Abdominal Pain - Female

By David A. Thompson, M.D. 
October 06, 2017

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Abdominal Pain - Female

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Does this describe your symptoms?

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Anatomy - Gastrointestinal


  • Pain or discomfort located between the bottom of the rib cage and the groin crease

General Information

  • There are multiple causes of abdominal pain. In women the range of diagnoses needs to be broadened to include problems related to pregnancy and the female organs.

  • The possibility of pregnancy must be considered in all women of childbearing age.

  • Abdominal pain in the elderly carries with it a higher risk of serious illness.

Top Causes of Abdominal Pain in Women Younger than 50 Years of Age

  • Appendicitis

  • Ectopic pregnancy

  • Endometriosis

  • Gallbladder disease

  • Nonspecific abdominal pain

  • Ovarian cyst

  • Pelvic Inflammatory Disease

  • Peptic ulcer disease

  • Spontaneous abortion

Top Causes of Abdominal Pain in Women Older than 50 Years of Age

  • Appendicitis

  • Bowel obstruction

  • Diverticulitis

  • Gallbladder disease

  • Pancreatitis

  • Peptic ulcer disease

If not, see these topics


When to Call Your Doctor

call 911

Call 911 Now (you may need an ambulance) If

  • Passed out (fainted)

  • Very weak (can't stand)

call now

Call Your Doctor Now (night or day) If

  • You feel weak or very sick

  • Severe pain

  • Constant abdominal pain for more than 2 hours

  • Vomiting blood or black (coffee-grounds)

  • Vomiting bile (bright yellow or green)

  • Vomiting and abdomen is more swollen than usual

  • Blood in bowel movements (black/tarry or red)

  • Recent injury to the abdomen

  • Fever of 103° F (39.4° C) or higher

  • Fever of 100.5° F (38.1° C) or higher and you:

    • Are over 60 years of age OR

    • Have diabetes mellitus or a weakened immune system (e.g., HIV positive, cancer chemotherapy, chronic steroid treatment, splenectomy) OR

    • Are bedridden (e.g., nursing home patient, stroke, chronic illness, recovering from surgery)

  • Whites of the eyes have turned yellow (jaundice)

call within 24 hours

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

  • You think you need to be seen

  • Moderate or mild pain comes and goes (cramps), but lasts greater than 24 hours

  • Abnormal vaginal discharge (e.g., bad odor; yellow, gray or green in color)

  • Age greater than 60 years

  • Pregnant or could be pregnant (e.g., missed last menstrual period)

  • Blood in urine

call within 24 hours

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns

  • Abdominal pains are a recurrent problem

  • Pain with sexual intercourse

home care

Self Care at Home If

  • Mild abdominal pain and you don't think you need to be seen



  1. Reassurance: A mild stomachache can be caused by indigestion, gas pains or overeating. Sometimes a stomachache signals the onset of a vomiting illness due to a viral gastroenteritis ("stomach flu").

  2. Rest: Lie down and rest until you feel better.

  3. Fluids: Sip clear fluids only (e.g., water, flat soft drinks or 1/2 strength fruit juice) until the pain has been gone for over 2 hours. Then slowly return to a regular diet.

  4. Diet:

    • Slowly advance diet from clear liquids to a bland diet

    • Avoid alcohol or caffeinated beverages

    • Avoid greasy or fatty foods.

  5. Pass A BM: Sit on the toilet and try to pass a bowel movement (BM). Do not strain. This may relieve the pain if it is due to constipation or impending diarrhea.

  6. Avoid Medicines: Any drug could irritate the stomach lining and make the pain worse, especially an anti-inflammatory medicine such as aspirin and ibuprofen. Do not take any pain medicines, fever medicines or laxatives for stomach cramps.

  7. Expected Course: With harmless causes, the pain is usually better or goes away within 2 hours. With viral gastroenteritis ("stomach flu"), belly cramps may precede each bout of vomiting or diarrhea and may last 2-3 days. With serious causes (such as appendicitis) the pain becomes constant and more severe.

  8. Pregnancy test, when in doubt:

    • If there is any possibility of pregnancy, obtain and use a urine pregnancy test from the local drug store.

    • Follow the instructions included in the package.

  9. Call Your Doctor If:

    • Abdominal pain is constant and present for more than 2 hours

    • Abdominal pains come and go, and are present for more than 24 hours

    • You are pregnant

    • You become worse

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.


October 06, 2017