Written on June 26, 2023 by Amy Harris, MS, RN, CNM. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.
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We all know that familiar but unwelcome feeling of a stomach ache. Figuring out how to make it go away can be tricky because many different things can cause abdominal pain. Indigestion after a spicy meal, constipation, a nasty GI bug, and even sometimes sexually-transmitted infections (STIs) are all possible causes of abdominal pain. So how worried about STIs should you be the next time you have abdominal pain? Keep reading to learn more about which STIs can cause abdominal pain.
Abdominal pain is any pain coming from your belly area. It does not necessarily come from your stomach, even though people often complain of stomach aches when they have abdominal pain. Many organs in your belly region, such as your stomach, liver, gall bladder, pancreas, small intestine, and large intestine, can cause pain.
The nerves, connective tissue, muscles, or skin covering your abdomen can also cause abdominal pain. You can also experience something called referred pain, which means the cause of the pain may be located far away from where you actually feel it. For example, people sometimes have referred abdominal pain when having a heart attack.
The good news is that most causes of abdominal pain are temporary and not something to worry about. The most common causes of non-serious belly pain are digestion, menstruation, or a temporary infection. Other causes of abdominal pain are injury and disease.
Many healthcare providers sometimes wish it was easier to tell the difference between pelvic pain and abdominal pain. The pelvis is the lower part of your belly region, which holds the following organs in females and people assigned female at birth (AFAB): uterus, ovaries, fallopian tubes, bladder, cervix, vagina, and rectum. In men or those assigned male at birth (AMAB), the pelvis is home to the bladder, prostate, seminal vesicles, and rectum.
It is not always easy to tell whether your pain is in your pelvis or abdomen. STIs are more likely to cause pelvic pain than abdominal pain. Most STIs start in the rectum, vagina, or urethra and then travel upwards into other organs in the pelvis. As the infection spreads, inflammation grows, and you feel pain.
When an STI spreads from the vagina, through the cervix, and up into the uterus, ovaries, or fallopian tubes, the resulting infection is called pelvic inflammatory disease (PID).[5,6] STIs cause most (85%) PID cases. PID affects more than 1 million women or those AFAB in the U.S. annually and causes chronic pelvic pain in as many as one out of every three women who have PID.
People tend to feel pelvic pain lower down in their abdomen and especially during their period, when having sex, during a bowel movement, or when urinating (peeing). In contrast, abdominal pain is more likely to be triggered by eating than pelvic pain. A temporary inflammation from an infection, flu, stomach bug, or stomach ulcer may also cause abdominal pain.
If you have sex — oral, anal, or vaginal intercourse and genital touching — you can get an STI (sometimes also known as a sexually transmitted disease or STD). Of the dozen STIs followed by the U.S. Centers for Disease Control (CDC), several can cause abdominal pain. They include:
Genital herpes and human papillomavirus (HPV) do not cause abdominal pain. Late-stage HIV and syphilis rarely cause abdominal pain. If HIV progresses and is not treated, people become more ill. The lymph nodes in their abdomen can swell, and they may experience diarrhea, which could cause abdominal pain. There have been several cases of people with syphilis who experience gastritis (a painful stomach inflammation), but this is relatively uncommon.
Viral hepatitis is an infection of your liver with a virus. Hepatitis A and B can be transmitted sexually, but hepatitis C is less often transmitted through sexual contact. When infected with the Hepatitis A, B, or C virus, you may initially not have any symptoms. Some people develop acute hepatitis with fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, light-colored stools, joint pain, and jaundice (yellowing of your skin and whites of your eyes). Acute hepatitis usually develops anywhere between 2 weeks to 6 months after you first become infected with the virus. Symptoms of chronic viral hepatitis may take years to develop and may or may not include abdominal pain.
The most common STIs are the two most likely to cause abdominal pain – gonorrhea and chlamydia.[5,7] They are also the two STIs most commonly responsible for PID — a significant source of pelvic pain that you might feel as abdominal pain.[5,6] It can be difficult to tell the difference between gonorrhea and chlamydia symptoms, so testing helps ensure you get the correct treatment for your abdominal pain.
An emerging STI, Mycoplasma genitalium (mGen), typically does not cause noticeable symptoms early on in the infection, but if untreated, it can also lead to PID, pelvic pain, and chronic pain.
The Cleveland Clinic advises you to “always seek medical care if your abdominal pain is unexplained, persistent or severe.” Other warning signs that you shouldn’t ignore your abdominal pain are[1,3,4-6]:
The more symptoms you have on this list, the more critical it is that you have a healthcare provider evaluate what could be causing your abdominal pain. STI symptoms can come and go, which can be confusing, but they rarely go away on their own, and if not treated, can have lasting consequences for your health and well-being.
STIs can be asymptomatic, meaning even if you don’t have abdominal or pelvic pain (or any other symptoms, for that matter), you could still have an STI. That is why it is a good idea to get tested for STIs regularly.
Knowing how often to test for STDs can be challenging. The answer depends on your risk factors. You can always discuss the best sexual health screening regimen with a healthcare provider via a sexual health consult telehealth visit.