Groin pain in women has a wide range of causes, and not all are musculoskeletal. The groin is a crossroads — the hip joint, inner-thigh (adductor) tendons, the abdominal/inguinal wall, and, in women specifically, pregnancy-related and gynaecological causes can all produce pain in the same area.
This guide explains the common musculoskeletal causes a hip specialist treats, the location clues that help narrow it down, and — importantly — the red flags that mean you should see your GP or seek urgent care rather than a physiotherapist.
Common musculoskeletal causes
Where the picture points clearly to a musculoskeletal cause, the most common structures involved are:
Hip-joint problems (FAI, labral tear, osteoarthritis)
Particularly common in women — the hip joint is a frequent source of deep, central groin pain. FAI and labral tears are most common in active 20–50 year olds; osteoarthritis tends to present later. Catching, pinching and pain with deep flexion or sitting are common features. Hip-joint pain in women is often mislabelled as a "strain" or "soft-tissue problem" when the joint is the actual source.
→ FAI and labral tears explained →Adductor-related groin pain
Inner-thigh tendon or muscle injury — common in pivoting and kicking sports, but also possible in everyday life from a sudden load or twist. Tenderness is felt on the inner thigh, with pain on resisted adduction (squeezing the legs together) and on stretching the legs apart.
→ Groin strain: grades, healing time, and how to treat it →Iliopsoas-related pain
The deep hip flexor can become overloaded or irritated, producing pain higher and deeper than an adductor problem — sometimes with a click on hip flexion/extension. Common in dancers, runners, martial artists and strength training.
Referred pain from the lower back
The lumbar spine can refer pain into the groin — particularly when there's nerve involvement. Usually picked up on examination of the back alongside the hip.
The full picture — including the differential, the assessment approach, and the rehabilitation pathway — is covered on the broader groin pain pillar page.
What the location or side can suggest
Pain side or spot doesn't diagnose by itself, but it's one of the most useful starting clues:
Often hip-joint related (FAI, labral tear, OA). The "C-sign" — cupping the side of the hip — is a classic presentation. Worse with sitting and deep flexion.
Most often adductor-related — the inner-thigh muscle or tendon. Pain is usually worse with squeezing the legs together or stretching them apart.
Raises the possibility of referred pain from the lower back, sometimes with nerve involvement (pins and needles, numbness, pain extending into the leg).
Suggests inguinal wall / "sports hernia". Often worse with coughing, sneezing, or sit-ups. A visible or palpable bulge would push the picture toward a true inguinal hernia — needs medical assessment.
Unilateral groin pain is common and not inherently more concerning than bilateral. Many musculoskeletal causes (adductor strain, FAI, inguinal wall) are typically one-sided. Persistent one-sided pain is still worth assessing.
Pregnancy and cycle-related groin pain
Two patterns are specific to women and worth being aware of — neither is the same as a typical musculoskeletal injury, and both deserve a different conversation with a clinician:
Pregnancy-related pain
Round-ligament pain is a common cause of groin discomfort in pregnancy — a sharp or pulling sensation on one or both sides, often triggered by movement, coughing, or position change. Pelvic-girdle pain (PGP) is another recognised pattern, sometimes felt around the groin, pubic symphysis, or inner thigh. Both are usually benign and manageable with appropriate guidance, but worth mentioning to a midwife or GP so they're not confused with a tendon or joint problem.
Cyclical patterns
Some women notice hip or groin pain that varies with their menstrual cycle, often linked to hormonal changes affecting soft-tissue sensitivity and pain perception. It's a recognised pattern and usually benign — but worth flagging to a clinician so that anything more serious is ruled out, and so it isn't confused with a joint, tendon, or other structural problem.
Both patterns are covered briefly here because they're commonly searched for alongside groin pain in women — but the assessment and management of pregnancy-related or cyclical pain sits with a clinician experienced in those presentations.
When to worry — red flags (see a doctor, not a physio)
Groin pain in women sometimes points to a non-musculoskeletal cause. The following features are reasons to seek prompt medical assessment before (or instead of) physiotherapy:
See a doctor promptly if you have:
- Fever or feeling unwell, or a hot, swollen area in the groin — possible infection.
- A lump or bulge in the groin (possible hernia) — needs examination by a doctor, often surgical opinion.
- Severe or sudden pain, or pain after significant trauma.
- Pelvic, urinary, or gynaecological symptoms (unusual bleeding, discharge, or pain).
- Pregnancy with severe groin pain, bleeding, or change in baby's movements — contact midwife or emergency care promptly.
- Unexplained weight loss or night sweats alongside groin pain.
These features point away from routine musculoskeletal causes. A physiotherapist isn't the right first port of call — a medical assessment is.
How a specialist assesses musculoskeletal groin pain
Where the picture clearly fits a musculoskeletal cause, a hip and groin specialist assessment typically combines:
History and pattern recognition
Where the pain sits, what brings it on, what sport or activity, what makes it better or worse, and any history of previous strains, pregnancy, surgery, or cyclical patterns. This often points strongly toward the structure involved before any hands-on testing.
Resisted testing and joint provocation
Hip impingement tests, resisted adduction, iliopsoas provocation, abdominal-wall and lumbar screening — to localise the source across the structures that commonly present as groin pain.
Selective imaging, never in isolation
Imaging is interpreted alongside the clinical picture, not on its own. Where a non-musculoskeletal cause is suspected — or where features suggest pregnancy-related, gynaecological or other medical causes — onward referral is the priority.
When to see a specialist
If groin pain is persistent or recurring and a musculoskeletal cause is likely, a specialist assessment can pin down the source and plan treatment. Where features suggest a non-musculoskeletal cause, the right first step is a medical assessment — not physiotherapy.
Persistent or recurring groin pain?
John Gravenall offers specialist hip and groin assessments in London, the Midlands, and online.
Book a specialist hip assessment →Frequently Asked Questions
What causes groin pain in females?
Musculoskeletal causes include hip-joint problems (FAI, labral tears, osteoarthritis), adductor or iliopsoas issues, and referred pain from the lower back. In women specifically, pregnancy-related changes (round-ligament pain, pelvic-girdle pain) and cyclical patterns can also produce groin pain. Gynaecological and other non-musculoskeletal causes need to be considered and may need onward medical referral.
When should I worry about groin pain (female)?
Seek prompt medical care if groin pain comes with fever, a hot or swollen area, a lump or bulge in the groin, severe or sudden pain, pain after trauma, pelvic / urinary / gynaecological symptoms, or severe pain / bleeding in pregnancy. These features point away from routine musculoskeletal causes and need medical assessment, not physiotherapy.
Can hip problems cause groin pain in women?
Yes. FAI, labral tears and osteoarthritis commonly present as deep groin pain in women and are easily mislabelled as a 'strain' or a 'soft-tissue problem'. A specialist hip assessment can identify the joint as the source and direct treatment accordingly.
Why does my groin hurt during my period?
Some women experience cyclical hip or groin pain linked to hormonal changes across the menstrual cycle. It's a recognised pattern and usually benign, but worth mentioning to a clinician so it isn't confused with a tendon, joint or other problem — and so that anything more serious is ruled out.