Sharp Right-Sided Pelvic Pain? Why It’s Not Always Your Appendix (And What to Tell Your OBGYN)

Sharp Right-Sided Pelvic Pain? Why It's Not Always Your Appendix (And What to Tell Your OBGYN)

Sharp pain on the lower right side of your abdomen can be scary. Many people immediately think, "Is this my appendix?" While appendicitis is an important cause of lower abdominal pain, it's far from the only one—especially in women and people with female reproductive organs.

Right-sided pelvic pain can come from the reproductive system, urinary tract, digestive system, muscles, or even nerve irritation. Understanding the most common possibilities can help you have a clearer, more productive conversation with your OB‑GYN—and know when urgent care is needed.

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Why the Appendix Gets All the Attention

The appendix sits in the lower right abdomen, and appendicitis is a medical emergency. Classic symptoms include:

• Sudden pain that starts near the belly button and moves to the lower right side
• Worsening pain over several hours
• Fever, nausea, or vomiting
• Pain that gets worse with movement or coughing

However, not all right-sided pain follows this pattern, and many people—especially women—have pelvic conditions that can feel very similar.

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Common Non-Appendix Causes of Sharp Right-Sided Pelvic Pain

1. Ovulation Pain (Mittelschmerz)

Ovulation can cause brief, sharp pain on one side of the pelvis, often mid-cycle.

What it feels like:

• Sudden, stabbing or crampy pain
• Lasts minutes to a few hours (sometimes a day)
• Occurs about 10–14 days before your period

This type of lower abdominal pain is usually harmless, but if it's new, severe, or getting worse, it's worth mentioning to your OB‑GYN.

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2. Ovarian Cysts

Ovarian cysts are fluid-filled sacs that are very common. Many cause no symptoms, but some can cause sharp or aching pain.

Key features:

• Pain on one side of the pelvis
• Bloating or fullness
• Pain during sex or certain movements

A ruptured or twisted (torsed) cyst can cause sudden, severe pain and may require urgent care.

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3. Endometriosis

Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus.

Possible symptoms:

• Chronic pelvic pain
• Pain that worsens during periods
• Pain with bowel movements or sex
• Pain that may feel sharp, burning, or deep

Endometriosis can also irritate nearby nerves, leading to nerve irritation that causes pain to travel into the hip, groin, or lower back.

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4. Pelvic Inflammatory Disease (PID)

PID is an infection of the reproductive organs, often caused by untreated sexually transmitted infections.

Symptoms may include:

• Lower abdominal pain on one or both sides
• Fever or chills
• Abnormal vaginal discharge
• Pain during sex

PID needs prompt medical treatment to prevent long-term complications.

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5. Urinary Tract or Kidney Issues

Problems in the urinary system can cause pain that feels pelvic.

Examples include:

• Urinary tract infections (UTIs)
• Kidney stones

Pain may be sharp, crampy, or radiate from the back to the front. Burning with urination or blood in the urine can be clues.

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6. Digestive Causes That Aren't the Appendix

Several digestive issues can mimic appendicitis:

• Constipation
• Gas trapped in the bowel
• Irritable bowel syndrome (IBS)
• Inflammatory bowel conditions

These causes of lower abdominal pain often come with changes in bowel habits or bloating.

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7. Muscle Strain or Pelvic Floor Tension

Muscles in the abdominal wall or pelvic floor can become strained or tight.

Clues it may be muscular:

• Pain worsens with movement or certain positions
• Tenderness when pressing on the area
• Pain after exercise, lifting, or prolonged sitting

Pelvic floor dysfunction can also irritate nearby nerves, leading to sharp or burning sensations.

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8. Nerve Irritation: An Overlooked Cause

Nerve irritation is a common but under-recognized source of pelvic pain.

Possible nerve-related causes include:

• Pudendal nerve irritation
• Ilioinguinal or genitofemoral nerve involvement
• Scar tissue from prior surgery
• Endometriosis affecting nerves

How nerve pain often feels:

• Sharp, electric, burning, or stabbing
• Pain that comes and goes
• Pain that radiates to the groin, hip, thigh, or lower back
• Pain triggered by sitting or certain movements

This type of pain doesn't always show up on imaging, which is why clear symptom descriptions matter.

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What to Tell Your OB‑GYN (Be Specific)

Your OB‑GYN relies heavily on your description of the pain. Consider sharing:

• Exact location: One finger point is better than "my whole lower abdomen"
• Timing: Sudden or gradual? Constant or intermittent?
• Cycle connection: Related to ovulation or your period?
• Pain quality: Sharp, dull, burning, crampy, electric
• Triggers: Movement, sex, bowel movements, urination, sitting
• Associated symptoms: Fever, nausea, bleeding, discharge, urinary changes

These details help narrow down whether the pain is gynecologic, digestive, urinary, muscular, or related to nerve irritation.

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When Right-Sided Pelvic Pain Is an Emergency

While many causes are not dangerous, seek urgent medical care or speak to a doctor immediately if you have:

• Sudden, severe, worsening pain
• Fever with abdominal pain
• Persistent vomiting
• Fainting or dizziness
• Positive pregnancy test with pelvic pain (possible ectopic pregnancy)

These situations can be life-threatening and should never be ignored.

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A Helpful First Step: Check Your Symptoms

If you're experiencing unexplained right-sided pain and want to better understand what might be causing it, try using a free abdominal pain symptom checker to help organize your symptoms before your appointment. It can guide you through relevant questions and help you prepare a clearer picture to share with your healthcare provider—making your visit more productive and focused.

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The Bottom Line

Sharp right-sided pelvic pain doesn't automatically mean appendicitis. In fact, many cases of lower abdominal pain are linked to gynecologic conditions, digestive issues, muscle strain, or nerve irritation. Understanding the pattern and details of your pain can make a big difference in getting the right care.

Listen to your body, avoid brushing off persistent or severe symptoms, and speak to a doctor about anything that feels serious or life-threatening. Getting timely, accurate care is the best way to protect your health—and your peace of mind.