Lower Abdominal Pain in Women in Lagos: Causes and What Scan You Need
Lower abdominal pain in women has a long list of causes, from period pain and ovarian cysts to ectopic pregnancy and appendicitis. This guide tells you how to tell them apart, what tests or scan you need, and when it is urgent.
What Causes Lower Abdominal Pain in Women?
The location, timing in the cycle, and character of the pain, cramping, sharp, constant, gives important clues. Many causes are gynaecological; some are gastrointestinal or urological.
Cramping lower abdominal pain during menstruation: starting just before or at the onset of the period. The most common cause. May be primary (no structural cause) or secondary (fibroids, endometriosis, adenomyosis).
Sharp or dull pain on one side, often worse at mid-cycle. A functional cyst from a follicle that didn't rupture. Confirmed by pelvic ultrasound; most resolve without surgery.
Lower abdominal pain + abnormal discharge + fever + pain during sex, infection in the uterus and tubes. Requires urgent antibiotics to prevent infertility.
One-sided lower abdominal pain + positive pregnancy test = ectopic until proven otherwise. A ruptured ectopic can cause life-threatening internal bleeding.
Heavy, painful periods with pelvic pressure: fibroids or adenomyosis causing uterine enlargement. Confirmed by pelvic scan.
Pain that starts around the navel and moves to the right lower quadrant, worsening over hours with fever and nausea. Surgical emergency.
🚨 Go to hospital or clinic today if you have:
- Positive pregnancy test + one-sided pain: ectopic (come in today)
- Lower abdominal pain + fever > 38.5°C + vaginal discharge, possible PID
- Pain that started around the navel and moved to the right lower quadrant, possible appendicitis
- Sudden severe pain like "something tearing", possible rupture or torsion
- Lower abdominal pain + fainting or dizziness: possible internal bleeding
- Pain with significant rectal bleeding
What Tests or Scan Do You Need?
Recommended at Mascot Healthcare
Pregnancy Test (Urine): Mandatory first step for any woman of reproductive age with lower abdominal pain, excludes ectopic.
Pelvic Ultrasound: The primary imaging investigation: identifies ovarian cysts, fibroids, adenomyosis, free fluid, and uterine abnormalities.
High Vaginal Swab + STI Screen: If PID is suspected, identifies the causative organisms.
Full Blood Count + CRP: White cell count and inflammatory marker, distinguishes infection (elevated WBC) from structural/functional cause.
Urine Dipstick + Culture: Urinary tract infection can cause lower abdominal pain, especially in women.
What to Do Right Now
Before any other investigation: a positive test with lower abdominal pain changes the urgency and the next steps completely.
Mid-cycle pain → likely ovarian. Period-associated cramping → likely dysmenorrhoea or endometriosis. Constant pain not cycle-related → needs a scan.
Pain lasting more than 3 days, or recurring monthly, warrants a pelvic ultrasound. Most causes are identifiable on scan.
PID requires antibiotic treatment today: delay increases the risk of fallopian tube damage and infertility.
Lower abdominal pain? Pelvic ultrasound and assessment at Mascot Healthcare: same-day results.
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Last updated 16 October 2026.