Pain below the belly button may be experienced by anyone at any age, although it is more common in adult women of reproductive age. This pain commonly derives from the ovaries, uterus, stomach, and general abdominal region. It may be acute, intermittent, or chronic. As there are often different causes based on gender, we will discuss them accordingly.
Pelvic pain specific to women may be caused by problems in the female reproductive system, which includes the ovaries, fallopian tubes, uterus, cervix, and other associated organs and tissues.
Menstrual cramps - also called dysmenorrhea, these are dull, throbbing or cramping pains experienced just before and during menstrual periods. These may vary in intensity, from mild to severe, and can interfere with daily activities for a few days. The pain may also radiate to the lower back and thighs. Other symptoms include nausea, vomiting, dizziness, loose stools, and sweating.
Mittelschmerz - a German word that means "middle pain," since it usually occurs in the middle of a woman's menstrual cycle. It is characterized by a one-sided, usually mild, lower abdominal pain associated with ovulation and not related to any medical problem.
Endometriosis - a painful condition associated with the growth of uterine lining tissues outside the uterus, leading to bleeding, irritation, scarring and adhesions that can later result in infertility. Accompanying symptoms include diarrhea or constipation, nausea, bloating, pain during bowel movement, urination and/or sex, dysmenorrheal, excessive menstrual bleeding and bleeding between periods.
Adenomyosis - a condition where tissues from the uterine lining invade or grow inside the muscular walls of the uterus, causing severe cramping or sharp, pelvic pain that worsens with age. It is also associated with heavy or prolonged menstrual bleeding, bleeding between periods, and pain during intercourse.
Uterine fibroids - uterine growths or tumors that are not cancerous, but may cause pain below belly button. These may be accompanied by heavy menstrual bleeding, prolonged menstrual periods, frequent urination, difficulty emptying the bladder, constipation, backache, or leg pains.
Ovarian cysts - small fluid filled sacs in the ovary often do not cause symptoms, except when they increase in size and press on other organs, rupture and bleed, or twist. It can cause a constant or intermittent dull aching pain that may radiate to the lower back and thighs. It may be associated with a fullness or heaviness in the abdomen, pain during intercourse or bowel movements. The symptoms may sometimes mimic pregnancy, as they include nausea, vomiting, and breast tenderness.
Ectopic pregnancy - occurs when a fertilized egg is implanted outside the uterus. It will instead attach to an ovary, inside one of the fallopian tubes, or elsewhere in the abdomen. This usually occurs in the early weeks of pregnancy and causes intense pain, vaginal bleeding, lightheadedness, fainting, and circulatory shock. A pregnancy test and imaging studies will confirm this diagnosis.
Miscarriage - loss of a pregnancy during the first 20 weeks will result in severe lower abdominal pain below the belly button that may radiate to the lower back. It is also accompanied by vaginal bleeding and passage of fetal tissue.
Pelvic inflammatory disease (PID) - an infection that involves the female reproductive tract, it is usually caused by sexually transmitted disease, recent abortion, or insertion of an IUD (intrauterine device). It may be associated with a constant dull pain that gets worse with bowel movements, urination, and sex. It is also characterized by a yellow to green, foul smelling vaginal discharge.
Ovarian cancer - this does not usually cause symptoms until later, when a patient might experience lower abdominal pain associated with bloating, heaviness, and difficulties with urination and bowel movements. Changes in menstrual periods, loss of appetite, fatigue, and weight loss may also occur.
Prostatitis - lower abdominal pain in men may be caused by the swelling and inflammation of the prostate gland, a walnut-shaped gland that produces semen and is located directly below the bladder. It often causes pain in the groin, pelvic area or genitals, painful or difficult urination, and sometimes flu-like symptoms, including fever.
Other less common causes of pain below belly button that can occur in either male or female include diverticulitis, Crohn's disease, irritable bowel syndrome, fibromyalgia, ulcerative colitis, sciatica, and colon cancer. These usually cause a chronic or persistent set of symptoms associated with abdominal pain.
If you suddenly develop severe abdominal pain, it may be a medical emergency and you should seek immediate medical attention. Be sure to get appropriate medical evaluation of your pelvic pain by your doctor if it is a new symptom, if it causes a disruption in your daily life, or if the pain and any other symptoms worsen over time.