Groin pain is a common concern for women. The groin is defined as the crease where the lower abdomen meets the upper thigh, on either side of the pubic bone. The anatomical area is complex due to the close proximity of skeletal, muscular, reproductive, and digestive structures, all of which can contribute to discomfort. Because pain signals from these various systems can converge, pinpointing the precise source of groin pain often requires a careful assessment.
Common Musculoskeletal Contributors
Many instances of groin discomfort originate from issues involving the muscles, tendons, or joints in the hip and pelvic region. A frequent diagnosis is an adductor strain, or “pulled groin,” involving the inner thigh muscles used to pull the legs together. These injuries typically occur during movements involving sudden acceleration or rapid changes in direction, resulting in pain when lifting the knee or bringing the legs together. Severity ranges from minor inflammation to a significant tear, which may be accompanied by a popping sensation.
Hip joint pathology is another common source, where pain is often referred to the groin area due to shared nerve pathways. Conditions like hip osteoarthritis, involving cartilage breakdown, cause ongoing pain and stiffness that worsens with movement. A labral tear, affecting the cartilage cushioning the hip socket, can also cause deep groin pain, sometimes accompanied by a clicking or catching sensation.
The pubic bone joint, the pubic symphysis, can also become a source of pain, referred to as osteitis pubis. This involves inflammation of the joint and surrounding muscle attachments, often causing sharp pain aggravated by activities like coughing or walking. These causes are frequently managed conservatively with rest, physical therapy, and anti-inflammatory medications, focusing on restoring stability and strength.
Gynecological Sources of Groin Pain
Pain originating from the reproductive organs is a significant category of groin pain unique to women. A common source is the development of ovarian cysts, fluid-filled sacs that form on or within the ovaries. While often harmless, a cyst can cause pain on the affected side, and sudden, severe pain may signal a ruptured cyst or ovarian torsion, where the ovary twists on its supporting ligaments. Ovarian torsion is an immediate medical situation because it cuts off blood supply, potentially leading to tissue death.
Conditions involving the lining of the uterus can also cause groin pain, such as endometriosis, where tissue similar to the uterine lining grows outside the uterus. This manifests as chronic pelvic pain that is sometimes cyclical, or acute pain if an endometriotic cyst ruptures. Pelvic inflammatory disease (PID), an infection often caused by sexually transmitted bacteria, commonly presents with lower abdominal pain radiating to the groin, sometimes accompanied by fever and abnormal discharge.
During pregnancy, sharp groin pain is commonly caused by the stretching of the round ligaments supporting the uterus. This pain is typically a quick, sharp sensation, often occurring in the second trimester as the uterus expands rapidly. However, any groin or pelvic pain in a pregnant woman must be quickly evaluated to rule out an ectopic pregnancy, where a fertilized egg implants outside the uterus. This condition is a life-threatening emergency, typically presenting with severe pain, vaginal bleeding, or signs of internal blood loss.
Other Systemic and Non-Muscular Causes
Not all groin pain is related to muscles or reproductive health; other internal body systems can refer pain to the area. Hernias represent a significant non-muscular cause, occurring when internal tissue pushes through a weakness in the abdominal wall. In women, inguinal or femoral hernias can be subtle, often presenting as chronic groin pain rather than a noticeable bulge, making them more difficult to diagnose than in men. The pain can be aching, sharp, or shooting, and may worsen with activities that increase abdominal pressure, like lifting or coughing.
Pain signals can also originate from the urinary system, as with kidney stones. As these mineral deposits travel down the ureter, they cause intense, intermittent pain that radiates down the flank to the groin and even the vaginal area. A severe urinary tract infection (UTI) can also cause moderate pain in the lower abdomen and groin, often accompanied by burning during urination or the frequent need to void.
Neurological issues, such as nerve entrapment, occur when a nerve is compressed by surrounding tissues. One example is meralgia paresthetica, involving the lateral femoral cutaneous nerve, which typically causes burning pain, tingling, or numbness on the outer thigh, sometimes extending into the groin. Similarly, the ilioinguinal nerve can become entrapped, causing neurological pain distinct from a muscle strain.
Recognizing Warning Signs and Seeking Diagnosis
While most cases of groin pain are not serious and resolve with conservative measures, certain symptoms signal the need for immediate medical attention. Sudden, excruciating pain, especially if accompanied by nausea, vomiting, or dizziness, should be evaluated urgently. Other red flags include pain accompanied by a fever or chills, which can indicate an infection like PID or a severe UTI, or pain coupled with unexplained vaginal bleeding.
Any pain severe enough to prevent weight-bearing or walking also requires prompt assessment to rule out a fracture or serious hip injury. Seeking a diagnosis typically begins with a thorough medical history and physical examination to assess tenderness and range of motion. Imaging tests, such as ultrasound, X-rays, or Magnetic Resonance Imaging (MRI), are often used to visualize the internal structures, helping to distinguish between a muscle injury, a gynecological problem, or a hernia.