Lower Abdominal Pain With Bleeding – What Could Be Causing It?

Lower abdominal pain accompanied by bleeding can be caused by a variety of gynecological and hormonal conditions. While it may not always indicate a serious issue, understanding the possible causes is essential for timely diagnosis and treatment. Below are some common reasons behind this combination of symptoms:

1. Cervical Issues

Cervical abnormalities such as cervical polyps, cervical erosion, or even precancerous changes like cervical intraepithelial neoplasia (CIN) could lead to pain and abnormal vaginal bleeding. A Pap smear (TCT test) and HPV screening are recommended to rule out these conditions. In some cases, cervical cancer may also present with similar symptoms, especially if left undiagnosed.

2. Uterine Conditions

Abnormal uterine bleeding combined with cramping or pain might be due to endometrial hyperplasia, endometrial polyps, or fibroids. An ultrasound scan is often used to examine the thickness of the endometrium and detect any structural issues within the uterus. If necessary, procedures like hysteroscopy and dilation & curettage (D&C) may be performed to further evaluate and treat the condition.

3. Hormonal Imbalances

Certain endocrine disorders such as polycystic ovary syndrome (PCOS) or hyperprolactinemia can disrupt normal menstrual cycles and cause irregular bleeding along with pelvic discomfort. Blood tests including a full female hormone panel and thyroid function tests are useful in identifying such underlying hormonal problems.

4. Pelvic Inflammatory Disease

Infections affecting the reproductive organs, particularly pelvic inflammatory disease (PID), can cause lower abdominal pain and sometimes spotting or heavier bleeding. A thorough gynecological exam and possibly additional lab tests are needed to confirm the diagnosis and begin appropriate antibiotic therapy.

If you experience persistent or severe symptoms, it's important to consult a healthcare provider to determine the exact cause and receive proper care.