant women should always contact the gynecologist or midwife with unexplained abdominal pain in order to rule out serious causes for the pain. If pregnancy is possible, an ectopic pregnancy (tubal pregnancy) should also be considered in the case of acute pain in the area of ​​the uterus. This results in the embryo nestling in the mucous membrane of the fallopian tube instead of in the uterus. If this is not recognized in time, an ectopic pregnancy can tear at some point and result in severe internal bleeding with circulatory failure and shock.

You might also be interested in these topics:

• Pain in the uterine ligaments
• Pulling the mother ligaments

Uterine pain after childbirth

The uterus is exposed to extreme stress during childbirth. During pregnancy, it becomes extremely enlarged to give the growing child enough space.
During the birth, she contracts strongly to drive the baby out of the birth canal. Accordingly, the muscles of the uterus and the birth canal are heavily overused after the birth and have to regenerate.
This can be accompanied by severe pain, especially in the days immediately after the birth. In addition, the placenta also drops, leaving a bleeding wound in the uterus that must first heal. The pain in the lower abdomen is also perceived as abdominal pain by some women. During this time, the weekly flow, which makes regular intimate hygiene important, goes away.

After the first birth, this kind of pain is more common. Especially when breastfeeding the newborn, many women complain of sudden onset of pain caused by the contraction of the uterus.
Once the uterus has contracted enough, the pain subsides. As a result of the pressure during a natural birth, many women subsequently also suffer from hemorrhoids that protrude from the anus. These are vascular cushions in the mucous membrane of the rectum, which are enlarged and pressed out by the pressure load. This usually also regresses over time.

Read more on the topic: Abdominal pain in the puerperium

Pain in the uterus after a caesarean section

A caesarean section is a burden for the mother that should not be underestimated.
During the operation, a relatively large incision is made in the abdomen and then worked your way to the uterus. This is also opened with an incision in order to get the newborn out. This leaves wounds that are stitched up, but the body still needs time to heal. Therefore, pain for a few weeks after a caesarean section is not uncommon. The duration of pain also depends on how long the woman was in labor before the procedure. The longer the period of labor, the more pain you can expect. Normally, the pain on the scar and in the area of ​​the uterus will subside by itself. However, if other symptoms occur, such as fever or chills, and the area of ​​the scar changes color, an infection must be considered. This can also be painful and requires further treatment.

For more information about post-caesarean pain, what is normal, and what you can do about the pain, see our articles

• Abdominal pain after a caesarean section
• Pain in the quay incision scar

Pain after a hysterectomy

In the acute phase of a hysterectomy, pain can often occur. Since it is a surgical procedure, this is to be regarded as completely normal. As the wounds heal, the pain will subside after not too long.

However, between 15 and 30% (depending on the literature) of women suffer from chronic pain that can persist for months after the operation. Women who already suffered from pelvic pain before the operation, women who had more intense pain in the acute phase after the operation compared to other women, or women who have previously had pelvic surgery such as a caesarean section seem to be particularly at risk .

Because many uterine removals are performed through the vagina in a so-called minimally invasive procedure, the pain is to be minimized.

Duration

The duration of pain in the uterus depends entirely on the underlying disease.
Pain after an operation does not usually last longer than a few weeks after the operation. However, if the pain persists, for example due to endometriosis, the pain persists until the disease has been adequately treated.

A doctor should be consulted immediately if the pain in the uterus does not subside or even increases, if there is also a fever, vomiting or nausea, or if the abdominal wall feels hard and tense.
Blood in the stool or urine and low blood pressure, which is accompanied by a rapid pulse (so-called shock, which occurs with severe blood loss), point to a so-called acute abdomen and thus to an emergency situation that urgently requires medical treatment.

Please also read our page Inflammation of the abdomen.