Stomach pain affects millions of Americans, but women face particular challenges due to the complex relationship between their digestive system, reproductive organs, and other abdominal structures. The physical discomfort often comes with significant uncertainty about the source of the pain and its seriousness, especially when symptoms overlap between digestive and reproductive causes. This uncertainty can lead to frustration and even delayed diagnoses when symptoms don’t fit neatly into established categories. Understanding the range of possible causes specific to women provides the first step toward finding effective relief.

Women’s Health Considerations for Stomach Pain

When women experience stomach pain, several unique factors can make identifying the cause more complex than it might be for men. A woman’s abdominal area contains both digestive organs and reproductive structures in close proximity, creating situations where symptoms often overlap. What feels like digestive discomfort might actually stem from the reproductive system, or vice versa, making it difficult to pinpoint the exact source without careful evaluation.

Throughout a woman’s menstrual cycle each month, natural hormonal fluctuations significantly influence digestive function. Estrogen and progesterone levels change during different phases, affecting everything from intestinal sensitivity to how quickly food moves through the digestive tract. Many women notice their stomach feels more sensitive during certain times of the month, with symptoms like bloating, constipation, or heightened pain sensitivity before or during menstruation.

The potential causes of abdominal discomfort also shift as women move through different phases of life. Young women might experience pain related to menstruation or ovulation, while those in their childbearing years might face concerns like ectopic pregnancy or ovarian cysts. As women approach perimenopause and beyond, the incidence of gallbladder disease and digestive disorders like diverticulitis tends to increase. This changing landscape of potential causes means that proper assessment requires considering not just the specific symptoms but also how a woman’s body changes throughout her lifetime.1

Common Causes of Stomach Pain in Women

Stomach pain in women can originate from a variety of sources, including the digestive system, reproductive organs, and other abdominal structures. The nature, location, and timing of the pain often provide important clues about its underlying cause. While some conditions affect both men and women equally, others are unique to or more common in women. Here are some of the most frequent causes of stomach pain that women experience:

  • Menstrual cramps: Pain that occurs before or during menstruation, typically felt as dull, throbbing, or cramping sensations in the lower abdomen. This pain results from the uterus contracting to shed its lining and can range from mild discomfort to severe pain that interferes with daily activities.
  • Irritable bowel syndrome (IBS): A common digestive disorder characterized by abdominal pain, bloating, and changes in bowel habits. Women are twice as likely as men to develop IBS, with symptoms often worsening during menstrual periods due to hormonal fluctuations affecting gut sensitivity.
  • Endometriosis: A condition where tissue similar to the uterine lining grows outside the uterus, often causing severe pain during menstruation, intercourse, or bowel movements. This chronic condition can lead to persistent lower abdominal pain and may be mistaken for digestive disorders before proper diagnosis.
  • Ovarian cysts: Fluid-filled sacs that develop on or within the ovaries, sometimes causing sharp or dull pain on one side of the lower abdomen. While many ovarian cysts resolve without treatment, larger cysts may cause persistent discomfort or sudden, severe pain if they rupture or twist.
  • Urinary tract infections (UTIs): Infections affecting any part of the urinary system, commonly causing burning during urination and pain in the lower abdomen or back. Women are more susceptible to UTIs due to their shorter urethras, which allow bacteria easier access to the bladder.
  • Gallstones: Hard deposits that form in the gallbladder, potentially causing intense pain in the upper right abdomen, especially after eating fatty foods. Women are twice as likely as men to develop gallstones, with risk increasing during pregnancy and with the use of certain hormonal medications.
  • Inflammatory bowel disease (IBD): Conditions like Crohn’s disease and ulcerative colitis that cause chronic inflammation in the digestive tract. These disorders can produce cramping abdominal pain, persistent diarrhea, and unintended weight loss that may fluctuate in severity over time.
  • Gastroesophageal reflux disease (GERD): A digestive disorder where stomach acid frequently flows back into the esophagus, causing burning pain in the upper abdomen or chest, often worse after meals or when lying down. Pregnancy and obesity can increase the risk and severity of GERD symptoms.
  • Appendicitis: Inflammation of the appendix that typically begins with pain near the navel that shifts to the lower right abdomen and intensifies over hours. This condition requires urgent medical attention as a ruptured appendix can lead to life-threatening infection.
  • Pelvic inflammatory disease (PID): An infection of the female reproductive organs often caused by untreated sexually transmitted infections. PID typically causes lower abdominal pain and tenderness, abnormal vaginal discharge, and fever.
  • Diverticulitis: Inflammation or infection in small pouches that form in the digestive tract, most commonly in the lower colon. This condition often causes severe pain in the lower left abdomen, along with fever, nausea, and changes in bowel habits.2

How Stomach Pain is Diagnosed

Determining the cause of stomach pain requires a systematic approach that considers both digestive and reproductive factors. The diagnostic process typically begins with a detailed medical history and physical examination, then progresses to more specialized tests only when needed. Information about symptom patterns, including their relationship to the menstrual cycle, significantly helps healthcare providers determine the appropriate diagnostic path. Common diagnostic methods include:

  • Laboratory tests: Blood tests identify inflammation, infection, or abnormal liver function, while urinalysis detects urinary tract infections and kidney issues. Pregnancy testing is essential for women of reproductive age with lower abdominal pain.
  • Imaging studies: Ultrasound often serves as the first imaging choice for women, visualizing both digestive and reproductive organs without radiation exposure. CT scans provide more detailed abdominal images when needed, while MRI offers enhanced soft tissue detail for specific conditions.
  • Endoscopic procedures: Upper endoscopy allows direct visualization of the esophagus, stomach, and upper small intestine, while colonoscopy examines the large intestine. These procedures identify inflammation, ulcers, or other abnormalities not visible on imaging studies.
  • Gynecological evaluation: For suspected reproductive system causes, specialized tests like transvaginal ultrasound or laparoscopy examine the uterus, fallopian tubes, and ovaries more closely.

Overview of Treatment Approaches

Treatment for stomach pain in women is tailored to the specific underlying cause identified during diagnosis. Digestive conditions often respond to dietary changes and targeted medications, while reproductive causes might require hormonal therapies or surgical approaches. Inflammatory conditions typically need anti-inflammatory medications, and infections require appropriate antimicrobial treatment. Given the diverse origins of abdominal pain in women, healthcare providers develop individualized treatment plans that may combine multiple approaches based on the specific diagnosis and symptom severity, with the goal of providing effective relief while addressing the root cause.

Request an Appointment With Cary Gastro

Finding answers for stomach pain often requires specialized expertise, particularly when symptoms overlap between digestive and reproductive systems. At Cary Gastro, our physicians understand this complex relationship and provide comprehensive evaluation that considers all potential causes. We recognize that a woman’s abdominal pain can stem from multiple sources and requires careful assessment to identify accurately. If you’re experiencing persistent or recurring stomach discomfort, our experienced team can help navigate the path to diagnosis and relief. Contact us today to request an appointment with one of our specialists.


1https://www.usz.ch/en/disease/abdominal-pain-in-women/
2https://heritagehospitals.com/blog/what-causes-lower-abdominal-pain-in-females/