14 Causes of Female Groin Pain

Groin pain in females is most often caused by muscle strain. However, many other possible causes, include urinary tract infections, ovarian cysts, appendicitis, kidney stones, and osteoarthritis (OA). Groin pain can also be related to pregnancy.

This article discusses 14 common causes of female groin pain and how each is treated.

Groin Strain

One of the most common causes of pain in the groin is 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 of the five adductor muscles may be involved. These include the adductor magnus, adductor brevis, pectineus, adductor longus, and the gracilis.

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

• Running
• Jumping
• Cutting maneuvers (such as rapid side-stepping in soccer)

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

You may hear a popping noise during the strain depending on how serious it is. You may also develop bruising or swelling.

Mild strains typically only limit your ability to do more advanced exercises or activities. Severe sprains can cause pain while you walk or even while you are at rest.

To help with recovery, your primary healthcare provider may suggest:

• Using the RICE principle (Rest, Ice, Compression, and Elevation)
• Prescription 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 common cause of groin pain is osteoarthritis (OA) of the hip.

OA in the hip 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 causes increased friction with hip movement and can lead to a build-up of excess bone.

Over time, OA can also lead to pain in the thigh and buttocks.

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

Other symptoms that make it different from a muscle strain include:

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

OA can usually be treated by your primary healthcare provider, 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 these types of treatments fail, you may need surgery. In this case, an orthopedic surgeon typically performs a resurfacing procedure. This is done by covering or capping the femoral head with a metal shell. Another option is 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 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, in turn, causes pain and joint damage when you move your leg.

The pain from hip impingement is typically centered in the groin, but it can also extend 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 toward your chest or crossing your leg. Tasks involving squatting or twisting may also be painful.

Treatment can include:

• Modifying your activities to avoid movements that may contribute to joint damage
• Taking non-steroidal anti-inflammatory medications (if directed by your healthcare provider) 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 is also known as athletic pubalgia. This is a broad term referring to any strain or sprain of a ligament, muscle, or tendon in the lower stomach or groin region.

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 hiatal hernia, there is no palpable bulge in the area of injury (though sports hernias may eventually lead to a hiatal hernia if left untreated).

The typical treatment for this condition is similar to the treatment for an adductor strain, including:

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

Hip Fracture

If you're middle-aged and, especially if you have already gone through menopause, you're at a much higher risk of developing osteoporosis. Because this condition causes decreased bone density throughout the body, you are more likely to get a bone fracture. And the hip is the most common place for this to occur.

Fractures in the hip area typically affect the femur bone in the region just below the femoral head. This type of bone break (called an insufficiency fracture) can occur even after a small fall or twisting injury. In some cases, the bone is so brittle that even 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 on your leg.

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

Urinary Tract Infections

Urinary tract infections (UTI) occur when bacteria enter the body via the urethra (the tube through which urine leaves your body) and infect your urinary tract. Several factors increase your risk of developing a UTI:

• Being female (because females have a shorter urethra than males)
• Pregnancy
• Being sexually active
• Going through menopause
• Age: older people are more likely to experience UTIs

UTIs can cause a cramping sensation in your groin or the lower portion of your stomach. Other symptoms of a UTI include:

• Burning with urination
• Frequent urination
• Blood in the urine
• Feeling the need to urinate despite having an empty bladder
• Pressure or cramping in the groin or lower abdomen

Most urinary tract infections are easily treated with an antibiotic, so it is important to speak to a healthcare provider if you suspect you have one.

Appendicitis

The appendix is a thin tube joined to the large intestine and located in the lower portion of the right side of the abdomen.

The appendix is a working part of the immune system for young children. For everyone else, this organ serves no useful purpose, and in some cases, it can become infected or inflamed. This condition, known as appendicitis, usually affects people in their teens or 20s 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. The pain may come and go at first, but as it progresses, it becomes severe, especially if the appendix ultimately ruptures.

Along with sharp pain, appendicitis can cause:

• Constipation
• Fever
• Nausea
• Vomiting
• Diarrhea
• Swelling in the belly
• Loss of appetite
• An inability to pass gas
• The feeling that having a bowel movement will relieve discomfort

Once appendicitis is diagnosed with blood and urine tests and an MRI or CT scan, the appendix 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 essential to see a healthcare provider immediately if you think you may have appendicitis.

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. Lymph nodes contain lymphocytes (white blood cells) that help the body fight infection and disease.

Occasionally, infection or injury in the body causes the lymph nodes to become swollen and painful to the touch. Rarely, swollen lymph nodes may indicate a tumor.

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 due to an injury or infection in your foot, leg, groin, or vagina.

Swollen lymph nodes are frequently able to be felt under the skin.

Usually, treating the underlying injury or infection helps to reduce lymph node pain and swelling. Occasionally, however, you may need to see a physical therapist who is skilled in treating lymphedema (swelling of the lymph nodes) to resolve this condition.

Kidney Stones

A kidney stone is a solid, pebble-like 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. You might also experience sharp pain in your stomach or on the side of your back.

The severe pain from a kidney stone can come and go. It's frequently accompanied by blood in the urine.

In addition, when you have a kidney stone, you may notice that you pee less. In rarer cases, fever, chills, nausea, or vomiting can also occur.

If passing a stone is painful, your healthcare provider may recommend over-the-counter (OTC) or prescription pain medication.

Sometimes, the stone is too big and a urologist may need to do a procedure to break it up or remove it. Thus, it's best to speak to a healthcare provider immediately if you suspect 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.

Osteitis pubis can be caused by overusing the core, hip, or groin muscles that attach in the pelvic bones area. This may result from:

• Repetitive jumping
• Running
• Kicking
• Sit-ups

Surgeries to the pelvic area or childbirth may also cause osteitis pubis.

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

Normally this soreness comes on gradually and is bothersome only with strenuous activity. However, as the condition progresses, the pain can become more intense and impact daily tasks like standing or walking.

In most cases, your symptoms will resolve by:

• Modifying your activity
• Taking OTC pain medication
• Icing the area on and off

It can take months for the pain to go away completely, 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 can develop on one or both of your ovaries.

The ovaries are located on each side of the lower part of the abdomen. This is where female hormones are produced and eggs develop. Cysts in this area are actually quite common and may develop during ovulation.

In some situations, cysts 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. It may also cause:

• Bloating
• Constipation
• Abnormal menstruation
• Nausea
• Vomiting
• Feeling full after eating a small amount

Most cysts, even those that cause pain, will go away on their own in one to three months.

If a cyst isn't going away, you may need surgery to remove it. In some cases, your gynecologist may prescribe medication to help reduce the formation of a new cyst.

Pinched Nerve

A pinched nerve in your lower back or thigh can cause groin pain.

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

Many things can cause a pinched nerve. These include a bulging disc in the lower back or a narrowing of the spinal canal (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 is more likely to occur if you're overweight or pregnant, but other factors that can increase your risk include:

• Having diabetes
• Being exposed to lead paint
• Experiencing a seatbelt injury in a car accident

Occasionally, wearing tight-fitting clothes or belts could also cause a pinched nerve.

Meralgia paresthetica usually causes pain in the outer thigh that extends from the hip to the knee, but you may also feel groin pain, burning, numbness, and tingling. The symptoms are almost always on one side only. They're typically worse when standing or when the area is touched.

Weight loss and wearing non-restrictive clothing can often 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 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 area (like the uterus and the vagina). These muscles also play a role in your bowel, bladder, and sexual function.

Pelvic floor dysfunction can occur if you lose the ability to properly coordinate these important muscles.

Many things can cause this type of condition, including:

• Advancing age
• Pregnancy or childbirth
• Chronic straining or constipation
• 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 lower back pain.

Difficulty controlling your bowel or bladder function is another common complaint, and you may experience incontinence of stool or urine, or you may have constipation. In addition, pelvic floor dysfunction can lead to pain during sexual activity.

People with pelvic floor dysfunction are usually treated with pelvic floor physical therapy, which teaches you to effectively contract and relax your pelvic muscles. Biofeedback, which uses sensors to help you visualize these muscle contractions, can also be used. Injections, nerve stimulation, and oral medications may also be recommended to treat symptoms. Sometimes surgery is needed to treat pelvic floor dysfunction.

Pregnancy-Related Groin Pain

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

The round ligament is a supportive structure that spans from your uterus to the 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
• Sneezing or coughing

You may also feel a dull 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 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 resolves after birth.

Summary

Groin pain will likely affect you at some point. There are many different causes of groin pain, including muscle strain, a urinary tract infection, osteoarthritis, kidney stones, and pregnancy. Some of these conditions are related to physical activity, some to aging, and others to underlying conditions.

Treatments of groin pain depend on the specific cause and symptoms.