Pain below the belly button may be experienced by anyone at any age, although it is more common in adult women of reproductive age. This pain commonly derives from the ovaries, uterus, stomach, and general abdominal region. It may be acute, intermittent, or chronic. As there are often different causes based on gender, we will discuss them accordingly.

Pain Below Belly Button in Women

Pelvic pain specific to women may be caused by problems in the female reproductive system, which includes the ovaries, fallopian tubes, uterus, cervix, and other associated organs and tissues.

Menstrual cramps - also called dysmenorrhea, these are dull, throbbing or cramping pains experienced just before and during menstrual periods. These may vary in intensity, from mild to severe, and can interfere with daily activities for a few days. The pain may also radiate to the lower back and thighs. Other symptoms include nausea, vomiting, dizziness, loose stools, and sweating.

Mittelschmerz - a German word that means "middle pain," since it usually occurs in the middle of a woman's menstrual cycle. It is characterized by a one-sided, usually mild, lower abdominal pain associated with ovulation and not related to any medical problem.

Endometriosis - a painful condition associated with the growth of uterine lining tissues outside the uterus, leading to bleeding, irritation, scarring and adhesions that can later result in infertility. Accompanying symptoms include diarrhea or constipation, nausea, bloating, pain during bowel movement, urination and/or sex, dysmenorrheal, excessive menstrual bleeding and bleeding between periods.

Adenomyosis - a condition where tissues from the uterine lining invade or grow inside the muscular walls of the uterus, causing severe cramping or sharp, pelvic pain that worsens with age. It is also associated with heavy or prolonged menstrual bleeding, bleeding between periods, and pain during intercourse.

Uterine fibroids - uterine growths or tumors that are not cancerous, but may cause pain below belly button. These may be accompanied by heavy menstrual bleeding, prolonged menstrual periods, frequent urination, difficulty emptying the bladder, constipation, backache, or leg pains.

Ovarian cysts - small fluid filled sacs in the ovary often do not cause symptoms, except when they increase in size and press on other organs, rupture and bleed, or twist. It can cause a constant or intermittent dull aching pain that may radiate to the lower back and thighs. It may be associated with a fullness or heaviness in the abdomen, pain during intercourse or bowel movements. The symptoms may sometimes mimic pregnancy, as they include nausea, vomiting, and breast tenderness.

Ectopic pregnancy - occurs when a fertilized egg is implanted outside the uterus. It will instead attach to an ovary, inside one of the fallopian tubes, or elsewhere in the abdomen. This usually occurs in the early weeks of pregnancy and causes intense pain, vaginal bleeding, lightheadedness, fainting, and circulatory shock. A pregnancy test and imaging studies will confirm this diagnosis.

Miscarriage - loss of a pregnancy during the first 20 weeks will result in severe lower abdominal pain below the belly button that may radiate to the lower back. It is also accompanied by vaginal bleeding and passage of fetal tissue.

Pelvic inflammatory disease (PID) - an infection that involves the female reproductive tract, it is usually caused by sexually transmitted disease, recent abortion, or insertion of an IUD (intrauterine device). It may be associated with a constant dull pain that gets worse with bowel movements, urination, and sex. It is also characterized by a yellow to green, foul smelling vaginal discharge.

Ovarian cancer - this does not usually cause symptoms until later, when a patient might experience lower abdominal pain associated with bloating, heaviness, and difficulties with urination and bowel movements. Changes in menstrual periods, loss of appetite, fatigue, and weight loss may also occur.

Pain Below Belly Button in Men

Prostatitis - lower abdominal pain in men may be caused by the swelling and inflammation of the prostate gland, a walnut-shaped gland that produces semen and is located directly below the bladder. It often causes pain in the groin, pelvic area or genitals, painful or difficult urination, and sometimes flu-like symptoms, including fever.

General Causes

• Constipation - a common condition that occurs to anyone at any age, it is usually harmless except when associated with other medical conditions. Irregular passage of hard stools may be temporary, but can cause dull to intense abdominal pain if associated with cancer or other disease.
• Urinary tract infection - infection that affects any part of the kidneys, ureters, bladder, and urethra can bring about pelvic pain. You may experience an urgency to urinate, frequent urination, a burning sensation while passing urine, and observe a foul smelling, cloudy urine. Fever and chills are also common.
• Kidney stones - small hard deposits that look like stones may be passed from the kidney down to the urinary tract. The pain may start as a severe pain in the side, back, and below the ribs, which may spread to the lower abdomen and groin. The pain comes in waves and fluctuates in intensity, and may be associated with nausea, vomiting, fever, and chills if an infection is present. Other common symptoms include pain during urination, persistent urge to urinate, and frequent urination. You may also notice pink, red, brown, or cloudy and foul-smelling urine.
• Interstitial cystitis or painful bladder syndrome - a chronic condition characterized by a combination of bladder pressure, bladder pain, and pelvic pain, which can range from mild discomfort to severe pain. Those affected have persistent urgency to urinate, and frequently passes small amounts of urine throughout the day. The pain is felt in the pelvis just above the pubic bone, between the vagina and anus in women or between the scrotum and anus in men.
• Bladder spasms - this is caused by an involuntary squeezing of the bladder muscle, causing an urgent need to urinate and to experience leakage. The pain below the belly button is often described as a cramping pain or a burning sensation. These can be related to a urinary tract infection, giving birth, menopause, or recent abdominal surgery.
• Inguinal hernia - occurs when tissue pushes through a weak spot in the muscle of the groin, causing a bulge in the groin or scrotum (in males). The bulge may produce swelling, a feeling of heaviness, and may hurt or burn. If a sudden pain is accompanied by nausea and vomiting immediate medical attentinon should be sought.
• Past physical or sexual abuse - can cause trauma to any part of the reproductive tract and pelvic area, causing lower abdominal pains. Diagnosis depends on the patient's history, physical examination, and pertinent laboratory findings.

Other less common causes of pain below belly button that can occur in either male or female include diverticulitis, Crohn's disease, irritable bowel syndrome, fibromyalgia, ulcerative colitis, sciatica, and colon cancer. These usually cause a chronic or persistent set of symptoms associated with abdominal pain.

When to Seek Medical Help

If you suddenly develop severe abdominal pain, it may be a medical emergency and you should seek immediate medical attention. Be sure to get appropriate medical evaluation of your pelvic pain by your doctor if it is a new symptom, if it causes a disruption in your daily life, or if the pain and any other symptoms worsen over time.