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Why pulls the lower abdomen at 3 weeks of pregnancy and what to do?
Last reviewed: 04.07.2025
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At this stage of pregnancy, most women are still unaware of their condition and perceive the pulling sensation as a harbinger of the upcoming menstruation, without worrying too much about it.
Indeed, with rare exceptions, discomfort in the lower abdomen does not pose any threat to the health of the mother and the unborn child.
Epidemiology
The epidemiology of miscarriages at such an early stage has not been studied; most women do not yet consult a gynecologist about their pregnancy. However, spontaneous termination of pregnancy is considered the most frequent complication. About a fifth of clinically established cases of pregnancy end this way. Experts assume that the actual frequency of miscarriages is much higher; some claim that more than half of spontaneous abortions occur before the moment of clinical recognition of future motherhood.
Ectopic (extrauterine) pregnancies occur with a frequency of one case in approximately two hundred pregnancies.
Causes 3 weeks' lower abdominal pain
Such sensations at this stage are most likely caused by the onset of pregnancy and the activation of the blood circulation process in the vessels of the uterus, to which the blood flow increases.
Usually in the third week, the fertilized egg begins to implant itself in the uterine membrane and attach itself there to develop peacefully for nine months. At the same time, the cells of the uterine membrane fuse with the cells of the blastocyst (as the fertilized egg is now called), which causes microtrauma to the uterine wall and minor bleeding. At this time, the chorion, the future placenta, the system of vessels of the embryonic blood supply, begins to form. This process is also often accompanied by a pulling pain in the lower abdomen and lumbar region.
Pain in the lower abdomen can be caused by intestinal problems that accompany early toxicosis. In this case, bowel movements usually become rare and cause difficulties. It is necessary to try to improve this area of life with the help of fermented milk products or vegetable dishes (for example, beet salad). Usually, early toxicosis is not dangerous and quickly passes.
Within the normal range - nagging pains in the lower abdomen are not constant and exhausting, but periodic. In order for the condition to return to normal, as a rule, it is quite enough to lie down for a while, relax the muscles and rest.
However, if the pain is debilitating and severe, not going away even when lying down, then you should not postpone a visit to the doctor. The cause of such persistent pain may be a threat of termination of pregnancy. Risk factors for miscarriage in the early stages are chromosomal abnormalities, hormonal imbalance and endocrinological diseases, genital infections, tonsillitis, flu, chickenpox and rubella, previous abortions, hydatidiform mole, polycystic ovary disease, multiple pregnancy, medications (including herbal medicine), bad habits (substance abuse, alcoholism, smoking), severe stress.
Risk factors
The pathogenesis of pregnancy termination may be based on the death of the fertilized egg for some reason and, as a result, its implantation not occurring. The body reacts to this event with uterine contractions and expulsion of the frozen embryo. Hypertonicity of the uterus may be primary and cause the death and rejection of the embryo, and these two events may occur simultaneously. At such an early stage, a miscarriage may go unnoticed, like heavy menstruation.
A nagging pain in the lower abdomen at the beginning of pregnancy, especially localized in one part, right or left, can be caused by an ectopic pregnancy. Severe pain syndrome will appear a little later than the third week of pregnancy, when the embryo begins to grow in the fallopian tube or ovary. However, if the pain intensifies and is constant, and the condition worsens, you need to undergo an examination. Risk factors for the development of pregnancy outside the uterus are infectious and inflammatory diseases of the fallopian tubes or abnormalities in their development, surgical interventions on the fallopian tubes, adhesion growths in the small pelvis, intrauterine contraception, age and infertility.
The third week of pregnancy is of primary importance for further events. The blastocyst at this stage is subject to many external influences. If it is sufficiently stable, reaches the uterus and implants in its membrane, it will continue to develop. Non-viable specimens will die, they will be rejected, most likely, unnoticed by anyone.
Symptoms 3 weeks' lower abdominal pain
Thus, in the vast majority of cases, the first signs of pregnancy usually appear. Normally, there are sensations reminiscent of the usual premenstrual symptoms, so most women do not react to them. Particularly sensitive women feel more tired than usual, want to lie down, sleep, they may start to feel motion sickness in transport, unusual reactions to smells and taste preferences, frequent urination may appear. In the third week, the fertilized egg is implanted in the uterine membrane, the formation of the placenta begins, which causes some discomfort in the lower abdomen and lower back, as well as minor bloody discharge, although this is also an optional symptom. Therefore, if a woman has a pulling sensation in the lower abdomen and discharge in the 3rd week of pregnancy, then in most cases these are normal phenomena. You need to try to rest, lie down, not strain yourself physically, mentally or emotionally. And if such simple measures lead to relief of the condition, then, most likely, everything is normal.
The threat of miscarriage is accompanied by increased pain and discharge. If the situation is more serious than the usual premenstrual sensations, and you were planning a pregnancy, it is better to consult a doctor. It is possible to prevent a miscarriage even in the very early stages of pregnancy (second, third week), if you seek help from a specialist in time.
For example, high muscle tone of the uterus usually causes concern among doctors, however, after taking a course of antispasmodics prescribed by the doctor, it can be easily relieved.
It is necessary to pay attention to the presence of the following symptoms: spasmodic pain in the lower abdomen, nagging pain in the lumbar region, constant, not passing in a lying position; at the same time, the appearance of mucous or brownish, not quite normal discharge; in addition to everything - gastrointestinal disorder.
Similar symptoms in the third week of pregnancy may also indicate an ectopic pregnancy, the consequences and complications of which are associated with a risk to life. In this case, you should not delay the process, you need to urgently consult a doctor.
Diagnostics 3 weeks' lower abdominal pain
At this stage, people usually go to the doctor in two cases: either the symptoms are causing concern, or the pregnancy was planned and there is a slight delay, unpleasant sensations plus an incomprehensible semi-positive test (often at this stage only one strip is colored) require confirmation of the new condition.
Clinical tests are normal; only the level of human chorionic gonadotropin in the blood plasma, which is continuously increasing in the early stages, can clarify the situation.
Standard instrumental diagnostics (ultrasound) can confirm the onset of pregnancy only by indirect signs: by a noticeable thickening of the layer of the uterine mucosa, the maximum thickness is interpreted as the supposed site of implantation of the blastocyst and increased blood flow in the corpus luteum.
If there are complaints of a pulling sensation in the lower abdomen, the tone of the uterine muscles is assessed - increased tone in combination with poor blood supply may indicate a threat of miscarriage, and local thickening of one of the fallopian tubes - a pregnancy developing in it.
What do need to examine?
How to examine?
What tests are needed?
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Treatment 3 weeks' lower abdominal pain
Such sensations are completely physiological in the third week of pregnancy and, as a rule, do not require any treatment.
However, if they are combined with hypertonicity of the uterine muscles, women are prescribed No-shpa or Papaverine.
No-shpa (drotaverine hydrochloride) is an effective antispasmodic that eliminates spasms of the smooth muscles of the uterus without significant effects on the cardiovascular system. Embryotoxicity and teratogenicity of this drug have not been identified. The average daily dosage is 0.12-0.24 g, divided into two or three doses.
Papaverine (rectal suppositories, tablets, injection solution) – the form is selected depending on the intensity of muscle tone. The form of choice is rectal suppositories, they are used two to four times a day.
These drugs are prescribed to pregnant women as the safest, but expectant mothers can take them only under the supervision of a doctor. They can also cause allergic reactions and rare side effects, in particular, hypotension, drowsiness, dizziness, nausea and heart rhythm disorders.
If there is a risk of miscarriage, a woman is advised to reduce physical activity to a minimum, stay in bed, sometimes strictly. To reduce anxiety and worry, sedative herbal preparations can be prescribed - Motherwort extract or Valerian root in tablets. These are similar in action, having a calming effect, not having a direct hypnotic effect, but promoting sleep. Take one tablet three to four times a day.
Quite often, the cause of pregnancy termination is hormonal disorders, the most common of which is a deficiency of progesterone, a hormone necessary for the normal course of pregnancy. In this case, Duphaston is prescribed to compensate for this deficiency. It is taken at 0.04 g for the first time, and then at 0.01 g at eight-hour intervals until the symptoms are relieved. When they disappear, therapy with an effective dosage is continued for another week, after which it is reduced. If symptoms return, therapy is returned to the dosage that was effective in the previous case.
If androgens predominate, Metipred is prescribed - a drug with the active substance methylprednisolone, which has a wide range of serious side effects. It is taken only according to strict indications and under the supervision of a doctor. This is a favorite drug of domestic doctors, it is not prescribed to Western women. There are cases of successful delivery of apparently healthy children after taking this drug, however, it is advisable to consult another specialist in case of its prescription and carefully weigh all the pros and cons.
The threat of miscarriage in the early stages can be caused by many reasons and, based on the diagnosis, the doctor will prescribe adequate treatment or consultation with another specialist, for example, an endocrinologist.
Vitamins are usually prescribed to women in the early stages of pregnancy, based on the fact that it is difficult to fully balance your diet. And yet, if nothing seriously bothers you, and there are no signs of deficiency, consult a doctor whether it is worth taking synthetic vitamins for you, because their overdose can be dangerous for the future child no less than a deficiency.
Folic acid is usually prescribed, the deficiency of which can cause miscarriage. Folic acid can even, it is claimed, even even out chromosomal abnormalities and compensate for teratogenic environmental influences if taken before pregnancy and continued in the first months.
Physiotherapy treatment in early pregnancy should help the mother and not harm the new developing life. These procedures also have a number of contraindications, and a doctor should prescribe and monitor their effectiveness. Electrophoresis, acupuncture, electrorelaxation and balneotherapy are considered safe procedures.
Folk remedies
It should be noted that the vast majority of doctors disapprove of self-medication using folk recipes. It is still advisable to consult a doctor, since folk remedies are unlikely to be able to effectively compensate for, for example, a lack of progesterone or hypothyroidism. However, in a complex of prescribed treatment measures, folk remedies may not be superfluous either.
A popular folk remedy for preventing miscarriage is viburnum. The raw material used is viburnum bark, collected from young branches in the spring before the first leaves appear. The healing decoction is prepared as follows: a teaspoon of finely crushed raw material is brewed with boiling water (200 ml) and simmered in a water bath for about five minutes. Cool, filter and use three times a day, 30 ml.
The decoction has the ability to stop bleeding, nervous and convulsive attacks, and improves sleep.
In folk medicine, when there is a risk of miscarriage and a pulling sensation in the lower abdomen, an infusion of viburnum flowers is also used: brew two tablespoons of flowers in a thermos with ½ liter of boiling water, leave for two hours, then strain and drink ¼ cup three or four times a day. When the sensations return to normal, drink an infusion of viburnum flowers for another half month for preventive purposes, reducing the dose to 1/8 cup. It should be noted that viburnum has a moderate hypotensive effect and increases blood clotting, so you can drink infusions with viburnum only in short courses and preferably under the supervision of a doctor.
Many pregnant women are prescribed Magne B6, but you can instead focus on foods containing magnesium. For example, eat whole grain bread, different types of lettuce, spinach, nuts - cashews, almonds, buckwheat and oatmeal, cocoa and chicken eggs. Magnesium is well absorbed together with calcium, which is found in walnuts, pistachios and hazelnuts, beans, cottage cheese and dairy products. It is much more difficult to organize an excess of microelements, which is also undesirable, with the help of food products than by taking synthetic vitamins.
Herbal treatment of possible termination of pregnancy is carried out using an infusion of the above-ground part of the dandelion: grind the plant material, measure out a teaspoon and brew a glass of boiling water (200 ml), simmer in a water bath for three to five minutes. Strain and drink in small sips of 50 ml three to four times a day.
You can make a decoction from the dried and crushed roots of this plant. The dosage and method of its preparation are similar.
Some recommend an infusion of elecampane root, although not all herbalists recommend this plant for pregnant women. To prepare the infusion, pour one tablespoon of the medicinal raw material with a glass of boiling water and leave to infuse overnight. Strain in the morning and take two to three tablespoons four times a day before meals. This infusion can also be used for colds.
Pregnant women are not prohibited from drinking chamomile tea, which has a relaxing and calming effect: 25 g of dried chamomile flowers are brewed with 1/2 liter of boiling water, simmered in a water bath for at least five minutes, infused for a quarter of an hour, filtered and drunk in ½ glass with the addition of honey.
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Homeopathy
Homeopathic treatment can be useful in the early stages of pregnancy when there is a threat of miscarriage. In order for homeopathic treatment to be effective, it is necessary to consult a practicing homeopath and receive a prescription from him. In the early stages, for example, Sepia, Valerian, Secale are prescribed, and for habitual miscarriages - Eupatorium purrureum and Plumbum.
The issue of using pharmacy homeopathic remedies such as Mulimen, Ginikoheel, Spascuprel can be individually resolved with a doctor.
Surgical treatment
Surgical treatment is carried out for ectopic pregnancy and is performed in the required volume (laparotomy or laparoscopy), the choice of which is determined by the following factors: the clinical condition of the patient, the size and location of the ovum, the integrity of the organ in which it develops, the presence of adhesions and the patient's desire to preserve fertility. This determines the choice of either conservative plastic surgery (salpingotomy, removal of part of the fallopian tube or ovary, etc.) or radical intervention - complete removal of the tube.
Laparotomy is contraindicated if the patient has hemorrhagic shock or grade IV peritoneal adhesive disease.
Laparoscopic access is certainly preferable, as it is less traumatic, and the operation takes much less time. With laparoscopy, the frequency of postoperative complications is low and the functions of the organ are preserved, the duration of hospitalization is reduced and recovery is much faster.
Early diagnosis of ectopic pregnancy prevents serious complications, such as damage to the fallopian tube or ovary, and allows the function of the reproductive organs to be preserved.
Prevention
A healthy lifestyle, proper nutrition, and the absence of infectious and inflammatory diseases of the genitourinary system practically guarantee successful implantation of the blastocyst and its successful development.
Minor bloody discharge and pulling sensations in the lower abdomen are quite acceptable. Do not deny yourself the desire to lie down, rest, do not lift weights, limit physical activity. Walking in the fresh air in comfortable shoes is useful.
It is necessary to dress according to the weather, try to avoid crowded places, stressful situations and injuries.
Do not take any medications other than those prescribed by your doctor.
Forecast
So, pulling sensations in the lower abdomen and in the lumbar region, not constant and not exhausting, are quite physiological in the third week of pregnancy. However, if the condition worries you and causes significant discomfort, you should see a doctor to get qualified advice and assess the changes that are taking place.
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