What causes lower abdominal pain without menstruation?
May 31, 2022
Source: Cainiu Health
Dr. Chen Zhe
Introduction
Absence of menstruation accompanied by lower abdominal pain may indicate corpus luteum rupture, which typically occurs during the luteal phase—the period from ovulation to the onset of the next menstrual period. Symptoms commonly include lower abdominal pain, nausea, vomiting, and decreased hemoglobin levels. Pelvic inflammatory disease (PID) may also occur before menstruation and can be associated with fever, generalized fatigue, and other systemic symptoms. If menstruation is delayed and lower abdominal pain is present prior to the expected menses, further evaluation is warranted.
Menstrual delay is a common phenomenon among women, and thus many individuals do not consider it a cause for concern. However, some patients experience lower abdominal pain despite delayed menstruation. So, what could cause lower abdominal pain in the absence of menstruation?
What Causes Lower Abdominal Pain Without Menstruation?
Lower abdominal pain without menstruation may result from corpus luteum rupture, which typically occurs during the luteal phase—the period between ovulation and the onset of the next menstrual period. Symptoms commonly include lower abdominal pain, nausea, vomiting, and decreased hemoglobin levels. Pelvic inflammatory disease (PID) may also occur before menstruation and can be accompanied by fever and generalized fatigue.
If menstruation is delayed and lower abdominal pain is present, ectopic pregnancy must be ruled out. Prior to rupture, ectopic pregnancy often presents as unilateral lower abdominal pain; following rupture, the pain may become sharp and tearing in nature, rapidly progressing to generalized abdominal pain. Relevant diagnostic tests—including serum β-hCG measurement and transvaginal ultrasound of the uterus and adnexa—are essential to determine the underlying cause.
Pelvic inflammatory disease (PID) may also be responsible. During menstruation, the pelvis is naturally congested; this congestion intensifies premenstrually, potentially causing lower abdominal discomfort. Similarly, endometriosis may produce comparable symptoms. Gynecologic tumors can also cause menstrual irregularities; however, associated abdominal pain can often be preliminarily assessed via pelvic ultrasound and gynecologic examination, followed by appropriate treatment. We hope this information proves helpful.
