The groin is the area between the abdomen and thigh. Groin pain can occur due to conditions of the lower abdomen, inguinal region, proximal adductors, hip joint, upper anterior thigh, and perineum.
With so many possible conditions that may cause or contribute to groin pain, doctors may find it challenging to diagnose.
Some causes include athletic injuries, medical conditions, and internal anatomical irregularities.
In this article, learn more about some of the causes of groin pain in both males and females. The article also covers treatment options and when to see a doctor.
Some causes of groin pain may be specific to females. The sections below will discuss these in more detail.
According to the Office on Women’s Health, ovarian cysts are more common in premenopausal females. These growths are usually benign but can become cancerous, and the risk of malignancy increases with age.
According to a 2014 article, ovarian torsion can also occur.
Females may experience a sudden onset of severe, colicky, unilateral pain radiating from the groin.
Some may also have nausea and vomiting. If a cyst becomes malignant, a female may notice:
- weight loss
- persistent abdominal bloating
- feeling full quickly
- pelvic or abdominal pain
- increased urinary frequency and urgency
Ovarian cysts that are less than 5 centimeters across can resolve spontaneously. However, females can take pain relief medication if the cysts are causing discomfort.
Surgery may be necessary in some cases. A female may need surgery if they are postmenopausal, or if the cyst:
- does not go away
- becomes bigger
- causes pain
Groin pain associated with pregnancy
Some females may experience groin pain during pregnancy.
An article in the British Journal of Radiology investigated the occurrence of round ligament varicocele in pregnant females. This condition usually occurs on the right side but may appear on both sides of the body.
Round ligament varicocele may resemble inguinal hernias.
Doctors tend to treat round ligament varicocele in pregnancy by providing pain management tips. It typically resolves without intervention.
However, it sometimes requires surgery, which can be risky during pregnancy.
Some causes of groin pain may be specific to males. The following sections will discuss these in more detail.
Epididymitis and orchitis
Epididymitis refers to inflammation of the epididymis. Orchitis refers to inflammation of the testicles. These conditions may be linked to Chlamydia trachomatis and Neisseria gonorrhoeae.
Symptoms associated with inflammation of the epididymis and testicles include:
- scrotal pain
- symptoms of a urinary tract infection (UTI)
- swollen, tender epididymis
The main symptom of these conditions is scrotal pain, typically beginning in the back of one testis. It can then spread to the entire testis, scrotum, and groin.
Also, the skin may be firm, tender, flushed, and warm.
If a doctor finds that these symptoms are a result of C. trachomatis or N. gonorrhoeae, they will prescribe antibiotics.
Other suggestions to help relieve pain include:
- scrotal elevation
- limitation of certain activities
- cold packs
Males with testicular torsion may experience an acute onset of severe pain in the testes.
Health professionals describe testicular torsion as a “twisting of the spermatic cord.”
Apart from severe pain, males may also report the following symptoms:
- urinary problems
Testicular torsion is a medical emergency and requires surgery.
Other causes of groin pain include the following:
According to a 2015 article, 2–5% of all sports-related injuries are groin injuries. These types of injury have a recurrence rate of 15–31%.
Groin injuries typically occur when people play sports that involve sudden changes in direction and speed, as well as those that involve kicking.
A common cause of groin pain in athletes is adductor strains. This can be common in those who play:
It is also common among those who do karate, figure skating, and horseback riding.
People with adductor strain may experience pain when touching the affected muscle and when moving the leg toward the middle of the body against resistance.
Doctors may initially recommend rest, ice, compression, pain relief medication, and physical therapy. Rehabilitation can include stretching to improve the range of motion, as well as a gradual return to the sport.
According to a 2019 article, acute strains can take 4–8 weeks to recover from. However, chronic strains may take several months to heal.
A sports hernia, or athletic pubalgia, is not actually a hernia. It occurs when a person tears the tendons that attach to the pelvis.
A person can tear these tendons when performing explosive or repetitive motions, such as the twisting of the pelvis during:
Nonsurgical options include rest, ice, physical therapy, and anti-inflammatory medication.
Those with severe tears may need surgery.
According to the National Institute of Diabetes and Digestive and Kidney Diseases, an inguinal hernia is the bulging of the contents of a person’s abdomen through a weaker area in the abdominal wall.
These can occur on either side of the groin. Symptoms include:
- a bulge in the area between the thigh and lower abdomen
- a bulge in the scrotum (in males)
- discomfort, burning, pain, or heaviness in the groin
The pain may be worse when a person strains, coughs, lifts, or stands for long periods of time.
People should seek medical help immediately if they experience:
- a bulge that is larger than before
- a bulge that no longer goes back into the abdomen
- red, purple, or darker-than-usual skin
- sudden and severe pain
- abdominal pain
These symptoms could suggest that the hernia is stuck.
Doctors tend to recommend surgery for painful hernias.
People with kidney stones may experience groin pain and blood in the urine. Others may have pain in the abdomen and flank.
Females may have pain in the labia, while males may experience testicular pain.
Pain associated with kidney stones is often sharp and severe. Some people may also experience nausea and vomiting.
Small stones that are less than 5 millimeters across may pass in the urine with medical expulsive therapy, which may include one of the following medications:
If a doctor suspects that the person also has a UTI, they will treat it aggressively using antibiotics.
Urgent medical interventions with invasive procedures are necessary when there is:
- an obstructive stone in a person with a UTI, fever, or sepsis
- uncontrolled nausea or pain
- an obstructive stone in a person with only one kidney
- bilateral obstruction
- an obstruction with rising blood creatinine levels
Swollen lymph nodes
People may develop swollen lymph nodes due to an infection. This is called lymphadenitis.
The lymph nodes can become swollen when a bacterial, viral, or fungal infection spreads.
Depending on the infection, people may experience different symptoms. Usually, the lymph nodes near the area of infection are swollen. Sometimes, however, an infection can spread throughout the bloodstream, and this can cause lymph node swelling in different areas of the body.
Because there are many lymph nodes in the groin, lymphadenitis can be a source of groin pain.
People who suspect that they have an infection causing groin pain should consult a doctor to get a diagnosis and receive prompt treatment.
Treatment typically depends on what is causing the infection. The options can include:
- pain relief medications
- medications to help reduce swelling
- draining the lymph node (if it has become filled with pus)
A doctor will need to find the origin of the groin pain. To do so, they will take a thorough medical history and conduct a thorough physical examination that includes functional tests to detect:
- joint instability
- adductor-, psoas-, or inguinal-related pain
Some doctors may order laboratory tests (such as urine studies) or medical imaging (such as X-ray or CT scans).
A person should see a doctor if groin pain is persistent, severe, or accompanies pain in other body parts, such as the back or testicles.
People with groin pain need emergency medical attention if they have any of the following symptoms:
- blood in the urine
- unexplained weight loss
- urinary frequency or urgency
Anyone with unexplained pain should consult a doctor to find out the cause and receive appropriate treatment.
Groin pain can occur in several different pathologies and sports injuries.
Doctors may find it challenging to diagnose groin pain. Taking a thorough medical history and conducting a full physical examination will help aid the diagnosis.
Depending on the origin of the groin pain, people may experience different accompanying symptoms. Fever, chills, nausea, and vomiting are symptoms that require further investigation.
Treatments will also differ depending on the cause of groin pain.