Groin pain in females can be challenging to diagnose, as the groin area contains structures from the musculoskeletal system, reproductive organs, urinary tract, gastrointestinal tract, and nerves. Pinpointing the source requires careful consideration due to anatomical complexity and pain radiation. Understanding the diverse origins of groin pain helps in recognizing potential causes.
Musculoskeletal Pain
Musculoskeletal issues frequently cause groin pain, affecting hip and pelvic muscles, bones, joints, and ligaments. Muscle strains, particularly of the adductor muscles or hip flexors, result from sudden movements or overuse. These strains cause sharp pain that worsens with movement and may be tender. Hip joint problems like osteoarthritis or a labral tear can also manifest as groin pain.
Femoroacetabular impingement (FAI), a hip condition with extra bone growth, can lead to groin discomfort. Stress fractures, tiny bone cracks from overuse, can occur in the pelvis or upper thigh bone, causing deep, aching groin pain that intensifies with activity. Ligament sprains, such as pubic symphysis or sacroiliac joint sprains, can also cause groin pain.
Gynecological and Reproductive System Pain
Pain originating from the female reproductive system commonly causes groin discomfort. Ovarian cysts can cause sharp or dull pain in the lower abdomen and groin, especially if ruptured or twisted. Endometriosis, growth of uterine-like tissue outside the uterus, frequently causes chronic pelvic and groin pain, often worsening during menstruation. Pelvic inflammatory disease (PID), a reproductive organ infection, can also lead to lower abdominal and groin pain, sometimes with fever and unusual discharge.
Uterine fibroids, non-cancerous uterine growths, may cause groin pressure or pain by pressing on nearby organs. Pregnancy-related changes also contribute to groin pain. Round ligament pain, a sharp groin or lower abdomen sensation, occurs as the uterus grows and stretches its supporting ligaments. Pelvic girdle pain is common during pregnancy and can cause discomfort in the groin, hips, and lower back.
Pain from Other Internal Organs
Groin pain can also be referred from other internal organ systems, making diagnosis challenging. Urinary tract infections (UTIs) may cause lower abdominal and groin discomfort, with painful urination and frequent urges. Kidney stones, hard kidney deposits, can lead to severe, colicky pain that radiates from the back or side down into the groin as they move.
Conditions affecting the gastrointestinal tract can also refer pain to the groin. An inguinal hernia, a protrusion of intestine or fatty tissue, often presents as a bulge and discomfort that worsens with straining. Appendicitis, appendix inflammation, starts as pain around the navel that shifts to the lower right abdomen, but can sometimes be felt in the groin. Diverticulitis, colon pouch inflammation, and irritable bowel syndrome (IBS) can also cause abdominal pain that may extend to the groin.
Neurological Causes of Pain
Nerve involvement or entrapment can result in groin pain with specific sensations beyond typical muscle aches. Nerve entrapment occurs when a nerve is compressed or irritated by surrounding tissues, leading to burning, tingling, numbness, or shooting pain. The ilioinguinal nerve, supplying sensation to the inner thigh, groin, and external genitalia, is a common site for entrapment. Compression of this nerve can cause burning or aching pain in these areas, often worsened by hip extension.
The obturator nerve is another nerve that can cause groin pain when compressed. It provides sensation to the inner thigh and supplies hip adduction muscles. Obturator nerve entrapment can lead to pain along the inner thigh that may radiate to the groin, sometimes a deep ache. These neurological pains can also be accompanied by muscle weakness or changes in sensation within the affected nerve distribution.
When to Seek Medical Attention and What to Expect
Recognizing when to seek medical attention for groin pain is important, especially with certain symptoms. Severe, sudden onset of pain, particularly if it radiates or includes fever, chills, nausea, or vomiting, warrants immediate medical evaluation. Pain that prevents standing or bearing weight, or pain that develops suddenly during pregnancy, indicates urgent care is needed. Any groin pain that is persistent, worsening over time, or associated with a noticeable lump or bulge should prompt a healthcare visit.
When seeking medical attention for groin pain, a doctor will begin by taking a medical history, asking about its nature, duration, and accompanying symptoms. A physical examination will follow, involving hip range of motion, groin palpation for tenderness or bulges, and assessment of muscle strength and nerve function. Depending on initial findings, further diagnostic tests may be recommended, including imaging studies (ultrasound, MRI), blood tests for inflammation or infection, and urine tests. An accurate diagnosis is important for effective treatment and management.