A Doctor Reveals What Causes Left-Side Pain Under the Ribs in Women—and When To Seek Help

Pain is always disconcerting regardless of where it occurs, but it can be especially worrisome if it emanates from the left side of the body, where vital organs like the heart are located. The good news is that there are plenty of innocuous reasons you may be feeling discomfort, from indigestion to muscle strains. But just to be on the safe side, we asked a doctor to share more serious potential causes of pain under the ribs or in the lower left side of your abdomen so that you’ll know when it may be time to seek medical attention.

4 causes of left-side pain under the ribs

To help understand when left-side pain might need attention, we spoke with internal medicine physician Erin N. Marcus, MD, MPH, professor of clinical medicine at the Miller School of Medicine at the University of Miami. While her insights can guide you, she emphasizes that they’re not a substitute for professional medical care. “If someone has any concerning symptoms, they need to get medical attention right away” for an accurate diagnosis and treatment.

Here, she outlines a few potentially serious causes of left-side pain above the diaphragm or under the ribs.

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Heart disease

“For pain in the chest of a woman who has passed menopause or who has risk factors such as smoking, diabetes, a family history [of heart problems], high blood pressure or substance use, we would be most concerned about heart disease,” Dr. Marcus says.

Heart disease often presents atypically in women, she continues. “They may have vague symptoms or symptoms brought on by stress rather than the classic presentation of chest pressure.”

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Pulmonary embolus

If you have left-side pain under your ribs and have been on a recent long trip, had recent surgery, been immobilized or have cancer, doctors would be worried about a blood clot that has traveled to the lung—also called a pulmonary embolus—says Dr. Marcus. “These [heart disease and embolisms] are diagnoses we would be on highest alert for because they can be catastrophic” and life-threatening.

Pneumonia and other lung issues

“If the patient has a fever or chills or is coughing, we might consider pneumonia,” Dr. Macus says. Other concerning diagnoses could be a tumor in the lungs or elsewhere in the chest, particularly in a smoker or someone who has been exposed to toxic fumes.

“A sharp, sudden pain could indicate a pneumothorax, a rupture in the lung tissue,” she adds. “And for someone with asthma or who is a smoker, we might think about bronchoconstriction, in which the airways in the lungs constrict.”

“If they have cancer or a chronic infection or an autoimmune condition, we might think about an accumulation of fluid in the chest cavity called a pleural effusion,” Dr. Marcus notes.

Muscle strain

One reason to breathe easier if you feel pain in the left-side of your chest or under your ribs: “People can strain muscles through heavy lifting or even vigorous coughing,” says Dr. Marcus. “And sometimes, people develop a condition called costochondritis, which is an inflammation of the cartilage in the chest wall.” This pain can be confused with a heart attack, but it often resolves on its own through rest.

9 causes of pain in the lower left side of the abdomen

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For left-side pain in or below the abdomen, there is also a wide array of possible causes, says Dr. Marcus. “We would want to know what other symptoms the person is having, as well as their age and medical history.” A few potential culprits:

• Gastrointestinal issues: ulcer, tumor, irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), intestinal ischemia “when the bowel doesn’t get enough blood circulation,” intestinal inflammation or pain from constipation or an infection
• Urologic conditions: kidney stones or a tumor
• Gynecological problems: an ovarian cyst, fibroids or a tumor
• Enlarged spleen or liver
• Arterial problems
• Musculoskeletal issues
• Pain from something in the chest, radiating into the abdomen
• Neurological conditions such as shingles: “It can occur along a nerve anywhere in the body, and it’s not uncommon for us to see it in the chest wall or along the abdomen,” notes Dr. Marcus. “The pain is intense and can last a while; fortunately, there is an effective vaccine.”
• Inflamed or “pinched” nerve

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What a doctor might ask about pain in the left side of your abdomen

In order to help pinpoint what’s causing left-side abdominal pain, Dr. Marcus said your doctor might ask you the following questions:

• Are you constipated or have you had other changes in your bowel movements, such as diarrhea or blood?
• Are you vomiting?
• Have you had blood in your urine or pain when you pee?
• Do you still get your period, and is it regular or heavy?
• Do you have a fever or chills?
• Have you had bloating or swelling of your abdomen?
• Do you drink significant amounts of alcohol or have you been diagnosed with hepatitis?
• Could you be pregnant?

The bottom line on left-side pain in women

Dr. Marcus emphasizes that the range of causes of left-side abdominal pain is vast and depends on your individual symptoms and characteristics. “This is why it’s important to get a thorough history and physical exam by a well-trained professional.”