Causes of lower left quadrant, or LLQ, abdominal pain in young women are varied; LLQ pain in young women is often, but not always, related to reproductive issues. Some causes of LLQ pain, such as pain from ovulation, are normal and not dangerous, while others, such as ectopic pregnancy, can be life-threatening. Investigation of LLQ abdominal pain is necessary if pain is severe and continuous.
Ovulation
Young women normally ovulate an egg from the left or right ovary each month. Contrary to opinion, the ovaries don't alternate egg release; the same side may develop a follicle several months in a row. Egg release, or ovulation, often causes mittelschmerz, a term used to describe pain that occurs as the follicle ruptures and the egg releases. Mittelschmerz pain is felt in the LLQ of the abdomen if an egg releases on the left side; mittelschmerz occurs in the middle of the menstrual cycle, or approximately 14 days before the start of the next period.
Ovarian Cyst
Ovarian cysts develop when a follicle grows but the egg inside isn't released, or if an egg is released and the leftover follicle, called a corpus luteum, has fluid trapped inside it, the Mayo Clinic states. If a cyst enlarges, the resulting pain can be severe and will be felt in the LLQ if the cyst is on the left side. Cysts can grow as large as 4-inches in diameter before they rupture; ruptured ovarian cysts cause severe pain, and bleeding that can be life-threatening.
Ectopic Pregnancy
Ectopic pregnancy occurs when the embryo implantats in the fallopian tube rather than in the uterus. The tube is too narrow to support the growth of an embryo for more than a few weeks; once the tube has distended as far as it can, it ruptures. Ectopic pregnancy rupture causes severe pain and rapid blood loss; this is a life-threatening emergency that requires immediate medical attention. If the ectopic pregnancy is in the left fallopian tube, pain will be felt mostly in the LLQ, although pain may be felt all over the abdominal as blood fills up the pelvic cavity.
Endometriosis
Endometriosis is endometrial tissue growth outside the uterus. Endometrial tissue lines the inside of the uterus. Endometrial implants can occur anywhere in the pelvis; the ovaries and the areas around the uterus are the most common sites. During a menstrual period, endometriosis tissue breaks down and bleeds just like the tissue inside the uterus does. This causes pain and can lead to scar tissue formation throughout the pelvis. LLQ pain may be related to endometriosis, especially if it occurs during a menstrual period.
Diverticulitis
Diveriticula are small sac-like protrusions on the large intestine. While diverticula are more commonly found in people older than age 40, the Merck Manual states they can develop in younger women. Diverticulitis is inflammation of the diverticula, which can rupture and release bacteria into the intestinal cavity. Diverticulitis causes LLQ abdominal pain that may require surgery if rupture occurs.
