Lower abdominal pain during exercise

Pain that starts with lifting, running, or core work may involve abdominal or pelvic-floor muscles, especially after a change in training. Pain that follows the menstrual cycle, persists after exercise, or occurs with heavy periods can also be associated with endometriosis, adenomyosis, fibroids, or an ovarian cyst. Pelvic inflammatory disease may cause pain beyond exercise. Exercise pain alone does not establish any one condition.

Stop the activity that provokes the pain and use gentle movement only if it feels comfortable. Note the exercise, onset, side, intensity, bleeding, bowel or bladder symptoms, and how quickly it settles. Reintroduce activity gradually after symptoms improve. Arrange an assessment when pain keeps returning, limits normal activity, or comes with cycle-related pain, unusual bleeding, discharge, or pain during sex.

Get urgent medical help for sudden severe pain, collapse, faintness, vomiting, fever, a rigid or very tender abdomen, or pain with heavy bleeding. If pregnancy is possible, one-sided pain with bleeding or dizziness requires prompt assessment for ectopic pregnancy.

Could this be a muscle or pelvic-floor problem? Should I be checked for an ovarian cyst, endometriosis, infection, or fibroids? What exercises are reasonable while symptoms are being assessed?