5 Most Painful Things a Female Body Can Experience, According to an ER Doctor

When it comes to pain, the female body endures some of the most intense, complex, and often misunderstood medical conditions. As a board-certified emergency physician, I’ve treated countless women in the ER who were battling excruciating pain that others dismissed, misdiagnosed, or didn’t even know existed.

From sharp, stabbing pelvic pain to childbirth-level trauma, here are five of the most painful things a woman can experience — medically explained, symptom-spotlighted, and treatment-informed.

1. Bartholin Cyst: Small Gland, Big Pain

Bartholin glands are two tiny structures near the vaginal opening that release fluid to keep the area lubricated. But when the duct leading from the gland becomes blocked, fluid backs up, forming a Bartholin cyst. While some cysts are painless, others become infected, turning into an abscess that causes severe pain, swelling, and redness.

Symptoms of a Bartholin Cyst:

• Tender lump on one side of the vaginal opening

• Pain during walking, sitting, or intercourse

• Redness and swelling

• Fever or pus (if infected)

What causes them?

• Infections (E. coli, gonorrhea, chlamydia)

• Shaving, waxing, or irritation

• Trauma or poor hygiene

Treatment:

• Warm sitz baths for small cysts

• Incision and drainage for abscesses

• Word catheter or surgical removal for recurring cysts

Pain rating: Up to 9/10 — likened to a "hot poker" between the legs.

2. Ruptured Ovarian Cyst: Sudden Internal Explosion

Ovarian cysts are fluid-filled sacs that form during ovulation. While most resolve on their own, ruptured ovarian cysts can release fluid into the pelvic cavity, causing intense pain and inflammation.

Symptoms of a Ruptured Cyst:

• Sudden, sharp lower abdominal pain (usually on one side)

• Abdominal bloating

• Nausea or vomiting

• Dizziness or fainting (in case of internal bleeding)

Common triggers:

• Exercise

• Intercourse

• Spontaneous rupture

Treatment:

• Rest and NSAIDs for mild cases

• ER evaluation, IV fluids, and imaging for severe cases

• Surgery if internal bleeding is present

Pain rating: 8–9/10 — often mistaken for appendicitis or ectopic pregnancy.

3. Vulvodynia: Chronic Pain with No Clear Cause

Vulvodynia is chronic pain or discomfort around the opening of the vagina with no identifiable cause. It's often described as burning, stinging, or rawness that can make even simple activities like sitting or wearing leggings unbearable.

Symptoms:

• Persistent pain in the vulva

• Pain during intercourse or tampon use

• Burning, stinging, or raw sensations

Possible causes:

• Nerve hypersensitivity

• Hormonal changes (birth control, menopause)

• Pelvic floor tension

• Post-infection nerve damage

Treatment options:

• Pelvic floor physical therapy

• Topical anesthetics (e.g., lidocaine)

• Neuropathic medications

• Botox injections

• Surgery (vestibulectomy) in rare cases

Pain rating: 7–9/10 — often gaslit or dismissed, but very real and very disruptive.

4. Endometriosis: Pain That Spreads and Sticks

Endometriosis is a condition where tissue similar to the uterine lining grows outside the uterus — on ovaries, fallopian tubes, bladder, and other organs. This tissue bleeds and swells with every cycle, causing chronic pelvic pain, inflammation, and scarring.

Symptoms of Endometriosis:

• Severe cramping

• Painful intercourse or bowel movements

• Infertility

• Chronic fatigue and back pain

Why it's so painful: The rogue tissue has no way to exit the body, leading to inflammation, adhesions (organ fusion), and scar tissue.

Treatment options:

• Hormonal birth control

• Excision surgery

• Physical therapy

• Anti-inflammatory meds

• Hysterectomy (in severe cases)

Pain rating: 9–10/10 — described as "cheese-grater on the insides" pain. Diagnosis often takes 7–10 years.

5. Unmedicated Childbirth: Nature’s Final Boss

The most intense pain many women will ever feel comes during unmedicated labor and delivery. Uterine contractions during labor can exert 400+ newtons of force — enough to be compared to breaking 20 bones at once.

What happens during childbirth?

• Cervix dilates to 10 cm

• Uterus contracts powerfully

• Organs shift to accommodate the baby

• Perineal tearing is common

Symptoms:

• Deep, full-body aching contractions

• Pressure and pain in the pelvis and lower back

• Tearing, swelling, and tissue trauma

Treatment:

• Epidurals, nerve blocks, or natural techniques (breathing, movement, support)

• Perineal stitching and pelvic floor rehab post-birth

Pain rating: 10/10 — intensified by labor duration, baby's position, and tearing.

Female Pain Is Real — and Deserves Better Recognition

Women endure medical pain that is often minimized, under-researched, or misunderstood. Conditions like Bartholin cysts, ruptured ovarian cysts, vulvodynia, and endometriosis are not just "part of being a woman." They are serious, painful, and deserve proper care and acknowledgment.

If you're experiencing persistent pelvic pain, discomfort during intimacy, or anything that feels "off," don’t wait. Talk to your healthcare provider or seek care from a specialist. You deserve relief, respect, and real answers.