The mons pubis is a mound of fatty tissue located directly above the pubic bone, covered by skin and, in most adults, pubic hair. This article explores the diverse causes of mons pubis pain, ranging from superficial skin irritations to deeper musculoskeletal and internal conditions.
Anatomy and Function of the Mons Pubis
The mons pubis is situated at the lowest part of the abdominal wall, anterior to the pubic symphysis. It consists primarily of fatty and connective tissue. Its primary function is to cushion and protect the pubic bone from external forces.
Common Skin and Soft Tissue Related Causes
Pain in the mons pubis can stem from conditions affecting the skin and superficial soft tissues. Folliculitis, or inflamed hair follicles, presents as small, red, itchy, or painful bumps, often after shaving or friction from tight clothing. Ingrown hairs occur when a hair grows back into the skin, causing tender, red bumps that can sometimes become infected. These conditions are often localized and may resolve on their own.
Severe localized infections, such as boils and abscesses, can develop in the mons pubis. A boil is a painful, pus-filled lump from a deeply infected hair follicle. Abscesses are larger pus collections causing pain, swelling, and warmth. These infections often require medical intervention for drainage and antibiotic treatment.
Contact dermatitis is a common cause of discomfort, an itchy, red rash from skin contact with an irritant or allergen. Culprits include harsh soaps, detergents, lotions, or friction from tight clothing. Non-infectious lumps like sebaceous cysts (sacs filled with dead skin cells and oil) can also form. While often painless, they can become inflamed or infected, causing tenderness and swelling.
Superficial infections, including sexually transmitted infections (STIs) causing external sores, can cause pain, redness, and lesions. Cellulitis, a bacterial skin infection, presents as spreading redness, swelling, warmth, and pain. Trauma or irritation from activities such as exercise, tight clothing, or minor injuries can lead to localized soreness and bruising.
Musculoskeletal and Internal Causes
Pain can originate from deeper structures like bones, joints, and muscles in the mons pubis area. Osteitis pubis is an inflammatory condition affecting the pubic symphysis. It often results from repetitive stress or injury, causing pain radiating into the groin or lower abdomen. Athletes, especially those in sports with kicking or twisting motions, are commonly affected.
Pubic symphysis dysfunction (PSD) is a condition involving pain in the pubic joint, often observed during pregnancy. Hormonal changes and ligament laxity during pregnancy can lead to pubic symphysis instability, causing sharp or aching pain that worsens with movement. The discomfort associated with PSD can impact daily activities for expectant mothers.
Muscle strains in the inner thigh (adductor) or lower abdominal muscles can refer pain to the mons pubis. Attached near the pubic bone, their overstretching or tearing causes localized tenderness and pain intensifying with movement. Hernias (e.g., inguinal or femoral) can present as pain or a visible bulge in the groin, extending towards the mons pubis. These occur when a part of an internal organ pushes through a weak spot in the abdominal wall.
Post-surgical complications from lower abdominal or pelvic procedures (e.g., C-section, hernia repair) can cause mons pubis pain. Nerve entrapment, less common, can cause chronic pain if a nerve in the groin area becomes compressed or irritated. Specific nerve entrapments can cause burning, tingling, or aching sensations radiating to the mons pubis.
When to Seek Medical Advice
Seek medical evaluation if pain is severe, worsening, or interferes with daily activities like walking or urination. Additional symptoms like fever, chills, or widespread redness and swelling also indicate prompt medical attention.
An unexplained lump, persistent discharge, or new skin changes with pain warrant a healthcare provider visit. If pain persists for more than a few days without improvement, or developed after injury or trauma, seek medical assessment. Pregnant individuals with new or severe mons pubis pain should consult an obstetrician to rule out complications.
Diagnosis and Treatment Overview
Diagnosis for mons pubis pain begins with a medical history review and physical examination. The provider asks about pain’s onset, duration, characteristics, and any triggers. During examination, the area is inspected and palpated for tenderness, swelling, or lesions.
Further diagnostic tests may be needed depending on the suspected cause. Imaging (X-rays, ultrasound, MRI) can visualize bones, joints, soft tissues, and internal structures to identify conditions. Lab tests (blood work, urine analysis, swabs) may detect infections or inflammatory markers. These tests pinpoint the underlying cause, guiding the treatment plan.
Treatment for mons pubis pain varies and is tailored to the underlying cause. General approaches include conservative measures like rest, ice/heat, and over-the-counter pain relievers to manage discomfort and inflammation. For bacterial infections, antibiotics are prescribed, while anti-inflammatory medications may be used for inflammatory conditions. Physical therapy can benefit musculoskeletal causes with strengthening and flexibility exercises. Minor procedures (e.g., draining an abscess or cyst) or surgical intervention (e.g., hernia repair) may be necessary in some instances.