What are the causes of abdominal cramps in females?

From the Guidelines

Abdominal cramps in women are most commonly caused by gynecological etiologies, including adnexal torsion, tubo-ovarian abscess, and endometriosis, as well as other conditions such as menstrual cramps, ovulation pain, and pelvic inflammatory disease. According to the American College of Radiology Appropriateness Criteria, gynecological etiologies suspected in women with acute pelvic pain and negative b-hCG should be evaluated with initial imaging modalities such as ultrasound or MRI, rather than CT abdomen and pelvis with IV contrast 1. The CT evaluation has a sensitivity of 74% to 95% and a specificity of 80% to 90% for the diagnosis of adnexal torsion, which can present with asymmetrically enlarged ovary, twisted pedicle, and other findings 1.

Some key causes of abdominal cramps in women include:

• Menstrual cramps, which can be alleviated with over-the-counter medications like ibuprofen or naproxen, as well as heat therapy and gentle exercise
• Adnexal torsion, which can be diagnosed with CT evaluation and may require surgical intervention
• Tubo-ovarian abscess, which can be diagnosed with CT findings of a thick-walled fluid density in adnexal location and may require antibiotic treatment
• Endometriosis, which can cause architectural distortion, thickening of bowel serosa, and bowel obstruction, and may require hormonal or surgical treatment
• Other reproductive causes, such as ovulation pain, uterine fibroids, pelvic inflammatory disease, and pregnancy-related conditions
• Gastrointestinal issues, such as irritable bowel syndrome, inflammatory bowel disease, food intolerances, constipation, and gastroenteritis
• Urinary tract infections, which can present with lower abdominal pain and may require antibiotic treatment

It is essential to determine the underlying cause of abdominal cramps in women to provide appropriate treatment and prevent potential complications, such as infertility, chronic pain, or life-threatening conditions like ectopic pregnancy or ovarian torsion 1. If cramps are severe, persistent, accompanied by heavy bleeding, fever, or interfere with daily activities, medical evaluation is necessary to determine the underlying cause and appropriate treatment.

From the FDA Drug Label

NSAID medicines can cause ulcers and bleeding in the stomach and intestines at any time during treatment Ulcers and bleeding: can happen without warning symptoms may cause death The chance of a person getting an ulcer or bleeding increases with: taking medicines called "corticosteroids" and "anticoagulants" longer use smoking drinking alcohol older age having poor health Other side effects include: stomach pain constipation diarrhea gas heartburn nausea vomiting dizziness

The causes of abdominal cramps in women may include NSAID-induced ulcers and bleeding in the stomach and intestines, as well as other gastrointestinal side effects such as:

• Stomach pain
• Diarrhea
• Gas
• Heartburn
• Nausea
• Vomiting These side effects can be associated with the use of NSAIDs like ibuprofen and naproxen 2, 3.

From the Research

Causes of Abdominal Cramps in Women

The causes of abdominal cramps in women can be attributed to various factors, including:

• Irritable bowel syndrome (IBS) 4, 5, 6, 7, 8
• Gynaecological diseases such as endometriosis and chronic pelvic inflammatory disease 4
• Inflammatory bowel disease (IBD) 6, 7, 8
• Menstrual cycle-related changes 5, 6, 8

Gastrointestinal Disorders

Gastrointestinal disorders such as IBS and IBD can cause abdominal cramps in women, with symptoms including:

• Abdominal pain 4, 5, 6, 7, 8
• Bloating 5, 8
• Diarrhea 6, 8
• Constipation 5, 6

Menstrual Cycle-Related Changes

The menstrual cycle can exacerbate symptoms of abdominal cramps in women, with:

• Worsening of symptoms during the menstrual phase 5, 6, 8
• Cyclical changes in bowel habits 6, 8
• Elevated prostaglandin levels during menses contributing to worsened symptoms 8