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Abdominal pain - causes: women's diseases

Pain in the lower abdomen in women is often caused by diseases of the fallopian tubes, ovaries and uterus. Other causes are cysts, fibroids or endometriosis

Inflammation of the uterus: discharge, bleeding, abdominal pain

Infections of the uterine lining are rather rare. Mostly the infections are ascending. This means that it is preceded by a vaginal infection or inflammation of the cervix. The responsible pathogens can penetrate the cervix into the uterus. However, the uterus normally fights off such germs. However, this self-protection can become permeable during the menstrual period, during childbirth and insufficient regression of the uterus, through surgical interventions or, rarely, when the IUD is in place.

Symptoms: Often an uterine inflammation goes almost unnoticed. Discomfort only occurs when the inflammation occurs seized the muscle layer of the uterus or has passed to the fallopian tubes and ovaries. Important signs are above all Abnormal bleeding or irregular menstrual periods, Discharge, pain in the lower abdomen, and fever.

Diagnosis and therapy: The patient's medical history provides important information. The gynecologist often recognizes signs of inflammation at the end of the cervix, the uterus reacts to pressure with significant pain. This is followed by laboratory examinations of vaginal and cervical secretions, possibly also of tissue samples, in order to rule out malignant changes. Blood tests can show increased levels of inflammation.

Antibiotics are usually indicated for therapy. Serious inflammation may require hospital treatment. If necessary, the doctor will remove inflammatory tissue changes. Sometimes short-term hormone therapy can also aid healing. A medication can help if the uterus is only hesitant to shrink after giving birth. If the inflammation does not respond to therapy in women using an IUD, the doctor will remove the IUD.

Inflammation of the fallopian tubes and ovaries: Violent, acute pain in the lower abdomen

Acute inflammation of the fallopian tubes and ovaries (adnexitis) is a very serious disease. It often develops as a result of an infection ascending from the vagina through the uterus. It is primarily caused by bacteria such as chlamydia, combinations of skin germs, intestinal germs such as E. coli or gonococci (pathogens that cause gonorrhea). Occasionally, inflammation of neighboring organs, such as an inflamed appendix or a diverticulum inflammation of the intestine, ovaries and fallopian tubes can also include. Infection through the bloodstream is very rare. Younger, sexually active women are particularly affected.

If the infection spreads across the abdomen, it is life threatening. Abscesses can form on the ovaries and other organs in the pelvis. Sometimes the infection runs without clear signs of illness and heals on its own. However, it can also lead to infertility and increase the risk of ectopic pregnancies (see below). Chronic complaints due to adhesions and sticking can remain even after treatment. At the international level, the term pelvic inflammatory disease (PID) common for inflammation of the genital organs in the pelvis.

Symptoms: Acute severe pain occurs throughout the lower abdomen. In addition, there is often a fever, in flare-ups or permanently, and a general feeling of illness. The abdominal wall is usually tender and tense. Intermenstrual bleeding is also possible. Before that, the sick women often had unpleasant-smelling, purulent discharge due to the vaginal inflammation, as well as burning and itching as well as problems urinating and defecating. Sometimes, however, the symptoms are weak or absent, especially in the case of a chlamydial infection.

Chronic abdominal pain can persist as a result. In addition, it is not uncommon for lower back pain, pain during sexual intercourse, discharge, and disturbed menstrual bleeding.

You can find out more about the causes and effects as well as diagnosis and therapy in the guide "Inflammation of the fallopian tubes and ovarian inflammation (adnexitis)".

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Ectopic pregnancy: spotting and abdominal pain after a missed period

If unrecognized, an ectopic pregnancy can have life-threatening consequences. The fertilized egg does not first implant itself in the uterus, but for various reasons already in the fallopian tube, for example because adhesions block its further path through the fallopian tube. Other locations of the defective settlement are also possible, for example in the ovary or in the abdominal cavity. Often such a cell cluster does not develop any further and the pregnancy breaks off unnoticed.

However, if the early embryo gets larger or lies in an awkward spot, there is a risk that it will break through. This can lead to dangerous bleeding and, as a result, to circulatory shock.

Symptoms: Symptoms are often unilateral, worsening abdominal pain and often spotting after the period has stopped. Also clamping or Breast pain direct suspicion of pregnancy.

A rupture of the fallopian tubes can manifest itself as sudden, severe abdominal pain. An acute abdomen can develop. The abdominal wall is extremely tense and sensitive to pressure. Are signs of (bleeding) shock paleness, cold sweats, nausea, Palpitations. Here's the one right now Emergency doctor from the rescue service (emergency number: 112) to alert.

Diagnosis and therapy: The symptoms and the medical history give the gynecologist essential information. A positive pregnancy test confirms the diagnosis. In addition, an ultrasound examination may be indicated. If an ectopic pregnancy is discovered early, it can be treated with medication or, depending on the stage, with (minimally invasive) surgery. More on this in the article "Dangers of an ectopic pregnancy".

Ovarian cysts: Mostly benign

Ovarian cysts are not uncommon. Cysts correspond to fluid-filled cavities in tissues. Doctors differentiate between different types and causes of ovarian cysts. Cysts often form under the influence of sex hormones and are tied to the hormonal cycle (including follicle and corpus luteum cysts). Sometimes other hormones also play a role. Some cysts are congenital. Some cysts produce hormones themselves and then lead to permanent bleeding.

The so-called polycystic ovarian syndrome (PCOS; on our partner portal www.baby-und-familie.de) is a disease of its own. Endometriosis (more on this below) has cysts that contain blood (called chocolate cysts because of their color). Cysts can get very large.

Ovarian cysts often cause no symptoms, are small and regress spontaneously. That also means: They are mostly an incidental finding and benign. Other cysts persist longer. Once discovered, the doctor carefully checks a cyst so that a possible, albeit rare, degeneration is not overlooked. If in doubt, he will have it examined more closely using a laparoscopic technique. Further analyzes may be indicated more frequently, especially in women after the menopause.

Symptoms: If a cyst enlarges, it can cause a variety of complaints, such as diffuse, sometimes cyclical pelvic complaints, Back pain, Feeling of fullness, constipation, Problems with sex. Persistent spotting may also develop.

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! Colicky stomach pain smay signal an acute complication: twisting (torsion) or bleeding / bursting (rupture).

  • Ovarian (cyst) twisting (torsion): The twisting of an ovary around its axis is called torsion. Often an ovarian cyst is the cause. If a cyst has a certain volume and a stem, it is more likely to cause torsion. One then also speaks of stem rotation. Very large cysts, on the other hand, hardly rotate because they are usually stuck in the lower abdomen. In the case of torsion, blood vessels can easily constrict and the blood supply can be impeded or interrupted, as a result of which tissue perishes. This is associated with extremely acute pain, but only occurs in around three percent of all gynecological emergencies. Possible, but not always applicable, triggers of acute torsion can be sudden, jerky body movements or sporting activity.

    Symptoms: The main symptom in complete acute ovarian (cyst) torsion is acute, unilateral pain in the lower abdomen nausea and nausea ("acute abdomen"). If the torsion is incomplete, the symptoms are often less pronounced. Sometimes there is then a persistent, initially lighter pain that slowly increases. fever occurs later and shows a complicated course with severe tissue damage.

    Diagnosis, therapy