Nagging pain in the right side of the lower abdomen during menstruation

Many women are accustomed to considering severe pain in the lower abdomen before menstruation as the norm. However, this is not the case. Physiologically normal is a painless course of the menstrual cycle, let's say slight discomfort, a feeling of fullness in the lower abdominal cavity immediately before or during the menstrual period. If your right side hurts before your next period, you should assume the development of a pathology. In this case, it is necessary to exclude the possibility of inflammatory diseases of the reproductive and digestive systems, surgical, and neurological diseases. The reasons why there is pain in the right side before the onset of menstruation may require urgent medical intervention.

Causes of pain in the side during ovulation

The process of follicle maturation and egg release in the middle of the cycle can be painful if the production of prostaglandins is disrupted. In this case, the sides hurt during ovulation and before menstruation. Excessive enlargement of follicles sometimes leads to the formation of so-called functional cysts, which, under the influence of hormones, resolve within 1–3 months. In this case, before menstruation, the side on the side where the tumor arose may hurt.

A woman’s physical well-being during and after ovulation is influenced by the state of her blood circulation. In the second half of the cycle, there is a tendency to retain fluid in the body, which leads to increased pressure on peripheral vessels in the tissues and the development of swelling. The causes of pain in this case may be:

lack of physical activity;
stagnation of blood in the abdominal organs;
obesity;
peculiarity of the location of the uterus and appendages.

The pain is nagging, mild or moderate in nature, and is regularly repeated during each cycle. Short-term spasmodic attacks are possible on the left or right side, caused by contractions of smooth muscles.

You can determine exactly why the left or right side hurts every time during ovulation, you can only see a doctor and undergo an instrumental examination.

Gynecological diseases as causes of pain attacks

Menstruation - regular bleeding, part of the menstrual cycle - for many women is accompanied by discomfort in the lower abdomen. This may be a normal manifestation of physiological processes or a symptom of a disease. Among the most likely gynecological causes of sudden, sharp pain on the sides of the body below the waist: endometriosis, ovarian cyst, or ectopic pregnancy.

Endometriosis

Pathological growth of the layer of cells in the wall of the uterus occurs. During menstruation, pain caused by inflammation is felt. The process affects the organs that are located in the pelvic cavity. The pain that occurs with endometriosis affects the left or right ovary. In most cases, drug therapy or surgery is required.

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Pain in the left side during menstruation

The organs of the reproductive system occupy a fairly large volume of the abdominal cavity and are located in close proximity to the intestines, urinary tract, and liver. Peculiarities of innervation often do not allow one to clearly determine the location of pain, since symptoms during physiological and pathological processes may be similar. Pain in the left or right side before menstruation, which appears during certain periods of the cycle, is part of algomenorrhea. In such cases, it is aching, has no clear boundaries, and is accompanied by weakness, swelling and other health problems.

If before or after menstruation there is severe pain only on the left, and the pain has a shooting or cutting character, intensifies with movement, bending, turning from side to side, and there is nausea, painful or loose stools - there are probably problems with the intestines: colitis or diverticulitis.

Situations in which the left side hurts after or during menstruation occur with inflammation of the appendages, urolithiasis, cystitis, pyelonephritis. During menstruation, inflammatory processes in the body intensify. If the left side in the lower abdomen hurts, and the sensations are transferred to the lumbar region - as if there is a girdling sensation, you can assume renal colic. In this case, urination may be difficult.

Which doctor will help?

The causes of severe pain during menstruation in the lower abdomen should be identified by a gynecologist. Since severe pain syndrome affects the complete loss of ability to work, affects the girl’s well-being, as well as her psychological state, if it is present, it is necessary to consult a specialist. It is worth considering that unbearable pain can be a consequence of various diseases. Therefore, if the gynecologist does not reveal any abnormalities, you should consult a therapist and undergo a full diagnosis of the body. It is necessary to find out why the pain syndrome manifests itself. The therapist can give a referral to a gastroenterologist for diseases of the gastrointestinal tract, to a hepatologist for liver diseases, and to a nephrologist for kidney diseases.

The occurrence of pain during the menstrual cycle is not considered normal, as most patients think. The manifestation of pain is a signal from the body, indicating possible disorders and the occurrence of inflammatory processes. Therefore, in case of severe and frequently recurring pain, it is necessary to urgently consult a gynecologist. It is necessary to undergo diagnostics of the body in order to find the causes of painful sensations and eliminate them as soon as possible.

If there is pain in the right side during menstruation

Pain in the right side should be alarming at any period of the menstrual cycle. Their causes can be both functional disorders and diseases of the genital area, as well as pathologies not related to the female reproductive system. When the right side hurts due to a delay in menstruation, it is logical to assume the development of an ovarian cyst, an exacerbation of chronic salpingitis, oophoritis. The pain is constant and intensifies with palpation, rapid movement or exposure to the cold.

Pathologies of the liver or gall bladder are another reason why the right side constantly hurts before menstruation. Symptoms in such cases are felt in the hypochondrium, radiate to the shoulder, scapula on the right, and are combined with digestive disorders. Pain can occur suddenly, in paroxysms, and also disappear unexpectedly.

Situations in which there is severe pain in the right side of the lower abdomen may indicate right-sided inflammation of the kidney or the passage of a stone from the ureter.

Survey results

If, as a result of the examination, the gynecologist revealed the presence of an inflammatory disease, then therapeutic measures will be aimed at getting rid of this process. Inflammation of the appendages often affects one side, which is why one side hurts. If there is salpingitis or oophoritis on the right, then pain will bother the patient in the right beech. A manual examination, menstruation, and sexual intercourse will be extremely painful. Adnexitis is also accompanied by severe pain, requiring immediate and adequate treatment.

Therapeutic measures include the use of anti-inflammatory drugs, a complex of vitamins, and if necessary, the doctor will prescribe antibiotics. The treatment is a course, the course is at least 10 days. After the attack is stopped, restorative therapy will be required. It is important to consult a doctor in a timely manner, refusing to self-medicate and take painkillers.

One of the most dangerous diseases is apoplexy. The menstrual cycle is divided into several periods, and during the first, under the influence of estrogen, the follicle matures. At a certain time it ruptures and the egg is released. If such a rupture occurs ahead of schedule, it is accompanied by severe cutting pain. There is no conservative treatment for apoplexy. The patient needs urgent surgical intervention.

No less common is the so-called ectopic or tubal pregnancy. A fertilized egg is not able to penetrate the uterine cavity due to adhesions existing in the fallopian tubes, narrowing their lumen. This becomes the reason that the fertilized egg remains in the lumen of the tube, is implanted, and the embryo begins to develop and, of course, grow, increasing in size.

Despite the presence of a fertilized egg, menstruation may occur regularly for several months, in exact accordance with the menstrual cycle. Menstruation is accompanied by nagging pain in the right side if the fertilized egg is in the right tube.

Pregnancy

The onset of pregnancy after maturation and fertilization of the egg occurs, in a fairly large number of cases, it is signaled by painful signs. They can be provoked by the process of implantation of the embryo into the wall of the uterus, which occurs differently in all women. The pain can be quite severe, cramping and can be felt both during movement and at rest. In the case of successful physiological development of pregnancy, the woman stops feeling pain quite quickly - they gradually weaken and disappear within 2-3 weeks after conception.

If the resulting pregnancy turns out to be ectopic, the situation is complicated not only by pain, but also by the danger of rupture of the fallopian tube, peritonitis and other serious health consequences. The likelihood of attachment and development of the embryo in an unsuitable place increases if there are obstructions in the patency of the tubes, narrowing of their lumen, or the presence of endometrial areas outside the uterine cavity.

After conception occurs, the body needs to remove the reproductive cell from the fallopian tube and secure it for further development in the uterus. The presence of mechanical obstacles, high or insufficient physical activity of a woman can provoke the implantation of the embryo into the fallopian tube. This phenomenon can lead to subsequent rupture of the tube due to the embryo increasing in size. A signal of an ectopic pregnancy is usually acute pain on the right or left side. In this case, the menstrual cycle is delayed, and in the first few days the pregnancy test result is negative. The pain intensifies as pregnancy progresses, and after 4–7 weeks it can become unbearable: it is defined as constant, sharp, shooting, burning, radiating to the anus, and may be accompanied by severe nausea, vomiting, swelling, weakness and other manifestations of toxicosis.

For some women, ectopic pregnancy is the main reason why severe pain begins in the right or left side during their next period. Often in such a situation, periodic bleeding persists and causes confusion. The only outcome for this condition is surgery. The affected tube is opened, the embryo is removed and ligated. After an ectopic pregnancy, painful sensations from the operated tube are also likely before or during menstruation, which is explained by impaired patency of the organ.

Diagnostics

Any decision will be made after a full examination and examination using ultrasound. You will need to undergo some tests, including a smear for microflora and blood for the content of leukocytes. A timely visit to a gynecologist, a detailed examination and a correct diagnosis will help to cope with the problem and find the right solution and prescribe adequate treatment.

A manual examination is not always effective enough to make a diagnosis with certainty. That is why the gynecologist gives a referral for an ultrasound examination, during which pathologies such as an inflammatory process or neoplasms located in the abdominal cavity on the right side can be identified. The tumor compresses the organs and the uterus, which is enlarged during menstruation, causing pain.

A vaginal smear will help identify the presence of an inflammatory process. During examination of the contents, pathogenic microflora may be detected. The right side hurts before menstruation even if there is an ascending infection, which causes the emergence and rapid development of an inflammatory process in the fallopian tube and the right ovary. In this case, the right side and lower abdomen will hurt both at rest, during examination, and when walking.

Ultrasound examination will help to identify dysfunction of the uterine appendages or a developing ectopic pregnancy, and therefore it is mandatory. The treatment prescribed by a specialist will depend on the diagnosis and the characteristics of the detected disease.

Possible diseases and pathologies

The right side can hurt during menstruation for many reasons, but pathological ones should be considered first. If severe symptoms occur and before starting treatment, you need to assess the nature, intensity, frequency of pain, and the presence of other unhealthy signs.

Among the problems and diseases of the reproductive sphere and other body systems, there are several that can cause severe pain on the right side.

Diseases of the appendages

Adnexitis, salpingoophoritis are inflammatory diseases of the ovaries, fallopian tubes and associated uterine apparatus. They often develop due to the penetration and ascent of infection, including sexually transmitted infections. The initial pathogenesis can be hidden and asymptomatic. During the period of weakened immunity, after hypothermia, colds, during exhausting loads, under the influence of hormonal imbalance, the process intensifies. Severe aching or cutting pain appears in the abdominal cavity on the lower left or right, intensifying in the cold or during physical work.

Signs of the disease are constantly debilitating and may be accompanied by weakness, headache, fever up to +38–39 °C, difficulty urinating, and pathological bleeding in the middle or end of the cycle. The pain syndrome may intensify immediately before the onset of the critical days. If the mucous and muscular layers of the fallopian tubes are involved in inflammation, further formation of adhesions is possible, which threatens the development of their obstruction.

The inflammatory process in the ovaries, hormonal imbalance, follicle maturation defect, varicose veins of the epididymis sometimes cause the formation of a cystic formation - a clearly defined cavity filled with exudate. The cyst can be single, grow up to several centimeters and cause sharp cutting pain from the affected ovary. Chronic disruption of hormone synthesis provokes multiple cystic formations. Cysts and polycystic ovaries in case of complications are fraught with rupture of the walls - apoplexy of the organ. In this case, the pain can be so severe that it leads to loss of consciousness. In this case, medical care must be provided to the patient immediately.

Diagnosis and treatment of acute forms of diseases of the appendages is carried out in a clinical setting:

The doctor prescribes a smear test for pathogenic microflora and an ultrasound of the pelvic organs. In case of irregularities in the monthly cycle or the presence of pathological discharge, hysterosalpingography is performed.
Acute forms of inflammation are treated in a hospital. Depending on the degree of detected pathology, laparoscopy and abdominal surgery to remove the cyst may be performed. The patient must remain in bed. Therapy includes a course of antibiotics, anti-inflammatory, hormonal, and immunomodulatory agents.
Chronic inflammation without the risk of compromising the integrity of the ovaries is treated on an outpatient basis. The course includes infusion therapy, physiotherapy, and medication.

Pathologies of the uterus

Endometriosis - the release and growth of functional mucous epithelium outside the uterine cavity can be congenital, have an inflammatory, hormonal nature, or be a consequence of mechanical injuries to the organ cavity as a result of cleansing, abortion, or uterine contraception. Depending on the location of the endometrium, pain in this disease can be aching or cutting in nature, appear more often before the onset of menstruation, and are accompanied by spotting dark discharge.

Inflammation of the mucous layer - endometritis, occurs as a consequence of difficult childbirth, unsuccessful surgical interventions, and infection. Acute pain is characteristic of a rapid flow. Other symptoms: high temperature, fever, profuse acyclic mucous discharge.

A common disease of the uterine cavity is the formation of hormone-dependent benign tumors - myomatous nodes, differing in morphological structure and direction of growth. The main symptom of such neoplasms: severe pain, which can be localized in the pubic area, on the right or left side. Intermenstrual bleeding and heavy multi-day monthly bleeding, which can lead to anemia, are also characteristic.

Intestinal pathologies

One of the likely causes of moderate or severe pain in the right side is inflammation of the intestines, most often appendicitis. Its diagnosis cannot always be carried out even by experienced doctors, since the symptoms of the disease are nonspecific, and the pain syndrome is localized in the liver, in the pit of the stomach, and can even radiate to the spine. Characteristic features of acute appendicitis:

abdominal muscle tension;
increased symptoms when trying to lie on the left side;
one-time vomiting;
constipation or diarrhea.

Under no circumstances should such signs be ignored: perforation of the appendix is fraught with peritonitis and death.

Disorders of the hepatobiliary system often cause adverse symptoms on the right side of the abdominal region. In women suffering from cholecystitis, exacerbation can be caused by eating disorders, acute respiratory viral infections, and the use of potent medications. Pain syndrome in pathologies of the gallbladder has a clear localization - the region of the right hypochondrium. Often the sensations radiate to the spine, shoulder or under the shoulder blade, accompanied by lack of appetite, nausea, and worsen after eating.

Neuralgic attacks

In degenerative and inflammatory diseases of the lumbosacral or thoracic spine, the intervertebral nerve endings become pinched by hard tissues. Before menstruation, due to the retention of excess fluid in the body, the affected nerves are especially compressed. The condition is accompanied by severe pain, from which conventional analgesic drugs help little. Hypothermia or sudden movement can trigger another neuralgic attack.

In the case of any of the listed causes of the development of right-sided pain, after diagnosis, hospitalization may be required to undergo appropriate treatment in the department of gynecology, therapy, surgery or neurology. After the acute stage has passed, the patient is discharged and prescribed to take the necessary medications at home.

Gynecology

Abdominal pain can provoke gynecological problems:

inflammatory processes in the pelvic organs;
circulatory disorders;
pathological deformations of one of the organs;
neoplasms in the appendage area.

The pain can be of different nature and intensity, localized in the front or back, but it will clearly radiate to the side.

Ovulation

Sometimes it happens that your side hurts before your period. During ovulation, the follicle ruptures, from which fluid and blood flow out, which can cause pain in the side. If a woman has late ovulation, then an unpleasant symptom will appear just before her expected period. But this may cause a delay.

Pain during ovulation is usually not a sign of pathology and does not require treatment. But if it has been bothering you for longer than a day, and is very intense, then it is better to consult a gynecologist.

Endometriosis

A disease in which the lining of the uterus grows beyond its boundaries. These formations are benign. Due to the pathological proliferation of endometrial cells, menstruation becomes very heavy and prolonged (the cycle lasts more than a month). Pain appears both before and after menstruation, intensifies during sexual intercourse and defecation.

It is not yet known what exactly causes endometriosis. Experts say that endometrial growth is one of the symptoms of disruption of the immune and endocrine systems.

The risk group includes women who had complications during childbirth, underwent a cesarean section, or underwent various surgical operations on the genital organs (abortion, cervical coagulation). If surgical interventions were performed before the onset of menstruation, then there is a possibility of developing endometriosis in the affected area.

Treatment should be comprehensive: removal of areas of the endometrium using laparoscopy and the use of hormonal drugs. Sometimes physical therapy may be used.

Cyst

A common cause of pain on the right or left during and after menstruation is an ovarian cyst. It happens that during ovulation the dominant follicle does not burst, but continues to grow. Fluid accumulates in it and a cystic formation occurs.

In some cases, the cyst resolves and the woman does not even know about its formation, but in others it grows to large sizes and provokes inflammation and pain. During physical exertion or sex, the cyst may burst, then its contents leak into the abdominal cavity.

Cyst rupture requires mandatory anti-inflammatory therapy, otherwise complications will arise in the form of inflammation of the ovary and peritoneum, which is very dangerous for a woman’s health.

Adnexit

If your side hurts after your period, you can suspect the development of an inflammatory disease in the appendage area. Adnexitis is an inflammation of the fallopian tube and ovary, which is infectious in nature and is accompanied by the following symptoms:

pain in the lower abdomen on the left or right, on the side of the affected appendages;
increased body temperature;
purulent vaginal discharge;
general deterioration of condition, signs of intoxication.

Either one side or both can be affected; in the latter case, the patient complains that the lower abdomen hurts on the sides. In this case, the unpleasant sensations are quite pronounced and can radiate to the groin, rectum, lower back and even radiate to the legs.

Treatment of adnexitis is complex: diet, bed rest in combination with antibacterial therapy give a positive result in a short time. With prolonged use of antibiotics, a woman may develop thrush or dysbacteriosis. Therefore, it is advisable to use antifungal drugs and eubiotics in complex therapy.

If the disease has become chronic, then antibacterial drugs, immunostimulants and vitamin complexes are used for treatment to strengthen the body.

Apoplexy

Ovarian rupture or apoplexy is accompanied by a violation of the integrity of the gland and bleeding into the abdominal cavity. If the pathology occurs during menstruation, it will cause sharp pain on the left or right during menstruation.

Symptoms include: vaginal bleeding, pain in the left or right side that spreads to the groin area, increased sweating, body weakness, nausea and vomiting, rapid heartbeat, headache, pale skin.

Ectopic

Why does the left side hurt before menstruation, patients ask. Such symptoms can be very alarming, especially if a woman is planning a pregnancy or has had unprotected sexual intercourse in the near future. With such a symptom, an ectopic pregnancy can be suspected.

Ectopic pregnancy is a condition in which the fertilized egg attaches not in the uterus, but in the fallopian tube or somewhere else. The situation is very dangerous for a woman’s life, as a growing embryo ruptures the fallopian tube from the inside, which is fraught with internal bleeding and death.

Recommendations from gynecologists

Almost always, pain in the right or left side of the abdomen before menstruation is a deviation from the norm. Regardless of whether it suddenly appeared for the first time or occurred earlier, it is necessary to urgently consult a doctor, especially if the syndrome has developed against a background of general weakness of the body, accompanied by high fever and nausea. You need to be especially careful about how you feel after installing an intrauterine device. An unsuitable model can injure the cervix or lining of the uterus and provoke endometriosis. In addition, the presence of a foreign body is a constant factor in increasing infectious and inflammatory processes. Painful symptoms may occur immediately after installation or due to long-term use of the IUD: during menstruation, the lower part of the abdominal cavity hurts, the pain may be felt more strongly on the right or left.

The presence of a device in the uterus often causes the development of an ectopic pregnancy, since cases of conception with this type of contraception are not uncommon. Unable to gain a foothold in its intended place, the embryo usually implants and begins to develop in the fallopian tube. Obvious signs of pathology are cutting paroxysmal pains that can radiate to the sacrum or anus.

If there is any suspicion of a disease or ectopic pregnancy, they can be dispelled or confirmed through a gynecological examination and consultations with doctors in other areas of medicine. The sooner this is done, the greater the chance of avoiding complications.

If the disease has not progressed far, the main methods of treatment include the use of antibiotics, vitamins, immunomodulatory and restorative agents.

Of course, the best disease is the one that never happened, so the main attention should be paid to preventive measures:

see a doctor not when necessary, but regularly, at least once a year, for chronic diseases - every 3-6 months;
avoid jumping from heights, extreme sports, swimming in cold water, lifting weights;
timely cure infectious diseases;
select hormonal or barrier contraception only in consultation with your doctor.

Is prevention possible?

Since pain can appear for completely different reasons, there are no clear preventive measures.

Gynecologists give only general recommendations:

undergo regular medical examinations;
if there are diseases, treat them in a timely manner;
maintain proper nutrition;
reduce the risk of injury to the back and abdominal area;
install an intrauterine device only by experienced doctors and on individual recommendation.

Pain, before or during menstruation, in the side is always a symptom of a deviation in the functionality of the body. This sign can signal dangerous diseases, the treatment of which cannot be delayed. Therefore, if a feeling of pain in the area of the right side begins to bother you, it is better to immediately go to the gynecologist.