Lower Abdominal Tightness in Females: Causes & Treatments.

Our content is not intended nor recommended as a substitute for medical advice by your doctor. Use for informational purposes only.

What you need to Know:

  • Menstruation is far the most common cause of lower abdominal Tightness and pain if you are a fertile female.

Other causes of lower abdominal tightness in females include:

  • Colon pain as irritable bowel syndrome and chronic constipation.
  • Uterine fibroids.
  • Ovulation, ovarian cysts, inflammation of the ovaries, or cancer.
  • Urinary bladder inflammation (cystitis), stones, or tumor.
  • Early pregnancy.
  • Pelvic adhesions due to previous operations.
  • Pelvic congestion syndrome.
  • For other rare causes, see the below article. You will learn which cause fits your condition.

1- Menstruation.

Lower abdominal tightness or cramps can affect up to 91% of women during menstruation (reference).

The majority of females will experience some tightness or discomfort in the lower abdomen rather than pain. Severe menstrual pain only affects 2-29% of females.

The pain or tightness often occurs for at least one or two days of the cycle.

How to suspect (symptoms):

  • The tightness or pain begins with the onset of menses and fades gradually within 12-72 hours.
  • Nausea and sometimes diarrhea.
  • Headache.
  • Fatigue.
  • General sense of malaise.
  • The condition usually improves with advancing age.

How to deal (treatments).

  • Applying heat: This 2012 study found that applying heat to the lower abdomen is as effective as Ibuprofen (Advil).
  • Take an over-the-counter medication such as Ibuprofen (Advil) or Naproxen (Aleve).
  • Massaging with essential Oils
  • herbal supplements such as Chamomile tea, fennel seeds, cinnamon, and ginger.
  • Avoid alcohol, caffeine, carbonated beverages, and fatty foods.

Another condition called Premenstrual syndrome can also affect females BEFORE menstruation.

But the Premenstrual syndrome comes with a large group of behavioral changes (such as irritability and anxiety) and physical changes such as abdominal bloating, tightness, and hot flushes.

The symptoms of Premenstrual syndrome are usually experienced a week or two before menstruation. And it disappears when menstruation starts. Learn more about PMS HERE and HERE.

2- Colon (constipation or IBS).

Gases or hard stools inside your colon can cause lower abdominal pain or tightness in females.

Various conditions inside the colon can cause lower abdominal pain or tightness in the lower abdomen. The two most common conditions are chronic constipation and irritable bowel syndrome.

A- Constipation (Occasional and chronic):

Constipation affects about 20.8% of females (compared to 8% of males). one of the most common symptoms of chronic or recurrent constipation is lower abdominal tightness (reference).

Constipation means a passage of hard stools or you are passing fewer than 3 bowel movements per week.

Constipation can affect you occasionally or become chronic. The most common causes of chronic constipation are chronic idiopathic constipation and IBS constipation.

Also, constipation can be secondary to some diseases such as hypothyroidism, systemic sclerosis, diabetes mellitus, and other neurological diseases (reference).

How to deal with constipation and abdominal tightness:

  • You can control occasional constipation by a high-fiber diet, physical activity, or using some over-the-counter laxatives.
  • Chronic constipation usually requires evaluation by your doctor to spot the cause and the best treatment.
  • Gradually increase the amount of fiber in your diet.
  • Drink plenty of water.
  • increase the amount of physical activity you get every day.
  • Take a fiber supplement.
  • Ask your doctor about prescription medications for constipation and lower abdominal tightness.

B- Irritable Bowel Syndrome.

IBS affects about 10-15% of the population worldwide. Also, females are 2.5X more likely to be affected by IBS than males.

Symptoms of IBS include:

  • Abdominal pain or discomfort (tightness).
  • The pain or tightness can be diffuse or affect parts of your abdomen such as the lower abdomen.
  • The pain or tightness occurs at least one day per week for the past 3 months.
  • The lower abdominal tightness changes with bowel movements (either improves or worsens after bowel movements).
  • The onset of lower abdominal tightness is associated with a change in stool form (stool becomes harder or looser).
  • The onset of lower abdominal tightness is associated with a change in stool frequency (diarrhea or constipation).
  • Passage of mucus in stool.
  • Bloating.
  • Usually, the symptoms of IBS are triggered by eating certain foods or by stress and anxiety.

Learn more about IBS and its diagnosis.

3 – Early Pregnancy.

Tightness in the lower abdomen in a fertile female is one of the early signs of pregnancy.

Symptoms of early pregnancy:

  • Missed period: expect pregnancy if your period misses the expected date while feeling tightness in the lower abdomen.
  • Tender swollen breasts.
  • Mild discomfort or tightness in the lower abdomen. Sometimes, mild cramping and pain.
  • Nausea with or without vomiting.
  • Frequent urination.
  • Headache.
  • Tiredness and fatigue.
  • irritability or mood swings.
  • change in appetite (food aversions or cravings).
  • Heightened sense of smell.

Suspect pregnancy if you have a missed period. Order a urine pregnancy test to confirm pregnancy and call your doctor if you are unsure.

4- Fibroid.

Uterine Fibroids are abnormal (benign) growths in the wall of the uterus. Small fibroids often have no symptoms.

However, too large fibroids or the presence of numerous fibroids will make you experience symptoms such as menorrhagia and lower abdominal tightness in females.

Fibroids are very common. In a US study, the prevalence of fibroid was:

  • 40% of caucasian women have fibroids by the age of 35.
  • Up to 70% of Caucasian women have fibroids by the age of 50.
  • 40% of African American women have fibroids by the age of 35.
  • Over 80% of African American females have fibroids by the age of 50.

Risk factors of uterine fibroids:

  • Black race (Such as African American women) have 2-3 folds of risk than white women.
  • Older ages.
  • The risk DECREASES if you have previous pregnancies.
  • Early-onset of menses (before the age of 10 years).
  • Obesity.
  • Diet high in red meat, dairy products. Also, low dietary vitamin D is associated with an increased risk of fibroids.
  • Alcohol consumption (especially beer).
  • Hypertension.

How to suspect fibroids (symptoms):

  • Lower abdominal pain, discomfort, or tightness.
  • Painful menses.
  • Painful intercourse.
  • Menorrhagia: increased bleeding during the menses or increased duration of the menses.
  • Lower back pain can also occur.
  • Urine frequency, difficulty emptying the urinary bladder.
  • Large or multiple tumors may cause infertility.

5-The Ovary: ovulation, ovarian cyst, or Cancer.

Ovarian conditions are one of the most frequent causes of lower abdominal pain or tightness in females.

Common ovarian conditions (and their prevalence).

  • Ovarian cysts:
    An ovarian cyst is a fluid-filled sac that arises from the ovary. Most ovarian cysts occur naturally and go away within a few months (reference). It affects between 8 and 18% of the females in the childbearing period (reference)
  • Ovulation.
    In an average 28-day menstrual cycle, ovulation typically occurs about 14 days before the start of the next menstrual period.
    Mild lower abdominal tightness, breast tenderness, changes in the libido or smell, and vaginal mucus changes are the most common symptoms.
  • Ovarian cancer.
    Approximately, 1.2% of women will be diagnosed with ovarian cancer at some point during a lifetime (reference).
    Ovarian cancer can present with vague lower abdominal pain or discomfort in the early stages. Learn more about the symptoms of ovarian cancer.

6- Urinary Bladder: cystitis, stone, or bladder cancer.

Any condition causing inflammation or damage to your urinary bladder can lead to lower abdominal pain or tightness. For example:

  • cystitis.
    Inflammation of the urinary bladder is usually due to urinary tract infections. Cystitis is common in females due to the short urethra (making it easier for micro-organisms to infect the bladder).
  • Urinary bladder stones or gravels.
    A very common cause of persistent lower abdominal tightness. If your lower abdominal tightness is related to burning micturition, it is better to think of such a cause.
  • Painful bladder syndrome (interstitial cystitis).
    Chronic inflammation of your urinary bladder can lead to chronic pain or tightness in the lower abdomen. The symptoms are often prolonged without evidence of urinary tract infections, stones, or tumors. Learn more.

7- Pelvic adhesions.

Most often, pelvic adhesions result from previous pelvic or gynecological surgery.  it causes a wide variety of symptoms including lower abdominal tightness or discomfort.

Surgery is not the only cause of pelvic adhesions. Other conditions may cause such conditions as previous severe infections (such as abscess formation inside your abdomen. (Reference)

You should suspect Pelvic adhesions when you have previous abdominal surgery (especially if more than once).

8- Pelvic congestion syndrome.

Pelvic congestion syndrome occurs when the blood inside your pelvic veins builds up. The exact cause is still unclear. the dilated veins may cause some lower abdominal discomfort in females. (reference)

The character of lower abdominal discomfort:

  • It affects mainly females in the childbearing period.
  • The pain or lower abdominal discomfort increases before menstruation.
  • Increases with prolonged standing or walking.
  • Increases after intercourse.
  • You may also experience painful menses, lower abdominal discomfort during intercourse, and urine urgency.

Ask your doctor about the condition if the character of your lower abdominal discomfort is similar to what is described above.

Your doctor diagnoses Pelvic congestion syndrome based on characteristic symptoms and the presence of dilated pelvic veins.

For the relief of lower abdominal discomfort, your doctor may prescribe some hormonal pills. Common hormones are progesterone and Gonadotropin-releasing hormone.

In severe cases, you may undergo medical intervention to obstruct the dilated veins (by embolization or sclerotherapy). (reference)

9- Muscular pain or discomfort.

Any tear, stretch, or damage to the muscles of your lower abdomen can cause pain or discomfort. lower abdominal discomfort arising from muscles usually occurs due to:

  • Intensive workouts (especially abs workouts).
  • Lifting heavy objects.
  • Sudden twisting or any wrong movements that stretch or tear your abdominal muscles.
  • Vigorous coughing or sneezing.

Often, you will feel pain rather than comfort at the time of the event that caused the muscle strain. Later on, you may continue to feel lower abdominal pain or discomfort. This can last anywhere from several hours to several weeks.

10- Others (Infrequent or rare causes).

A- Intra-abdominal tumor.

B- Hernia.

C- Chronic Pelvic inflammatory disease.

D- Ectopic pregnancy.

E- Endometriosis.