The groin is the anatomical region where the lower abdomen meets the inner thigh. Pain in this area for females can originate from a wide range of body systems, including musculoskeletal structures, reproductive organs, and the digestive or urinary tracts. This information serves as guidance, not as a replacement for a medical diagnosis from a healthcare provider.
Musculoskeletal and Hip-Related Causes
The most common cause of acute groin discomfort, especially in physically active individuals, stems from surrounding muscles and tendons. An adductor muscle strain, often called a groin pull, involves overstretching or tearing the inner thigh muscles. This injury typically causes sharp, immediate pain during activities like sprinting or rapid changes in direction, followed by a persistent ache. Hip flexor strains, involving muscles like the iliopsoas, cause discomfort when lifting the knee toward the chest or during prolonged sitting.
Pain originating from the hip joint often projects directly to the groin due to shared nerve pathways. A hip labral tear involves the ring of cartilage lining the hip socket, causing deep, intense groin pain that may include a clicking or catching sensation. This pain is worsened by prolonged standing, sitting, or athletic activity.
Other structural issues in the hip also manifest as groin pain. Hip osteoarthritis, where cartilage wears down, causes a dull, persistent ache that worsens over time and limits range of motion. Stress fractures in the pelvis or upper thigh bone, common in runners, present with pain that increases with weight-bearing activities. These mechanical pains are exacerbated by movement.
Pain Originating from Reproductive Organs
Groin pain specific to females often involves the reproductive system, presenting as cyclical, sudden, or systemic pain. Ovarian cysts are fluid-filled sacs that form on the ovaries; while most are asymptomatic, a large cyst can cause a dull ache or sharp pain on the affected side. Severe complications occur if a cyst ruptures or causes ovarian torsion (twisting of the ovary and its blood supply). This triggers sudden, severe, one-sided abdominal or groin pain, often accompanied by nausea and vomiting.
Endometriosis, where tissue similar to the uterine lining grows outside the uterus, can cause pain that refers to the groin, hip, and lower back. This discomfort is often chronic or cyclical, worsening around the menstrual period due to inflammation and tension in pelvic floor muscles. Rarely, endometrial tissue can grow directly in the inguinal canal (inguinal endometriosis), presenting as a painful mass that changes with the menstrual cycle.
Pelvic inflammatory disease (PID), an infection of the upper reproductive tract, typically presents with lower abdominal or pelvic pain that can radiate to the groin. PID is often caused by a sexually transmitted infection and may include fever, unusual vaginal discharge, and painful intercourse. During pregnancy, the stretching of the round ligaments leads to a common, sharp, shooting sensation in the groin or lower abdomen, known as round ligament pain. An ectopic pregnancy, where a fertilized egg implants outside the uterus, is a severe, time-sensitive cause of sharp, one-sided pelvic pain requiring immediate medical attention.
Referred Pain from Abdominal and Urinary Systems
Visceral pain from non-gynecological organs can be perceived in the groin due to converging nerve pathways. Groin hernias occur when tissue pushes through a weak spot in the abdominal wall, causing pain that worsens with coughing, lifting, or straining. Femoral hernias, which protrude near the upper thigh, are more common in women and often present with pain as the first symptom, sometimes without a noticeable bulge.
Kidney stones cause an intense form of referred groin pain, known as renal colic. As a stone moves down the ureter, it causes excruciating, intermittent pain that begins in the flank or back. This pain characteristically radiates forward and downward into the lower abdomen and groin. It is often accompanied by nausea, vomiting, and a frequent or burning urge to urinate.
An advanced urinary tract infection (UTI) that has spread to the kidneys can cause flank pain referring to the groin, alongside fever and cloudy urine. Conditions affecting the digestive tract, such as appendicitis, initially present with vague abdominal pain that shifts to the lower right side and radiates into the groin as inflammation progresses. Swollen lymph nodes in the groin can also cause local pain, indicating infection or inflammation elsewhere in the body.
When to Seek Immediate Medical Attention
Certain symptoms accompanying groin pain signal a medical emergency and require immediate care. Sudden, severe, or debilitating groin pain that comes on without warning should be evaluated urgently, especially if accompanied by fainting or signs of shock (e.g., cold, clammy skin or rapid pulse). This may indicate a serious event like ovarian torsion, a ruptured cyst, or a strangulated hernia, where the blood supply to tissue is cut off.
Groin pain occurring alongside a high fever, chills, or persistent vomiting may suggest a widespread infection, such as advanced PID or a kidney infection. Seek emergency medical care if you notice a painful lump or bulge in the groin that cannot be gently pushed back in, or if the pain follows a major trauma that makes bearing weight impossible.