Groin pain in women most commonly comes from a muscle strain, but it can also stem from hip joint problems, hernias, gynecological conditions, nerve issues, or pregnancy-related changes. Because so many different structures converge in the groin, pinpointing the cause often depends on exactly where the pain is, what triggers it, and what other symptoms come along with it.
Muscle Strain: The Most Common Cause
The single most frequent reason for groin pain in women is a pulled or torn muscle. The muscles most often involved are the adductors, a group of muscles running along the inner thigh that pull your legs toward midline. These strains happen when the muscle is overstretched or forced to contract too quickly, common during activities like sprinting, changing direction, kicking, or even slipping on ice.
A mild to moderate adductor strain typically heals in one to two months. You’ll usually feel a sharp or pulling sensation on the inner thigh near the groin that gets worse when you squeeze your legs together, stretch, or push off while walking. More severe tears can cause bruising and significant weakness. Rest, ice, and gradual strengthening exercises are the standard approach, though a complete tear occasionally requires surgical repair.
Hip Joint Problems
The hip joint sits deep in the groin area, so problems inside the joint often show up as groin pain rather than pain on the outside of the hip where most people expect it. Two hip conditions are especially worth knowing about.
Hip Osteoarthritis
Osteoarthritis develops when the cartilage cushioning the ball-and-socket joint gradually wears thin. The result is a deep, achy groin pain that tends to be worst in the morning or after sitting for a while, then loosens up with gentle movement. Over time, you may notice your hip becoming stiffer and harder to rotate. This is more common after age 50 but can appear earlier in women who’ve had hip injuries or structural differences in the joint.
Hip Labral Tear
The labrum is a ring of cartilage lining the rim of the hip socket. When it tears, you typically feel pain in the hip or groin that worsens with long periods of standing, sitting, walking, or athletic activity. A clicking, catching, or locking sensation in the hip is a hallmark sign. Some women are born with hip shapes that make labral tears more likely: a shallow socket, a socket that doesn’t fully cover the ball of the thighbone, or extra bone along the rim that pinches the labrum over time. An MRI is usually needed to confirm the diagnosis.
Hernias in Women
A hernia happens when tissue pushes through a weak spot in the abdominal wall. In the groin, two types matter most.
Inguinal hernias are the most common type overall, making up about 80% of abdominal wall hernias. They’re far more frequent in men (roughly a 7:1 ratio), but women do get them. You may notice a bulge in the groin that becomes more visible when you cough or strain, along with a dull ache that worsens throughout the day.
Femoral hernias are less common overall but actually occur more often in women than in men, with a female-to-male ratio of roughly 1.8:1. These hernias appear lower in the groin, just below the crease where the leg meets the abdomen, and tend to affect the right side about twice as often as the left. Femoral hernias are more concerning because they have a much higher rate of becoming trapped (incarcerated). In one review, nearly 64% of femoral hernias were incarcerated at the time of diagnosis, compared to only about 5% of inguinal hernias. That means femoral hernias often need prompt surgical attention.
A sports hernia, or athletic pubalgia, is a different problem. It’s not a true hernia with a visible bulge but rather a strain or sprain of soft tissue in the lower abdomen or groin, usually caused by repetitive or explosive movements in sports. The pain tends to be insidious and progressive, worsening with exertion or bearing down.
Gynecological Conditions
Several conditions involving the reproductive organs can send pain into the groin or make it hard to distinguish pelvic pain from true groin pain.
Ovarian cysts are fluid-filled sacs that form on or inside the ovaries. Small ones often cause no symptoms at all, but larger cysts can create a lingering pressure or ache on one side as they push against nearby structures like the bladder. A cyst that ruptures or twists (ovarian torsion) causes sudden, severe pain that requires emergency care.
Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus and attaches to other organs in the pelvis. These growths trigger inflammation and can form scar tissue that binds organs together. The resulting pain is often cyclical (worse around your period) but can become constant over time, radiating into the groin, lower back, or thighs.
Fibroids, which are noncancerous growths in the uterine wall, don’t usually cause groin pain unless they’re large enough to press on surrounding organs or nerves. Adenomyosis, a related condition where uterine lining grows into the muscular wall of the uterus, can produce pain that radiates down one or both legs.
Pregnancy-Related Groin Pain
Groin pain during pregnancy is extremely common and usually traces back to a condition called symphysis pubis dysfunction (SPD). The two halves of your pelvis are connected at the front by a joint called the pubic symphysis. During pregnancy, your body produces a hormone called relaxin that loosens the ligaments holding this joint together, allowing the pelvis to widen for delivery. Your body can start releasing this hormone as early as 10 weeks into pregnancy.
The loosening is necessary for childbirth, but it also makes the joint unstable. Combined with the extra weight your pelvis is carrying, this instability can cause sharp or grinding pain right at the front of the groin, especially when walking, climbing stairs, rolling over in bed, or standing on one leg. The pain can range from mildly annoying to severely limiting. Physical therapy focused on pelvic stability, supportive belts, and modifying how you move (keeping your knees together when turning in bed, for instance) are the main ways to manage it.
Nerve Entrapment
Nerves passing through the groin can become compressed or irritated, producing burning, numbness, or shooting pain that doesn’t quite match a muscle injury pattern. The obturator nerve, which provides sensation to the inner thigh and portions of the hip and knee, is one common culprit. It can become entrapped from swollen ligaments, endometriosis pressing on surrounding tissue, or prolonged pressure during activities like cycling or horseback riding. Pain that worsens specifically with side-to-side leg movements is a characteristic sign.
Childbirth is another trigger. Positioning your legs wide apart during delivery can stretch or compress the obturator nerve, and bleeding or swelling in the pelvis after a difficult delivery can put pressure on it as well. Other nerves in the region, including the ilioinguinal nerve, can be irritated after abdominal or pelvic surgery when scar tissue forms around them.
Kidney Stones and Urinary Causes
A kidney stone passing through the ureter (the tube connecting the kidney to the bladder) can cause intense, wave-like pain that starts in the back or flank and radiates down into the groin on the affected side. This pain typically comes on suddenly, shifts in intensity, and is often accompanied by nausea, blood in the urine, or a frequent urge to urinate. Urinary tract infections can also cause lower abdominal and groin discomfort, though the primary symptoms are usually burning with urination and urgency.
How Groin Pain Gets Diagnosed
Because so many different structures can be responsible, getting to the right diagnosis usually follows a step-by-step process. Your doctor will start with your history and a physical exam, paying close attention to exactly where the pain is, what movements reproduce it, and whether there’s a visible bulge or swelling. Blood work and urine tests help rule out infection or kidney stones.
For pain that localizes to the pelvis or lower abdomen in women, a pelvic ultrasound is typically the first imaging step. It can identify ovarian cysts, fibroids, and some hernias without radiation. If ultrasound doesn’t provide an answer, or if a hip joint problem or sports hernia is suspected, an MRI of the pelvis is the next step. For sports hernias specifically, imaging guidelines generally call for at least six weeks of conservative treatment before ordering an MRI, unless symptoms are severe or worsening. A plain X-ray may be done early on to check for arthritis or bone abnormalities in the hip.
Signs That Need Urgent Attention
Most groin pain is not an emergency, but certain combinations of symptoms warrant immediate medical care: groin pain with fever, nausea or vomiting, sudden severe pain in a known hernia site, or visible swelling with skin color changes near a hernia. Sudden, intense one-sided pelvic pain in a woman of reproductive age could indicate a ruptured ovarian cyst or ovarian torsion, both of which need rapid evaluation. Pain accompanied by inability to bear weight or a visible deformity suggests a possible fracture, particularly in older women with osteoporosis.