Some sexually transmitted infections (STIs) can cause discomfort often described as “stomach pain.” This pain is typically located in the lower abdomen or the pelvic region, not the true stomach area. STIs are caused by pathogens passed through sexual contact, leading to inflammation and tissue damage. Recognizing this link is important because abdominal pain, especially when combined with other symptoms, can indicate that an STI has progressed to a more serious stage.
Understanding Abdominal Pain Versus Stomach Pain
The term “stomach pain” is commonly used for discomfort felt in the midsection, but STI-related pain is almost always abdominal or pelvic. The actual stomach is located high in the abdomen, near the ribcage, and is primarily involved in digestion. Pain originating from the stomach usually indicates gastrointestinal issues like ulcers or acid reflux.
STI-related pain, particularly in individuals with female reproductive anatomy, is centered much lower. This discomfort is felt in the lower abdomen, which is the region containing the reproductive organs. This distinction is medically important because lower abdominal or pelvic pain suggests an infection affecting the reproductive tract, while true stomach pain points to a gastrointestinal problem.
The pain from an STI is an inflammatory response in the pelvic structures, not a digestive issue. The discomfort can range from a dull ache or pressure to sharp, severe cramping. Because the pain is internal and deep, many people mistakenly label it as a general “stomach ache.”
Pelvic Inflammatory Disease and Ascending Infection
The most common cause of STI-related lower abdominal pain is Pelvic Inflammatory Disease (PID). PID is an infection of the upper female reproductive organs, including the uterus, fallopian tubes, and ovaries. Bacteria from common STIs, such as Chlamydia trachomatis and Neisseria gonorrhoeae, are the most frequent culprits leading to PID.
This process begins as an “ascending infection,” where bacteria travel upward from the cervix and vagina into the higher reproductive tract. As the microorganisms move, they cause significant inflammation and tissue damage. This inflammatory cascade results in the characteristic dull or cramping pain felt in the lower abdomen.
If left untreated, this infection can cause scarring in the fallopian tubes, leading to long-term complications. The pain is not always severe; PID can be asymptomatic or cause only mild abdominal discomfort. Acute PID, however, presents with intense lower abdominal pain, often accompanied by fever and unusual vaginal discharge.
Specific Infections That Affect the Abdomen
While PID is the major cause of STI-related lower abdominal pain, other sexually transmitted pathogens can cause discomfort through different mechanisms. Certain viral infections, such as Hepatitis B and Hepatitis C, target the liver, which is located in the upper right quadrant of the abdomen. Inflammation of the liver (hepatitis) can cause pain, tenderness, or a feeling of fullness in this area.
These viral infections can cause acute symptoms, including abdominal pain, dark urine, and jaundice (yellowing of the skin and eyes). The abdominal pain is directly related to the liver’s response to the viral attack, a process distinct from the pelvic inflammation seen in PID.
The Human Immunodeficiency Virus (HIV) does not directly cause abdominal pain, but it weakens the immune system, making the body vulnerable to opportunistic infections. These secondary infections, such as Cytomegalovirus (CMV), can affect the gastrointestinal tract and cause severe abdominal issues. Symptoms like chronic diarrhea, nausea, and cramping abdominal pain may be signs of a gastrointestinal opportunistic infection in a person with advanced HIV.
Recognizing Related Symptoms and Seeking Testing
STI-related abdominal pain is rarely the sole symptom and is often accompanied by other specific indicators that help identify the need for medical attention and testing. Common accompanying symptoms include unusual vaginal or penile discharge, pain during sexual intercourse (dyspareunia), or a burning sensation during urination (dysuria).
Other symptoms suggesting a systemic infection include fever, chills, nausea, and irregular menstrual bleeding or spotting. Many STIs, including Chlamydia and Gonorrhea, frequently cause no noticeable symptoms at all. Relying only on the presence of pain is insufficient for diagnosis.
Importance of Testing
Anyone experiencing new or persistent abdominal or pelvic pain, especially if they have risk factors, should seek immediate testing and consultation with a healthcare provider. Self-diagnosing based on pain alone is not recommended because the symptoms are vague and overlap with many other conditions. Prompt diagnosis through testing allows for appropriate antibiotic or antiviral treatment, which prevents the infection from progressing and causing long-term damage, such as infertility or chronic pain.