Why Do Women Experience Groin Pain—and Is It Serious?

Groin pain sometimes signals a recent injury to the area and often goes away within a few weeks. Osteoarthritis is another potential cause of chronic (long-term) groin pain.

The anatomy of the groin itself is complex, and nearby organs can also sometimes cause pain in this area.

Some important structures to understand are:

• Abdominal wall muscles: The external oblique, internal oblique, and transverse abdominis muscles all pass through this area.
• Inner thigh and hip muscles: Important muscles include the adductor longus, adductor brevis, iliopsoas, pectineus, and gracilis. Each of these muscles is also connected to a tendon, so tendon strains and tendinitis can be other sources of pain.
• The hip joint: The hip bone, ischium, and pubis come together and meet the femur (thigh bone) to help you move your hip.
• Reproductive organs: In women, the abdomen houses the ovaries, as well as thin tubes called fallopian tubes that connect the ovaries to the uterus (uterus).
• Urinary organs: Urine passes from the kidneys (at the back of the body) to the bladder and finally through the urinary opening.
• Digestive organs: Important abdominal organs include the large intestine, which contributes to the final stages of stool (poop) elimination, and the appendix, a short outgrowth of the large intestine.

The specific nature of groin pain and its accompanying symptoms can help a healthcare professional determine potential causes.

Sudden muscle strain or other injury

A muscle strain, or pulled muscle, can occur when a muscle is overstretched and partially torn during a quick run, jump, or side step.

In the case of a pulled muscle, you will likely notice the pain and injury immediately, and you may hear a popping noise.

Depending on the severity, you might also develop bruising and swelling in the area. You may also have difficulty lifting your leg or bringing your leg closer to the midline.

Other injuries are also possible, such as a stress fracture of one of the thigh or pelvic bones or damage to surrounding tendons, ligaments and nerves.

Chronic muscle injury (sports pubalgia)

Professional and amateur athletes are particularly prone to a type of long-term groin pain, sometimes called “athletic pain.” pubalgia,”, “groin pain syndrome” or “sports hernia” (although it is not a hernia).

These injuries are common in sports that require rapid acceleration and turning and that put a lot of strain on the muscles of the lower abdomen and thighs, such as football.

In sports pubalgia, the pain evolves gradually over several months. At first it may be sudden and intense, then dull or burning. The pain is usually deep in the groin, but can also be felt in the lower abdomen and inner thigh.

Sudden accelerations, twisting, cutting movements, sit-ups and coughing can make the pain worse. The pain usually goes away with rest, but returns if you return to sports without proper care.

Urinary system problems

A urinary tract infection (UTI) can cause pressure or cramping in the groin or lower abdomen. Women are much more at risk of urinary infections than men. A UTI can also cause pain when urinating and frequent urination.

If you have a fever and the pain begins to spread down your sides and back, it may indicate a more serious infection that has reached your kidneys (pyelonephritis).

Kidney stones are stone-like materials that form in the kidneys and cause pain when they enter the urinary tract. They can cause bloody urine and sometimes intense, sharp pain, which you might feel in your lower abdomen, back, side, or groin.

Hip arthritis

Arthritis of the hip can cause groin pain that tends to get worse during vigorous activity, but can also occur at rest. You may feel pain in your groin that radiates (travels) to your knee or buttocks.

Joint stiffness can make walking difficult and limit your range of motion. You may also notice the joint locking up and hear a grinding noise during movement.

The most common cause of hip arthritis is osteoarthritis, in which the cartilage in the hip joint wears down and degenerates over time. It is more common with age (over 50).

Other types of arthritis, including psoriatic, rheumatoid, and infectious arthritis, can also affect the hip. These usually cause additional symptoms and affect multiple joints.

Groin hernia

In a groin hernia, underlying tissues and organs push through a weakness in the lowest part of the abdominal wall, causing a bulge in the groin area. This area may be painless or have painful pain or discomfort, especially when bending, lifting, or coughing.

Some people think that women cannot have a hernia in the groin, but that is not true. However, women are less likely to have a hernia than men. Advanced age is a major risk factor.

Ovarian torsion or other reproductive system problems

In an ectopic pregnancy, a fertilized egg implants outside the uterus, usually in a fallopian tube. This can cause pain in the groin, lower abdomen, or back, as well as other pregnancy symptoms, like missed periods and tender breasts.

If the fallopian tube bursts, it can be a life-threatening emergency.

Ovarian torsion is another medical emergency in which the affected ovary (and sometimes the fallopian tube) twists, limiting blood supply to the ovary. This occurs in people with a growth, such as an ovarian cyst, on the affected ovary.

The pain usually appears suddenly and sharply, usually in the lower abdominal area, but you can sometimes feel it in the groin.

Other causes

There are other, less common causes of pain in or near the groin. Some cancers can cause pain in the area, or a pinched nerve can cause burning and tingling.

Developmental problems with the hip, such as femoroacetabular impingement, can predispose a person to pain later in life.

If you are experiencing moderate to severe groin pain following a recent injury, it is a good idea to get checked out by a healthcare professional.

Don’t ignore groin pain that develops gradually. For athletes suffering from sports rash or related conditions, experts can help you determine the cause and best treatment option.

Get medical attention promptly if your groin pain develops more quickly and is accompanied by other symptoms, such as fever, nausea, severe pain, or pain radiating to the side or back.

Your medical history is essential in diagnosing the underlying cause of your groin pain. The type of pain, its exact location, its onset, and accompanying symptoms all provide important clues to your doctor.

The medical examination is also important. Your doctor will likely check for tenderness in the area and surrounding areas. They can also check muscle strength and range of motion.

A medical history and examination is sometimes enough to diagnose the cause of groin pain. In certain circumstances, additional testing may be necessary. Tests may include:

• Basic blood tests to check for infection, inflammation, and general health, such as a complete blood count (CBC)
• Pregnancy test
• Urine tests, for example to look for signs of urinary tract infection (UTI)
• Imaging tests such as computed tomography (CT) for conditions such as kidney stones

Imaging tests can offer more specific information about chronic groin pain, such as the pain experienced by athletes. These may include ultrasound, x-rays, MRI, or other tests.

Treatment for groin pain depends on the underlying cause.

If there is a strain in the groin, it is important to rest the muscle while it heals. Elevate the injured area and apply ice several times during the first day or two. Pain relievers like Advil (ibuprofen) or Tylenol (acetaminophen) may also help.

Physical therapy (PT) can also help with more serious strains, but only after the area has healed. Physical therapy can help strengthen your muscles and improve your range of motion.

Seeing a physical therapist within one to two weeks can help symptoms improve sooner. It may still be weeks or more before you can safely return to sports activities, putting you at risk of straining the muscle.

Athletes with chronic (long-term) groin pain may benefit from similar strategies, and orthopedic sports specialists may be particularly helpful in guiding treatment.

Steroid injections and compression garments may also be beneficial. Some people may eventually need surgical procedures.

Other potential treatments include: