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Dr. Andrew Rynne

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What causes pulling stretching ache in lower abdomen?

Answered by
Dr. Jacqueline Brown


Practicing since :1996

Answered : 1425 Questions

Posted on Sat, 31 Oct 2015 in Women's Health
Question: Hi, I'm 40 years old, I've had 2 C-sections, that's a little background.
I've been feeling for sometime pulling, stretching and ache in my lower abdomen. the pain
sometimes I feel sometimes in my groin, I use to start around when I ovulated, but now I don't think that
is the case. Its been a year of this, it went away for some time now it's back. No history in my family
Wondering if it could be my colon. I'm having a pelvic ultra sound Friday. Just worried, I procrastinated
and just scared.
Answered by Dr. Jacqueline Brown 1 hour later
Brief Answer:
The ultrasound will rule out a GYN cause of the pain

Detailed Answer:
Hello, and I hope I can help you today.

I am glad that you took the brave step in getting a medical evaluation of your pain, even if it may be a bit overdue.

There are many potential causes for pelvic pain. Some are gynecologic, some are not. You mentioned that you had two previous cesarean sections, however you did not mentioned how long ago. If your surgery was more than a year ago, your discomfort is not likely related to your previous surgery.

The main organs in your pelvis are your bladder, your uterus and ovaries, and your colon. All of them can cause pelvic pain. You do mention that this pain used to occur around your ovulation time, which leads away from a digestive diagnosis. I do not know if you had last had a physical examination by a gynecologist, or when your last routine Pap smear was done, but if the doctors examination was recent and normal, it is unlikely anything serious could be going on.

Diseases of the colon usually start with some bowel related symptom along with pain. Constipation, diarrhea or blood in the stool are warning signs for problems. Colon cancer is uncommon in women under the age of 50 unless there is a family history.

So in summary, I think you most likely have a gynecologic diagnosis and your pelvic ultrasound will likely add a lot of useful information. They should so a transvaginal ultrasound to get a good view of your uterus and ovaries. And if you have not done so already, please schedule a visit with a GYN doctor to review the results with you and perform a physical examination if necessary.

I hope I was able to adequately answer your question and that my advice was helpful. Please do not hesitate to contact me if you need anything further.

Best wishes, Dr. Brown
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
Follow up: Dr. Jacqueline Brown 20 hours later
so I had my pap in July, and all was clear. as far as constipation or issues there,
have not been any no. My dad had colon cancer at 75, but he was treated and thank god fine. however then I should maybe look into having a colonoscopy. I feel discomfort on the C-section line, and corners, it radiates to the hip and thigh.
there is no other history of cancer in my family, other than my dad few years ago. He also had Prostate cancer caught it early too. Is prostate something I should be concerned with or mention? I was concerned after pap only because I know there are certain vaginal cancers pap does not catch. I go to U/S tomorrow
thanks you
Answered by Dr. Jacqueline Brown 26 minutes later
Brief Answer:
A colonoscopy would not be unreasonable given your family history.

Detailed Answer:
Hello again and thank you for providing this additional helpful information.

I do agree with you that it would not be a bad idea for you to see a GI doctor and get a colonoscopy given your family history. They usually recommend starting screening at 10 years before the age of when your relative was diagnosed, but it would be good to see what the specialist advises and take it from there. Your father's prostate cancer is one of the cancers included in some hereditary cancer syndromes, so your GI doctor may recommend genetic testing of you (or even better- your father if he is alive) to determine if there is a danger.

It is true that the PAP test only screens for cervical cancer, however vaginal cancer is very rare and also frequently presents as an abnormal PAP smear. Uterine and ovarian cancer though are different; however, uterine cancer usually presents with abnormal vaginal bleeding, and ovarian cancer is very uncommon in general, however signs of either can be seen on an ultrasound test. I assume your doctor also did a bimanual examination at the time of your PAP smear, which means they likely did not feel a large tumor or enlargement of your uterus or ovaries at that time.

As an aside, if you are concerned about cancer, you shoud get a baseline mammogram if you haven't had one already. Breast cancer is more common than any gynecologic cancer or colon cancer in women, and some genetic causes of colon cancer also increase the risk of breast cancer too.

Regarding your c-section scar, it can get uncomfortable if your belly is growing larger or being stretched, so if you gained weight or you have swelling in your pelvis this also can be a reason for that symptom.

So I hope your ultrasound tomorrow sheds some light on how you are feeling and that you get an accurate diagnosis, and that you get better soon.

Please let me know if you need anything else, otherwise you can close this question and if you had a positive experience please post a star review.

Thanks so much for using and take care,

Dr. Brown
Above answer was peer-reviewed by : Dr. Neel Kudchadkar

The User accepted the expert's answer

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