The mid lower abdomen is home to the organs of reproduction in the woman like uterus and ovaries as well as tubes. Both sexes have their bladder in this region and in the male the prostate gland sits right under the bladder. There is a close relationship also to the small and large bowel reach into the pelvis resting on top of the bladder.
The physician can examine a woman in the lithotomy position with a bimanual exam to assess the size of the uterus and the ovaries. In the male a rectal examination will reveal the size of the prostate and also whether it is tender as it would be with prostatitis.
During labor the physician makes sure that the baby’s head is descending through the pelvis into the birth channel.
Both sexes can have cystitis (bladder infection), which will radiate pain into the mid lower abdomen. Proper urine cultures need to be made and an appropriate antibiotic will eradicate this infection.
In women dysmenorrhea is a painful period that can be from endometriosis or adenomyosis. Not only have these women severe pain in their uterus, but also pain that radiates into the mid abdomen and in some women also into the lower back. Fibroids may cause pain with intercourse, but eventually will produce pain on their own because of the size of the fibroids that can reach the size of a tennis ball or more. Usually they develop because the woman is estrogen dominant meaning that she lacks progesterone relative to estrogen. These women also often have missed periods, which causes this progesterone deficiency (no corpus luteum that would produce it). Hormone treatment with bioidentical progesterone can often melt the fibroids, if the process has not gone too far.
Endometritis and PID (pelvic inflammatory disease) are infections, often due to Chlamydia or gonorrhea. A gynecologist needs to be involved in these cases. Cancer of the uterus is a common gynecological cancer, which is particularly common in obese females and requires the services of a gynecologist as well.
Now to the male diseases that can lead to referred pain into the mid lower abdomen. Prostate hypertrophy is common in the aging male an may have something to do with the relative loss of testosterone. Many physicians still have hang-ups about testosterone replacement, but Dr. Morgentaler from Harvard University has shown that prostate cancer does not get caused and is not made worse by testosterone replacement (Ref. 9). Prostate cancer needs to be detected early, often this is done by monitoring the PSA in the blood and when it exceeds a critical level, biopsies of the prostate are done to detect the tumor. If it is detected early, a radical selective prostate resection can be done with very good results.
This is an overview that mentions only the most common causes of pain in the mid lower abdomen. There are many others.