Sakit Ari-Ari: Punca pada Wanita & Bila Perlu Jumpa Doktor

Sakit ari-ari is pain in the lowest part of the tummy, just above the pubic bone. In women it is most often caused by period pain, ovulation pain, a urine infection (UTI), constipation or trapped wind. Less often it is a sign of something that needs urgent treatment, such as an ectopic pregnancy, pelvic inflammatory disease (PID), a twisted or burst ovarian cyst, or appendicitis. Call 999 or go to the emergency department if the pain is severe or getting worse, or if you feel faint, have pain in the tip of your shoulder or have heavy vaginal bleeding (NHS). This guide explains how timing, side and other symptoms help narrow down the cause, what is normal in pregnancy, and how to ease the pain.

Apa itu ari-ari?

In Malay, ari-ari means the lowest part of the belly, just above the private parts, between the belly button and the pubic bone (Kamus Dewan Edisi Keempat). Doctors usually call pain here lower abdominal pain or pelvic pain.

Many organs sit in this small space: the bladder, the womb, the ovaries, the lower bowel and, on the right, the appendix (Cleveland Clinic). Pain from the kidneys can also wrap around to the front (Cleveland Clinic). Because these organs are so close together, it can be hard to tell bowel cramps from period cramps (Cleveland Clinic).

Pelvic pain can feel different from person to person. According to the NHS, it may be:

• a sudden sharp, stabbing or burning pain;
• a dull or heavy ache, or a feeling of pressure;
• cramping or throbbing that comes and goes;
• a twisted or knotted feeling;
• pain only when you do something, such as exercising, having sex or peeing.

Pain that comes on suddenly is called acute pelvic pain. Pain that lasts 6 months or longer is called chronic pelvic pain (NHS).

Bila sakit ari-ari perlu rawatan segera

Call 999 or go to the nearest emergency department if you have pelvic pain and (NHS):

• the pain is severe, getting worse, or hurts when you move or touch the area;
• you feel faint, dizzy or lightheaded, or you pass out;
• you have pain in the tip of your shoulder;
• you have heavy bleeding from your vagina;
• you have difficulty breathing or suddenly feel confused.

Do not drive yourself; ask someone to take you or call an ambulance (NHS).

See a doctor the same day if you have pelvic pain and (NHS):

• you are pregnant or may be pregnant;
• you have a very high temperature, or feel hot, cold or shivery;
• you have pain when peeing or need to pee more than usual;
• you have unusual discharge, fluid or bleeding from your vagina;
• there is blood in your pee or poo, or you find it hard to pee or poo;
• you have vomiting and diarrhoea, or feel sick.

If you are 20 weeks pregnant or more, contact your labour ward or maternity clinic directly (NHS).

Punca mengikut masa dalam kitaran haid

When the pain happens is often the most useful clue. Keep a note of the date, where it hurts and what else you notice.

Period pain is very common in Malaysia. In a study of 210 women aged 18 to 35 at a government health clinic in Kuala Selangor, 60.5% had period pain with no other cause found, and about 1 in 9 of them described it as severe (Yahaya et al., 2022). Common does not mean you have to put up with it: see a doctor if your periods become more painful or the pain stops you doing your usual activities (NHS).

Sakit ari-ari sebelah kiri, kanan atau tengah

The side of the pain gives your doctor a clue, but it is not a diagnosis. Many causes can appear on either side (Cleveland Clinic).

Sakit ari-ari tapi tak period

Pain in the ari-ari when you are not on your period is common, and usually has a simple reason. According to the NHS, the most likely causes are:

• Ovulation pain, about 14 days before your next period. It usually lasts a short time and is nothing to worry about (NHS).
• A urine infection, especially if peeing burns or you need to go often.
• Constipation, trapped wind or IBS. See our guides to sembelit and perut kembung.
• Endometriosis, which can cause pain in the lower tummy and back at any time of the month, as well as severe period pain (NHS).
• PID, an infection of the womb, fallopian tubes and ovaries, usually caused by a sexually transmitted infection such as chlamydia or gonorrhoea. It can also cause pain deep inside during sex, bleeding between periods or after sex, and unusual discharge (NHS).
• Pregnancy. If your period is late, do a pregnancy test. See our guide to period lambat.

Ovarian cysts, scar tissue from surgery near the ovaries (such as a caesarean section) and an ectopic pregnancy can cause pain that feels like ovulation pain (NHS). See a doctor if the pain does not get better with painkillers or keeps coming back (NHS).

Sakit ari-ari semasa mengandung

Sakit ari-ari tanda hamil?

Pain is not a reliable sign of pregnancy. Mild cramps also happen just before a period, and the NHS list of early pregnancy signs does not include pelvic pain. Some women have light spotting around the time the pregnancy implants; any cramping then should be milder than period cramps (Cleveland Clinic). A missed period and a pregnancy test are more useful. See our guide to tanda-tanda mengandung.

Sakit yang biasanya tidak bahaya

Tummy pain and cramps are common in pregnancy. It is probably nothing to worry about if the pain is mild and goes away when you change position, rest, poo or pass wind (NHS). Common harmless causes include (NHS):

• Ligament pain, as the ligaments stretch to support your growing bump. It can feel like a sharp cramp on one side of your lower tummy.
• Constipation, which is common in pregnancy.
• Trapped wind.

Sakit tulang ari-ari (pelvic girdle pain)

Pain right over the pubic bone, at the front in the centre, can be pregnancy-related pelvic girdle pain (PGP), also called symphysis pubis dysfunction (SPD). It affects up to 1 in 5 pregnant women to some degree (NHS). The pain may also be felt in the lower back, between the vagina and anus, or down the thighs, and it is often worse when walking, climbing stairs, turning over in bed or getting out of a car (NHS). PGP is not harmful to your baby, and most women with it can have a vaginal birth (NHS). Tell your doctor or midwife; a physiotherapist can teach exercises and may suggest a pelvic support belt (NHS).

Bila perlu ke hospital segera

Contact your labour ward or maternity clinic straight away if you have tummy pain and (NHS):

• vaginal bleeding or spotting;
• regular cramping or tightenings;
• lower back pain;
• vaginal discharge that is unusual for you, or fluid leaking from your vagina;
• pain when you pee, needing to pee suddenly or more often, or pee that looks cloudy, pink, red or brown;
• pain that is severe or does not go away after 30 to 60 minutes of rest.

Serious causes include ectopic pregnancy (symptoms usually appear between 4 and 12 weeks), miscarriage (cramping and bleeding before 24 weeks), premature labour, problems with the placenta, and urine infections, which are common in pregnancy (NHS).

Sakit ari-ari selepas bersama

Pain during or after sex is common. ACOG says nearly 3 out of 4 women have it at some time in their lives, and for many it is temporary. Where you feel it gives a clue (ACOG; NHS):

• Deep pain in the pelvis can be linked to PID, endometriosis, ovarian cysts or scar tissue (adhesions).
• Pain near the opening of the vagina is more often from dryness (for example after menopause), a yeast or bacterial infection, skin irritation, or the muscles tightening by reflex (vaginismus). See our guide to gatal faraj.
• After childbirth, a tear or cut in the area between the vagina and anus can make sex painful for several months.

See a doctor if sex is often or severely painful (ACOG), or if you also have bleeding after sex, bleeding between periods or unusual discharge, which can be signs of PID (NHS). PID is easily treated with antibiotics if it is found early (NHS). If you have a new partner, ask about a sexual health check.

Sakit ari-ari yang berpanjangan

Pelvic pain that lasts 6 months or longer is called chronic pelvic pain. It does not have to happen every day, and it may come and go with your period, with peeing or opening your bowels, or with sex (ACOG). Possible causes include (ACOG):

• Womb and ovaries: endometriosis, adenomyosis (period pain and heavy bleeding that get worse with age), fibroids, and PID.
• Bladder: repeated UTIs and painful bladder syndrome (interstitial cystitis), which causes pelvic pain with frequent, urgent peeing.
• Bowel: irritable bowel syndrome (IBS) is one of the most common, along with inflammatory bowel disease.
• Muscles and joints: lower back problems, tight pelvic floor muscles, poor posture, and pain that started during or after pregnancy.

Sometimes more than one cause is involved, and sometimes no cause is found. ACOG stresses that the pain is still real and can still be treated, with the aim of reducing the pain and its effect on your life.

See a doctor if you have pelvic pain that comes and goes or does not go away, especially with bloating that keeps coming back, feeling full quickly, losing weight without trying, or a change in your bowel habits (NHS). These symptoms are usually caused by something else, but they are also the symptoms of ovarian cancer, so they should be checked (NHS).

Cara hilangkan sakit ari-ari

Treatment depends on the cause. For period pain or ovulation pain, these can help (NHS):

• a warm bath or shower;
• a heat pad or hot water bottle, wrapped in a towel, on your tummy;
• massaging your tummy and back;
• gentle exercise, such as walking, swimming or yoga;
• painkillers such as paracetamol or ibuprofen.

In the Kuala Selangor study, women who did not exercise regularly were much more likely to have period pain (Yahaya et al., 2022). This type of study shows a link and cannot prove that exercise prevents pain, but gentle activity is safe for most women.

If you are pregnant, paracetamol is usually the best painkiller, and you should avoid ibuprofen unless a doctor or pharmacist advises it (NHS). Ibuprofen can also cause more side effects than paracetamol, so try paracetamol first if you can (NHS).

For pain caused by constipation, more fibre and water usually help; see our guide to sembelit. A doctor may suggest antibiotics for an infection, physiotherapy for pelvic floor or pelvic girdle pain, or hormonal treatments for conditions such as endometriosis (NHS). For severe period pain, stronger anti-inflammatory medicines or hormonal contraception may be offered (NHS).

Do not keep taking painkillers to cover up pain that is severe, getting worse or coming back. Some causes, such as PID, appendicitis and ectopic pregnancy, need treatment quickly.

Apa yang doktor akan periksa

Getting a diagnosis can take time, because many conditions cause similar pain (NHS). It helps to tell your doctor as much as you can (NHS):

• where the pain is, what it feels like and how long it lasts;
• when it happens in your menstrual cycle, and the date of your last period;
• whether it is linked to peeing, opening your bowels, eating or sex;
• any discharge, bleeding, fever or changes in your periods;
• your contraception, and whether you could be pregnant.

Depending on your symptoms, the doctor may feel your tummy, do an internal examination, and arrange a pregnancy test, a urine test, swabs for infection, a blood test or an ultrasound scan (NHS). If the cause is still not clear, you may be referred to a gynaecologist or another specialist (NHS).

Frequently asked questions (FAQ)

Sakit ari-ari tanda apa (what does pain in the ari-ari mean)?

In women, the most common causes are period pain, ovulation pain, a urine infection (UTI), constipation and trapped wind (NHS; Cleveland Clinic). Less often it can be a sign of something that needs urgent treatment, such as an ectopic pregnancy, pelvic inflammatory disease (PID), a burst or twisted ovarian cyst, or appendicitis (NHS). When the pain happens in your cycle, which side it is on and what other symptoms you have are the best clues.

Sakit ari-ari tanda hamil ke (is it a sign of pregnancy)?

Not on its own. Mild cramps also happen in the days before a period, and the NHS list of early pregnancy signs does not include pelvic pain. If you have light spotting at implantation, any cramping should be milder than period cramps (Cleveland Clinic). If your period is late, take a pregnancy test. If you could be pregnant and have pain low down on one side, bleeding or pain in the tip of your shoulder, get checked the same day, because these can be signs of an ectopic pregnancy (NHS).

Sakit ari-ari sebelah kanan bahaya ke (is pain on the right side dangerous)?

It can be. Pain in the lower right side may come from the appendix, and severe pain there needs emergency care (Cleveland Clinic). Appendicitis usually starts around the belly button and moves to the lower right side over a few hours, getting worse when you move or cough (NHS). In women, ovulation pain, an ovarian cyst, PID or an ectopic pregnancy can also cause pain on the right (Cleveland Clinic).

Sakit ari-ari sebelah kiri kenapa (why does the left side hurt)?

Lower left pain can come from the bowel, such as constipation or diverticulitis, and in women from period pain, ovulation pain, an ovarian cyst, endometriosis, PID or an ectopic pregnancy (Cleveland Clinic). Ovulation pain switches sides from month to month, depending on which ovary releases an egg (NHS).

Sakit ari-ari tapi tak period kenapa (why does it hurt when I am not on my period)?

Common reasons include ovulation pain about 14 days before your period, a UTI, constipation or wind (NHS). Endometriosis can also cause lower tummy pain at any time of the month (NHS). If your period is late, rule out pregnancy first with a test. See a doctor if the pain keeps coming back, does not get better with painkillers, or comes with unusual discharge, bleeding between periods or pain during sex (NHS).

Sakit ari-ari selepas bersama kenapa (why does it hurt after sex)?

Pain during sex is common: ACOG says nearly 3 out of 4 women have it at some point. Deep pain can be linked to PID, endometriosis, ovarian cysts or scar tissue, while pain near the opening of the vagina often comes from dryness, infection or tight muscles (ACOG). See a doctor if it happens often, is severe, or comes with bleeding after sex or unusual discharge, which can be signs of PID (NHS).

Sakit ari-ari dan pinggang kenapa (pain in the ari-ari and lower back)?

Period pain often spreads to the back and thighs (NHS). Endometriosis can cause pain in the lower tummy and back (NHS). In pregnancy, pelvic girdle pain can be felt over the pubic bone and across the lower back (NHS). If you also have a high temperature, feel sick, or have burning when you pee, it may be a kidney infection, which needs prompt treatment (NHS).

Sakit ari-ari semasa mengandung normal ke (is it normal in pregnancy)?

Mild pain that goes away when you rest, change position, poo or pass wind is usually harmless, and stretching ligaments can cause a sharp cramp on one side (NHS). Call your clinic or labour ward straight away if the pain comes with bleeding, regular tightenings, unusual discharge or leaking fluid, pain when you pee, or does not go away after 30 to 60 minutes of rest (NHS).

Cara hilangkan sakit ari-ari (how to ease the pain)?

For period or ovulation pain, a warm bath, a hot water bottle on your tummy, gentle exercise and paracetamol or ibuprofen can help (NHS). If you are pregnant, paracetamol is usually the best choice, and ibuprofen should be avoided unless a doctor or pharmacist advises it (NHS). Painkillers do not treat the cause, so see a doctor if the pain is severe, keeps coming back or comes with warning signs.

Sakit ari-ari lelaki kenapa (what about men)?

Men can also get pain in this area from constipation, a UTI or appendicitis. Causes specific to men include an inguinal hernia and problems with the testicles or prostate, such as prostatitis (NHS). This guide focuses on women.

Disclaimer

This article is for general information only and is not a substitute for advice from a doctor. If you have severe pelvic pain, feel faint, have heavy bleeding, or could be pregnant and have pain on one side, call 999 or go to the nearest emergency department.

References

• ari-ari — Kamus Dewan Edisi Keempat, Pusat Rujukan Persuratan Melayu, Dewan Bahasa dan Pustaka
• Yahaya Y, Ismail AH, Shamsuddin NH. Primary dysmenorrhoea among reproductive-age women at Kuala Selangor health clinic: Prevalence and factors associated. Med J Malaysia. 2022;77(5):569-575.
• Pelvic pain — NHS
• Period pain — NHS
• Ovulation pain — NHS
• Pelvic inflammatory disease — NHS
• Ovarian cyst — NHS
• Endometriosis — NHS
• Ovarian cancer: symptoms — NHS
• Appendicitis — NHS
• Urinary tract infections (UTIs) — NHS
• Kidney infection — NHS
• Stomach pain in pregnancy — NHS
• Pelvic pain in pregnancy — NHS
• Signs and symptoms that might mean you're pregnant — NHS
• Ibuprofen for adults — NHS
• Lower abdominal pain — Cleveland Clinic
• Left side abdominal pain — Cleveland Clinic
• Right side abdominal pain — Cleveland Clinic
• Implantation bleeding — Cleveland Clinic
• Chronic pelvic pain — American College of Obstetricians and Gynecologists (ACOG)
• When sex is painful — ACOG