Causes of Groin Pain in Women

If you are a woman who is experiencing pain in your groin, a wide variety of conditions may be to blame.

From commonplace injuries to serious concerns, many different issues have to be considered. To help get to the bottom of your symptoms, read more about the most common causes of female groin pain in the sections below.

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Groin Strain

One of the most common causes of pain in the groin is a muscle strain.

A strain (also known as a pull) occurs when a muscle is overstretched and either partially or completely torn. When this occurs in the groin, it typically involves a group of muscles called your adductors which are located on the inside of your thigh.

Any one of the five adductor muscles (the adductor magnus, adductor brevis, pectineus, adductor longus, and the gracilis) may be involved.

This type of injury typically occurs while performing a sport or exercise that involves:

  • Running
  • Jumping
  • Cutting

In addition to pain in the groin, a strain can make lifting your leg or moving your thigh closer to your other leg painful.

Depending on the severity, a pop may occur during the strain, and bruising or swelling can develop.

Mild strains typically only limit higher-level exercise or activities, while severe sprains can cause pain while you walk or even at rest.

Groin Strain Recovery

Most strains heal on their own, however, this can take up to 8 weeks for more severe injuries.

To help with recovery, your primary doctor may suggest:

  • Using the RICE principle (rest, ice, compression, and elevation)
  • Prescribing anti-inflammatory medication to help reduce pain or swelling
  • Physical therapy to help improve your strength, increase your flexibility, and help guide your return to exercise.

Hip Osteoarthritis

Another extremely common cause of groin pain is osteoarthritis (OA) of the hip.

OA occurs when the smooth cartilage on the end of the ball (femoral head) and socket (acetabulum) portions of the hip joint begins to thin and wear away. This cartilage degeneration causes increased friction with hip movement and can lead to excess bone building up.

Over time, it can also lead to pain in the groin, thigh, or buttocks.

Who Is at Risk for OA?

Osteoarthritis typically occurs in middle or older-aged individuals and is more common in women than in men.

The pain from OA is typically worst in the morning and after a long period of activity.

Other symptoms can help distinguish it from a muscle strain. These include:

  • Joint stiffness (particularly when you wake up)
  • Popping or snapping with hip movement
  • Limitations in the hip’s range of motion

OA is usually treated by your primary doctor who may suggest managing your symptoms with:

  • Heat or ice
  • Weight loss, so less stress is placed on the joint
  • Physical therapy to aid in strengthening the muscles that surround and support the hip
  • Low impact aerobic exercise (like walking or swimming) to help reduce pain and stiffness

If conservative treatments fail, surgery may be necessary. In this case, an orthopedic surgeon typically performs a resurfacing procedure (covering or capping the femoral head with a metal shell) or a total hip replacement.

Hip Impingement

Hip impingement, also known as femoroacetabular impingement (FAI), is another bone-related condition that can lead to groin pain.

This issue occurs when extra bone growth on either the acetabulum or femoral head portion of the hip causes the joint to take on an irregular shape. This abnormal bone growth impacts the congruity of the hip joint and causes pain and joint damage when you move your leg.

The pain from hip impingement is typically centered in the groin, but can also radiate to the outside of the hip.

The soreness is usually deep within the joint and is frequently made worse with movements like bringing your knees towards your chest or crossing your leg. Tasks involving squatting or twisting may also be painful.

Treatment can include:

  • Modifying your activities to avoid irritating movements.
  • Taking non-steroidal anti-inflammatory medications (if directed by your doctor) to help reduce your symptoms.
  • Physical therapy to help decrease the pain by improving the strength and flexibility of your hips.

In more severe cases, an orthopedic surgeon may need to perform surgery on the joint itself. This procedure typically involves removing the excess bone growth on the femoral head or acetabulum and cleaning up any damage it has caused within the hip.

Sports Hernia

In some cases, the pain in your groin could be caused by a condition called a sports hernia.

This issue, which is also known as athletic pubalgia, is a broad term referring to any strain or sprain of a ligament, muscle, or tendon in the lower stomach or groin region.

Sports Hernia vs. Traditional Hernia

Although it is similarly named, this particular syndrome differs from a traditional hernia which involves the bulging of fat or organs through a weak area of muscle or connective tissue

Sports hernias, like adductor strains, traditionally occur while playing activities like hockey or soccer that involve a lot of cutting or quick changes in direction.

The groin pain associated with athletic pubalgia is usually severe while playing sports or exercising, but better with rest.

Unlike a traditional hernia, there is not a palpable bulge in the area of injury (though sports hernias may eventually lead to a traditional hernia if left untreated).

Ultimately, your primary doctor typically treats this condition similar to an adductor strain with:

  • The RICE principle
  • Taking over-the-counter (OTC) pain medications
  • Physical therapy to help build strength in your core, improve flexibility, and gradually reintroduce cutting and sports-related activities.

Hip Fracture

Middle and older-aged women, particularly those who have already gone through menopause, are at a much higher risk of developing osteoporosis. This condition, which causes decreased bone density throughout the body, puts you at a higher risk of experiencing a bone fracture.

One of the most common locations where this can occur is the hip.

Osteoporotic fractures in this area typically affect the femur bone in the region just below the femoral head (the ball portion of the joint). This type of bone break (called an insufficiency fracture) can occur even after a small fall or twist injury. In some cases, the bone is so brittle that even the act of standing or walking can break it.

Hip fractures typically lead to immediate, sharp pain in the groin or upper thigh region. This extreme pain usually makes it nearly impossible to bear weight through your leg.

If you suspect a fracture, you should have your hip immediately assessed by a physician.

This type of injury is diagnosed with an X-Ray and usually needs to be surgically stabilized within a day or two by an orthopedic surgeon to prevent further damage from occurring.

Urinary Tract Infections

Urinary tract infections (UTI) occur when bacteria enters the body via the urethra (the tube through which urine leaves your body) and infects your urinary tract. This issue is more common in:

  • Women due to the shorter distance of their urethra and its proximity to the rectum.
  • People who are pregnant or sexually active
  • Those who are going through menopause
  • Older-aged individuals
  • Children with poor hygiene

UTIs can cause a cramping sensation in your groin or the lower portion of your stomach. They also typically lead to:

  • Burning with urination
  • Frequent urination
  • Blood in the urine

Most urinary tract infections are easily treated by your primary doctor with an antibiotic, so it is important to speak to a physician if you suspect you may have one.

Appendicitis

The appendix is a small, tube-shaped structure located in the lower portion of the right side of the abdomen. While this organ serves no useful purpose, in some cases it can become infected or inflamed. This condition, known as appendicitis, usually affects people in their teens or twenties and is considered a medical emergency.

The pain from appendicitis is typically located on the right side of the lower portion of the stomach near the groin. It may be intermittent initially, but as it progresses the pain becomes severe (especially if the appendix ultimately ruptures).

Along with this sharp pain, you may also experience:

  • Constipation
  • Fever
  • Nausea
  • Vomiting
  • Diarrhea
  • Swelling in the belly

Once the appendicitis is diagnosed with an MRI or CT scan, the structure is typically removed by a general surgeon with a laparoscopic procedure.

If the organ ruptures, however, a more complex abdominal surgery may be needed. Because of this, it is important to see a doctor immediately if you suspect you may have this condition.

Enlarged Lymph Nodes

Throughout your body, a series of bean-shaped nodules called lymph nodes form the lymphatic system. This complex network helps transport nutrients and waste in lymph fluid between the body’s tissue and your bloodstream.

Occasionally, infection or injury in the body causes adjacent lymph nodes to become swollen and painful to the touch. A developing tumor in the area can also cause this issue, though this is much rarer.

One location where this lymph node enlargement is frequently seen is the groin. Nodes in the groin region (called the inguinal or femoral lymph nodes) may grow in size as a result of an injury or infection in your foot, leg, groin, or vagina.

Lymph node pain is typically very focal and the node is frequently able to be palpated under the skin.

Size of Lymph Nodes

While nodes can vary in size, a severely enlarged one can grow to the size of a small olive.

Typically, treating the underlying injury or infection helps to alleviate the lymph node pain and swelling. Occasionally, however, a physical therapist who is skilled in treating lymphedema (swelling of the lymph nodes) may also be needed to resolve this condition.

Kidney Stones

A kidney stone is a small mass of miniature, crystal-like structures that originates in the kidney. These structures occasionally travel from the kidney to the bladder via a tube called the ureter.

Because the ureter is quite narrow, the sharp edges of the stone can scrape against the tube’s walls and cause excruciating pain in the groin or vaginal area. Sharpness in your stomach or on the side of your back may also occur.

The severe pain from a kidney stone is often intermittent and can start and stop randomly. It is frequently accompanied by discoloration or blood in the urine.

In addition, you may notice decreased urine output if you have a stone. In rarer cases, fever, chills, nausea or vomiting can also occur.

In most instances, smaller kidney stones can pass through the body on their own. Staying hydrated by drinking plenty of water can help with this process.

Unfortunately, however, passing a stone is often quite painful, and over-the-counter (OTC) or prescription pain medication may be recommended by your primary doctor.

In rarer cases, the stone is too big and a urologist may need to do a procedure to break up or remove it. Because of this, it is best to speak to a doctor right away if you suspect that you have a kidney stone to ensure you get the appropriate treatment.

Osteitis Pubis

Osteitis pubis refers to the pain and swelling that can occur when the area where your pelvic bones meet (called the pubic symphysis) becomes inflamed.

This condition typically occurs after the core, hip, or groin muscles that attach in this area are overused, such as with:

  • Repetitive jumping
  • Running
  • Kicking
  • Sit-ups

Surgeries to the pelvic area or childbirth may also be to blame, however. 

Osteitis pubis pain is typically located in the groin, lower abdomen, or just above your vaginal area.

Normally this soreness comes on gradually and initially bothers you only with strenuous activity. As the condition progresses, however, the pain can become more intense and can impact daily tasks like standing or walking.

In most cases, your symptoms will resolve by:

  • Modifying your activity
  • Utilizing OTC pain medication
  • Icing the area intermittently

This may take several months to occur, however. In more severe cases, physical therapy and a cortisone injection may be needed to help you get rid of your symptoms. 

Ovarian Cyst

Ovarian cysts are fluid-filled pockets that are located on a woman’s ovaries.

Women have two ovaries, located on each side of the lower part of the abdomen, where their eggs and female hormones are made. Cysts in this area are actually quite common and typically develop during the time frame when ovulation occurs.

These fluid-filled structures normally cause no symptoms, and in most cases they end up disappearing on their own without treatment.

In some situations, however, they can cause pain in the lower abdomen or groin region. This pain is usually only on one side and can be either sharp or dull in nature. It may also be accompanied by:

  • Bloating
  • Constipation
  • Abnormal menstruation
  • Nausea
  • Vomiting

Most cysts, even those that cause pain, will self-resolve in 1 to 3 months.

If a cyst is persistent or of a certain size, removal surgery may be necessary. In some cases, your gynecologist may prescribe medication to help reduce the formation of a new cyst.

Pinched Nerve

The groin pain you are experiencing may actually be the result of a pinched nerve in your low back or thigh.

The lower (lumbar) portion of your spine contains spinal nerves that originate from your spinal cord and travel down your leg to the feet. These nerves control the feeling and strength in your legs and can cause pain when they are pinched.

While many things can cause a pinched nerve— including a bulged disc in the low back or the degenerative narrowing of the spine’s openings (called stenosis)—one of the most common nerve conditions that causes groin pain is meralgia paresthetica.

This issue arises when a nerve called the lateral femoral cutaneous nerve (which provides sensation to the front and side of your thigh) becomes compressed. This typically occurs in overweight or pregnant individuals, but can also be seen in:

  • People with diabetes
  • Those with lead paint exposure
  • People who were injured by a seatbelt in a car accident

Occasionally, wearing tight-fitting clothes or belts may also be to blame.

Meralgia paresthetica usually causes pain in the outer thigh that extends from the hip to the knee, though groin pain may also occur.

Burning, numbness, and tingling in the same areas is also a common complaint. The symptoms are almost always one-sided and are typically worse when on your feet or when the area is touched.

Typically, weight loss and wearing non-restrictive clothing can help resolve the symptoms of this condition. Occasionally, physical therapy, a cortisone injection, or anti-inflammatory pain medications may also be necessary if the pain from meralgia paresthetica persists.

Pelvic Floor Dysfunction

The pelvic floor is a group of muscles in the base of your pelvis that helps support the organs in that region (like the uterus and the vagina). These muscles also play an influential role in your bowel, bladder, and sexual function.

Pelvic floor dysfunction occurs when a person loses the ability to properly coordinate these important muscles.

Many different things can cause this type of condition, including:

  • Advancing age
  • Pregnancy
  • Surgery in the pelvic area
  • Being overweight

In some cases, however, it can be difficult to find a direct cause.

Pelvic floor dysfunction can result in groin, genital, rectal, or low back pain.

Difficulty controlling your bowel or bladder function is another common complaint, and you may experience either incontinence of stool or urine, or constipation. In addition, women with this issue may experience pain during sexual activity.

People with this condition are usually treated with pelvic floor physical therapy, which teaches you to effectively contract and relax your pelvic muscles. Biofeedback, a machine that helps you visualize these muscle contractions, can also be used to give you feedback while you are in therapy. Sometimes surgery is needed to treat pelvic floor dysfunction.

In addition, stool-softening medications may be prescribed by your primary physician or gynecologist to help reduce any constipation you are experiencing.

Pregnancy-Related

There are several other pregnancy-related issues that can lead to groin pain in females. One example is round-ligament pain.

The round ligament is a supportive structure that spans from a woman’s uterus to their groin region. As your uterus expands during pregnancy, this ligament stretches and becomes thicker to support the excess weight.

This ligament expansion can cause sharp, stabbing sensations in the groin or lower abdominal region. The pain can occur on one or both sides of your body and is most frequent:

  • When getting up and down from a chair
  • Transferring in or out of bed
  • When sneezing or coughing

You may also feel a duller ache in the same areas after a long day of activity.

Round-ligament pain is typically relieved with rest (lying on your side with your hips bent can be beneficial). Occasionally, your OB-GYN doctor may also suggest applying heat or taking pain medication, though it is best to check with them first.

The expansion of your pelvis and relaxation of the body’s ligaments during pregnancy can also cause another issue known as symphysis pubis dysfunction (SPD).

This condition occurs when the joint that connects the pelvic bones (the pubic symphysis) becomes inflamed and irritated due to pregnancy-related changes in the area.

SPD causes pinching or aching pain in the groin or inner thigh. The pain can occur on one or both sides of the body and is typically provoked by activities like:

  • Moving the legs apart
  • Getting in or out of bed
  • Climbing stairs
  • Getting in or out of a car

During pregnancy, modifying your activities and wearing a support belt can help reduce the frequency and intensity of SPD symptoms. The issue frequently self resolves after birth.

A Word from Verywell

Dealing with groin pain can be both frustrating and debilitating, but for most conditions, there are many different steps you can take to alleviate your discomfort. The key is getting a definitive diagnosis.

Be sure to speak to your doctor about your groin symptoms so he or she can perform a thorough evaluation and develop a comprehensive treatment plan that is right for you. 

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Article Sources
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  1. Johns Hopkins Medicine. Groin strain.

  2. Arthritis Foundation. Osteoarthritis of the hip.

  3. American Academy of Orthopaedic Surgeons. Femoroacetabular impingement. Updated August 2020. 

  4. American Academy of Orthopaedic Surgeons. Sports hernia (athletic pubalgia). Updated June 2017. 

  5. American Academy of Orthopaedic Surgeons. Sports hernia (athletic pubalgia). Updated June 2017. 

  6. American Academy of Orthopaedic Surgeons. Hip fractures. Updated November 2020. 

  7. Cleveland Clinic. Urinary tract infections. Updated March 7, 2020. 

  8. Cleveland Clinic. Appendicitis. Updated July 6, 2020. 

  9. Michigan Medicine. Swollen lymph nodes. Updated January 26, 2020. 

  10. Penn Medicine. Kidney stones. Updated January 15, 2020. 

  11. Tufts Medical Center. Pubic bone stress injury (osteitis pubis).

  12. American Academy of Family Physicians. Ovarian cyst. Updated July 25, 2018. 

  13. Cleveland Clinic. Meralgia paresthetica. Updated November 8, 2018. 

  14. Cleveland Clinic. Pelvic floor dysfunction. Updated May 26, 2020. 

  15. Marshfield Clinic. Round ligament pain- its causes, symptoms, and treatments. Updated 2020. 

  16. Lamaze International. Seven things to know about the pain from pubic symphysis. Updated October 20, 2020.