Groin pain in females is discomfort where the upper thigh meets the abdomen. This region is a complex junction of muscle, bone, nerves, blood vessels, and internal organs. Because of the wide variety of structures in this small anatomical space, the source of pain is often difficult to pinpoint without medical evaluation. Pain can originate from a simple muscle pull, a chronic joint issue, or a problem with a reproductive organ.
Musculoskeletal and Joint-Related Causes
Orthopedic issues are a frequent cause of groin discomfort, especially among active women, as the hip joint is a major weight-bearing structure. Pain often originates directly from the hip joint itself. Degenerative conditions like hip osteoarthritis, where the protective cartilage wears down, cause a deep, aching pain that worsens with activity and may lead to morning stiffness.
A labral tear, involving the cartilage ring lining the hip socket, is another common source. This tear often causes a sharp, catching, or clicking sensation that radiates into the groin. A related structural issue is femoroacetabular impingement (FAI), where extra bone grows along the hip, causing them to rub against each other during movement. This leads to sharp pain when twisting or squatting.
Soft tissue injuries are also highly prevalent, typically presenting as sudden, sharp pain during physical activity. A muscle strain, or “pulled groin,” occurs when the adductor muscles on the inner thigh or the hip flexor muscles are overstretched or torn. These injuries are common in sports requiring rapid changes in direction, running, or jumping, and the pain worsens with continued leg movement.
Stress Fractures and Pelvic Pain
Less obvious causes include stress fractures, which are tiny cracks in a bone from repetitive force. These can occur in the pubic bone or the femoral neck, causing pain that initially appears mild but becomes persistent and severe over time, making weight-bearing difficult.
The pubic symphysis, the cartilage joint connecting the two halves of the pelvis, can also be a source of pain. Symphysis pubis dysfunction (SPD) involves inflammation and irritation of this joint. SPD is common during or after pregnancy due to hormonal changes and increased mechanical stress on the pelvis. This condition often results in an aching or pinching pain in the groin or inner thigh, provoked by activities like climbing stairs or separating the legs.
Gynecological and Pelvic Organ Sources
Many groin pain complaints originate from the reproductive organs, with pain often referred from the deeper pelvis. Ovarian cysts, which are fluid-filled sacs on the ovary, are a common source of discomfort. While most cysts are harmless, a large cyst or ovarian torsion (where the ovary twists) can cause sudden, severe, unilateral pain that radiates into the groin.
Endometriosis is another significant cause, involving the growth of uterine-lining-like tissue outside the uterus. This misplaced tissue responds to the menstrual cycle, leading to chronic inflammation and pain. This pain can feel sharp or burning in the lower abdomen and radiate to the groin and legs. Scar tissue and adhesions resulting from endometriosis can also contribute to chronic groin pain, especially during physical activity.
Pelvic inflammatory disease (PID), an infection of the female reproductive organs, can also manifest as groin pain. PID is often a complication of sexually transmitted infections. The resulting infection and inflammation irritate nerves and tissues, causing pain that spreads into the groin area. Prompt treatment is necessary to prevent long-term complications.
Pregnancy-Related Causes
Pregnancy introduces specific causes of groin pain, most notably round ligament pain. The round ligament connects the uterus to the groin. As the uterus rapidly expands during the second and third trimesters, this ligament stretches. This causes sharp, stabbing sensations in the groin, often triggered by sudden movements like coughing. Uterine fibroids, which are non-cancerous growths, can also cause groin discomfort if they are large or press on surrounding structures, leading to a feeling of heaviness.
Abdominal Wall and Urogenital Conditions
Pain in the groin can stem from issues involving the abdominal wall or the urinary system. Hernias are a common cause, occurring when tissue bulges through a weak spot in the abdominal muscles. Inguinal hernias push through the inguinal canal, while femoral hernias, which are more common in women, occur slightly lower.
Hernias in women are often subtle, frequently lacking an obvious visible bulge. Instead, they present as an aching or burning sensation in the groin that intensifies with activities like lifting or coughing. Because these hernias can be smaller and deeper, they are sometimes misdiagnosed as gynecological pain. The discomfort often stems from pressure on surrounding nerves, such as the ilioinguinal nerve.
Urogenital and Nerve Issues
Urogenital issues frequently refer pain to the groin region. Kidney stones, which are hard deposits of minerals, typically cause intense, sharp pain in the side or back. As they move down the urinary tract, this pain can radiate powerfully into the groin. Urinary tract infections (UTIs) can also cause groin pain due to inflammation, often accompanied by increased urinary frequency or burning.
Nerve entrapment syndromes involve a nerve becoming compressed or irritated, causing pain, numbness, or tingling. Meralgia paresthetica involves the lateral femoral cutaneous nerve, leading to burning pain and numbness on the outer thigh, which may be perceived as groin discomfort. Irritation of the ilioinguinal or genitofemoral nerves, sometimes following surgery or due to a hernia, can also cause chronic pain localized deep within the groin.
When to Seek Emergency Medical Care
While many causes of groin pain are not urgent, certain symptoms indicate a medical emergency requiring immediate attention. Sudden, severe, or debilitating groin pain that comes on without warning should be evaluated urgently. This acute onset pain could signal a serious condition, such as ovarian torsion or a complicated kidney stone.
Immediate care is necessary if the pain is accompanied by other severe symptoms. These signs may indicate a severe infection or a life-threatening structural issue:
- High fever, chills, or persistent nausea and vomiting.
- Inability to bear weight on the leg or hip following a trauma, which may indicate a bone fracture.
- A hernia that suddenly becomes much more painful or is associated with redness, warmth, or inflammation.
- A visible lump in the groin that cannot be gently pushed back in, suggesting a potential strangulated hernia.
A strangulated hernia occurs when the blood supply to the trapped tissue is cut off, requiring immediate medical assessment.