Ovarian Cancer Symptoms

Early and Advanced Signs You Should Know

Ovarian cancer has been nicknamed the "silent killer." That's because there are said to be few signs and symptoms of ovarian cancer in the early stages of the disease.

Recently, however, researchers have found that people with early-stage ovarian cancer do often have symptoms, such as pelvic pain, bloating, and frequent urination. Unfortunately, these early symptoms are usually subtle and easily attributed to other causes.

Because there is no screening test for ovarian cancer, most cases are only found in the advanced stages when symptoms like abdominal swelling, unintentional weight loss, and the inability to have a bowel movement raise serious concerns.

This article discusses the early and later symptoms of ovarian cancer. It also looks at some of the complications of ovarian cancer, and when you should see a doctor.

ovarian cancer symptoms


Early Symptoms of Ovarian Cancer

After an ovarian cancer diagnosis, many people will look back and realize they had symptoms they did not recognize. The symptoms were just too mild or vague to prompt a visit to the doctor.

Four symptoms may appear in the early stages of ovarian cancer:

  • Abdominal bloating
  • Pelvic pain or pressure
  • Feeling full quickly with eating
  • Frequent urination

Abdominal Bloating

Most people with early-stage ovarian cancer will report bloating with bouts of abdominal swelling. While it is common to experience bloating prior to your period or just after eating a large meal, persistent bloating should never be ignored as this may be a sign of ovarian cancer.

This type of bloating may vary in degree from mild to severe. It often occurs on a daily basis and can worsen with time. You may also have mild indigestion. 

This symptom can be subtle. Your clothes may feel tight around your waistline, even when you haven't gained any weight.

Look in the mirror. You may be able to see visible bloating. Some people may even develop stretch marks. This can happen especially if you have never been pregnant.

Bloating with early ovarian cancer is often dismissed as something else. You may think it's related to age, menopause, or gaining a few pounds. Remember, though, if you feel bloated for more than a day or two it is a reason for concern.

Pelvic Pain or Pressure

Pelvic pain that feels like menstrual cramps is another symptom of early ovarian cancer. Like bloating, occasional pelvic pain is common, especially during menstruation. This is why this symptom may be overlooked.

See your doctor if you have pelvic pain that doesn't go away, especially if you also have a feeling of pressure in your pelvis.

The pain may be on one side of your pelvis. It can also be diffuse and felt all over your pelvis. 

Feeling Full Quickly With Eating

Many people with early ovarian cancer notice they feel full more quickly than normal after eating an average size meal. This sensation may also occur between meals. There may or may not also be gas and indigestion.

Weight loss is common with more advanced ovarian cancers. As an early symptom, it can be related to this sense of fullness.

Frequent urination

Another early symptom of ovarian cancer is more frequent urination. There may also be a sense of urgency when you need to go.

This may be related to a tumor putting pressure on the bladder. It can also be related to hormonal changes caused by some tumors.

Some people also feel a strong need to urinate, but upon sitting down realize they do not need to go.


Understanding Ovarian Cancer Symptoms, Stages, and Treatment

Advanced Stage Symptoms of Ovarian Cancer

Many other symptoms of ovarian cancer happen only after the tumor has reached an advanced stage. Again, there are many potential causes of these symptoms. This is why it is important to see your doctor.

These advanced symptoms include:

  • Changes in bowel habits
  • Pain with intercourse
  • Back pain
  • Unintentional weight loss or weight gain
  • Fluid in the abdomen
  • Fatigue

Changes in Bowel Habits

This is the most important symptom to note. It may also be a symptom of colon cancer.

Changes in bowel habits can include both constipation and diarrhea. Stools may also become skinnier. This is because the tumor puts pressure on the bowel.

In later stages of ovarian cancer, tumors may cause bowel obstruction. Symptoms include:

  • Worsening and crampy abdominal pain
  • Vomiting
  • Diarrhea

Pain With Intercourse

Pain during intercourse is also called dyspareunia. It may occur with ovarian cancer. It can also be a symptom of other conditions such as pelvic inflammatory disease.

This pain is often felt on one side more than the other but can be generalized. The pain is similar to menstrual cramps. It may begin with intercourse and continue for some time afterward.

Painful sex can be a warning sign for a number of physical conditions. It can also be a source of emotional stress and put a strain on relationships.

Discuss any discomfort or pain during sexual activity with your doctor.

Back Pain

Pain may occur in the lower back or flank region. The flank is the side of the body, roughly between the rib cage and the hip.

The pain can feel similar to menstrual pain or the early stages of labor. If you have lower back pain that is not related to activities such as heavy lifting, talk to your doctor.

Unintentional Weight Loss or Weight Gain

Weight gain from ovarian cancer often happens quickly. This is due to the accumulation of fluid in the abdomen.

Weight loss may occur for a combination of reasons. The early sensation of fullness and loss of appetite may cause weight loss.

With more advanced cancers, cancer cachexia may contribute. Cachexia is a syndrome of weight loss, loss of muscle mass, and loss of appetite. 

Unintentional weight loss is the loss of 5% or more of body weight over six to 12 months.

An example of unexplained weight loss would be a 150-pound woman losing 7.5 pounds over a six-month period without diet or exercise.

Unintentional weight loss should always be evaluated. Besides ovarian cancer, there are other serious conditions that can cause this.

Studies have found that over a third of people who have unexpected weight loss have an underlying cancer of some form. 

Fluid in the Abdomen (Ascites)

Ascites is another form of abdominal swelling that can occur in more advanced stages of ovarian cancer. This is when large amounts of fluid accumulate in the abdomen.

Ascites can happen when the cancer spreads to the abdominal cavity and liver. The fluid needs to be drained.

Ascites can also lead to shortness of breath if the fluid pushes upward on the lungs.


Fatigue is the most common cancer symptom. It can also be a symptom of a wide range of other medical conditions, though.

Cancer-related fatigue tends to differ from ordinary tiredness. It doesn't go away after a good night of sleep or a cup of coffee.

As ovarian cancer progresses, cancer cells compete with healthy cells for energy. This is what causes fatigue.

Fluid in the abdomen and fatigue are other signs of later-stage ovarian cancer.

Symptoms of Germ Cell or Stromal Cell Tumors

Younger people with ovarian cancer often have germ cell tumors or sex cord stromal tumors.

Germ cell tumors are those that arise from reproductive cells called germ cells that are responsible for producing eggs in females and sperm in males. Sex cord stromal tumors are those that arise from cells and tissues that support the ovaries.

These individuals may have the symptoms described above but may have other symptoms as well due, in part, to imbalances in the sex hormones estrogen and testosterone.


Tumors that produce male-type hormones may result in masculinization. Symptoms may include a lowering of the voice and male pattern hair growth.

These symptoms are often found in the subtype of stromal ovarian tumors called Sertoli-Leydig cell tumors.

Vaginal Discharge or Bleeding

Vaginal discharge may also occur. It may be clear, yellow, or blood-tinged. There may also be bleeding similar to a period.

Abnormal vaginal bleeding is a common symptom of stromal cell tumors. It is associated with the female hormone estrogen secreted by these tumors.

Bleeding before a girl's first period, after menopause, or mid-cycle in females of reproductive age should be brought to a doctor's attention. There are many potential causes.

Precocious Puberty

Early puberty is called precocious puberty. It may occur in girls due to estrogen-secreting tumors. It is most often seen with germ cell and stromal cell tumors.

Symptoms may also include:

  • Early breast development
  • Development of pubic hair
  • Early onset of the first period

Severe Pelvic Pain

Mild pelvic pain and pressure are common early symptoms of ovarian cancer. Pain that is severe could be a different kind of ovarian tumor symptom.

Ovarian tumors can cause the ovary to twist around the fallopian tube. This is known as torsion. It is more common with germ cell and stromal cell tumors.

When this happens, the blood vessels that bring blood to the ovary may be cut off. The lack of blood supply can cause severe pain, bleeding, and often infection.

Pelvic Mass

A pelvic mass is more common with germ cell and stromal cell tumors in girls and young females. It may even occasionally be the first sign of cancer.

Ovarian tumors and cysts can become quite large before they cause symptoms. 

Ovarian Cancer Complications

Ovarian cancer can cause other complications. This happens most often when the cancer spreads to the abdomen and lungs.

Many people have few, if any, of these complications. Still, it is important to be aware of the possibilities and seek medical attention if you have any symptoms.

Bowel Obstruction

Bowel obstructions may occur when cancer spreads to the abdomen and pelvis. It may also happen because of scar tissue that forms after abdominal or pelvic surgery. This includes surgery for ovarian cancer.

Scar tissue can lead to kinks and twists in the bowel. This can cause an obstruction. Symptoms of a bowel obstruction include:

  • Severe, crampy abdominal pain
  • Vomiting

Surgery is often needed to remove the affected parts of the intestine. After surgery, feeding is often temporarily done through a tube. This gives the bowel time to recover.

Perforated Colon

Ovarian cancer tends to spread to the wall of the intestines. As it grows, tissue can weaken. This may set the stage for bowel perforation.

When the bowel is perforated, bowel contents leak into the abdominal cavity. This causes an infection called peritonitis. Surgery is often needed to bypass the diseased area of the bowel.

Urinary Blockage or Urinary Retention

Ovarian cancer can spread in the pelvis. It may block the tubes that travel from the kidneys to the bladder. These tubes are called ureters.

If both ureters are blocked, urine output drops. If only one ureter is blocked, there could be severe pain. There may also be no pain, depending on the location of the blockage.

A stent may be placed to resolve the blockage. This is a small tube that holds the ureter open.

Pleural Effusion

When the cancer spreads to the lungs or the chest region, fluid may build up between the membranes that line the lungs. These membranes are called pleura.

Sometimes this fluid contains cancer cells. Pleura that contains cancer cells is called malignant pleural effusion.

A procedure called thoracentesis can be used to drain the fluid. During this procedure, a needle is placed through the skin on the chest into the pleural cavity.

Pleural effusions often recur with cancer.

A stent can be placed to allow continual drainage. Pleurodesis is another option. During this procedure, a chemical is placed between the layers. This causes the membranes to scar together, preventing additional fluid build-up.

Bone Pain

When cancer spreads to the bones it can cause pain. This pain can be severe. Fortunately, there are treatments that can help, such as:

When to See a Healthcare Provider

Early symptoms of ovarian cancer, when present, are often vague and subtle. For each of these symptoms, there are usually other, less harmful conditions that could be the cause.

A 2016 review of studies looked at early symptoms of ovarian cancer. It found that the symptoms most likely to suggest ovarian cancer included:

  • An abdominal mass
  • Abdominal distention or increased girth
  • Abdominal or pelvic pain
  • Abdominal or pelvic bloating
  • Loss of appetite

See a doctor for anything that seems not quite right and lasts for more than a few days. This is especially important if your symptoms are similar to what you see above.

Ovarian Cancer Healthcare Provider Discussion Guide

Get our printable guide for your next healthcare provider's appointment to help you ask the right questions.

Doctor Discussion Guide Woman

If your exam is normal, but your body is still telling you something is wrong, listen. Follow-up or get a second opinion.

In the early stages, ovarian cancer can be cured or treated to allow for a very low probability of returning.


Early symptoms of ovarian cancer can be vague and mild. Pay attention if you have persistent bloating or pelvic pain or pressure, if you feel full quickly after eating, or if you urinate more frequently or urgently.

Later stage ovarian cancer symptoms may include changes in bowel habits, pain with intercourse, back pain, unintentional weight loss, fluid in the abdomen, or fatigue.

Some types of ovarian cancer may cause other symptoms, such as masculinization, abnormal bleeding, early puberty, or severe pelvic pain. A pelvic mass is another common symptom of these types of cancers.

Complications of ovarian cancer may include bowel obstruction, perforated colon, urinary problems, fluid in the membranes of the lungs, and bone pain.

See a doctor if you have any signs of ovarian cancer, even if they are subtle. Your symptoms are likely to have other causes. If they are related to ovarian cancer, though, early detection can help you get life-saving treatment.

A Word From Verywell

As scary as ovarian cancer may seem, it is very treatable if caught early. In fact, if the tumor is limited to the tumor, the five-year survival rate is an optimistic 93%. This means that, if diagnosed and treated in the early stages, 93 out of every 100 people with ovarian cancer will live for at least five years. Many live for years longer.

As such, it is in your interest to educate yourself about the different cancers that affect people born biologically female, particularly if you have a family history of these cancers. They include breast cancer, uterine cancer, cervical cancer, and ovarian cancer.

By understanding the early signs and symptoms—as well as your individual risk factors for the diseases—you will be better equipped to respond should ever be faced with cancer.

Frequently Asked Questions

  • What is the survival rate for ovarian cancer?

    There are different types of ovarian cancer. Each has its own average survival rate. Invasive epithelial ovarian cancer has an average five-year survival rate of 49%. Ovarian stromal tumors and germ cell tumors have an average five-year survival of 90% and 93%, respectively.

  • How is ovarian cancer diagnosed?

    Diagnosis involves:

    • A pelvic exam
    • Imaging tests like ultrasound and CT scan
    • Blood work to test for certain tumor markers
    • Biopsy of the tumor
  • How is ovarian cancer treated?

    Treatment for ovarian cancer may involve surgery. During surgery, cancerous tissue is removed. Depending on the stage, chemotherapy or radiation may also be used. There are also targeted medications that inhibit cancer growth. These include angiogenesis inhibitors and PARP inhibitors.

  • What can mimic ovarian cancer?

    There are a number of medical conditions that have symptoms similar to that of ovarian cancer, many of which are far more common. These include:

  • Do you get hot flashes with ovarian cancer?

    People with ovarian cancer can sometimes mistake hot flashes for night sweats, particularly if they are going through menopause. Night sweats are spontaneous, drenching sweats that are common with many different types of cancers, typically in the advanced stages.

35 Sources
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  1. Northwestern Medicine. Ovarian cancer: taking on the ‘silent killer’.

  2. Goff B. Symptoms associated with ovarian cancerClin Obstet Gynecol. 2012;55(1):36‐42. doi:10.1097/GRF.0b013e3182480523

  3. Henderson JT, Webber EM, Sawaya GF. Screening for ovarian Cancer: updated evidence report and systematic review for the US Preventive Services Task ForceJAMA. 2018;319(6):595‐606. doi:10.1001/jama.2017.21421

  4. The American Cancer Society. Signs and symptoms of ovarian cancer.

  5. Rush University System for Health. 5 early signs of ovarian cancer.

  6. Gajjar K, Ogden G, Mujahid MI, Razvi K. Symptoms and risk factors of ovarian cancer: a survey in primary careISRN Obstet Gynecol. 2012;2012:754197. doi:10.5402/2012/754197

  7. Al-Azri M, Al-Saidi M, AL-Mutair E, Panchatcharam SM. Awareness of risk factors, symptoms and time to seek medical help of ovarian cancer amongst Omani women attending teaching hospital in Muscat Governorate, OmanAsian Pac J Cancer Prev. 2018;19(7):1833‐1843. doi:10.22034/APJCP.2018.19.7.1833

  8. Pin F, Barreto R, Kitase Y, et al. Growth of ovarian cancer xenografts causes loss of muscle and bone mass: a new model for the study of cancer cachexia. Journal of Cachexia, Sarcopenia and Muscle. 2018;9(4):685-700. doi:10.1002/jcsm.12311

  9. National Collaborating Centre for Cancer (UK). Ovarian cancer: the recognition and initial management of ovarian cancer. Cardiff (UK): National Collaborating Centre for Cancer (UK); 2011.

  10. Rietveld MJA, Husson O, Vos MCC, van de Poll-Franse LV, Ottevanger PBN, Ezendam NPM. Presence of gastro-intestinal symptoms in ovarian cancer patients during survivorship: a cross-sectional study from the PROFILES registrySupport Care Cancer. 2019;27(6):2285‐2293. doi:10.1007/s00520-018-4510-9

  11. Mooney SJ, Winner M, Hershman DL, et al. Bowel obstruction in elderly ovarian cancer patients: A population-based study. Gynecologic Oncology. 2013;129(1):107-112. doi:10.1016/j.ygyno.2012.12.028

  12. Sorensen J, Bautista KE, Lamvu G, Feranec J. Evaluation and treatment of female sexual pain: A clinical reviewCureus. 2018;10(3):e2379. doi:10.7759/cureus.2379

  13. Doubeni CA, Doubeni AR, Myers AE. Diagnosis and management of ovarian cancerAm Fam Physician. 2016;93(11):937-944.

  14. Erondu CO, Alberg AJ, Bandera EV, et al. The association between body mass index and presenting symptoms in African American women with ovarian cancerJ Womens Health (Larchmt). 2016;25(6):571‐578. doi:10.1089/jwh.2015.5359

  15. American Society of Clinical Oncology. Weight loss.

  16. Penet MF, Krishnamachary B, Wildes FB, et al. Ascites volumes and the ovarian cancer microenvironmentFront Oncol. 2018;8:595. doi:10.3389/fonc.2018.00595

  17. Clevenger L, Schrepf A, Christensen D, et al. Sleep disturbance, cytokines, and fatigue in women with ovarian cancerBrain Behav Immun. 2012;26(7):1037‐1044. doi:10.1016/j.bbi.2012.04.003

  18. American Cancer Society. Ovarian stromal tumors.

  19. Liggins CA, Ma LT, Schlumbrecht MP. Sertoli-Leydig cell tumor of the ovary: a diagnostic dilemmaGynecol Oncol Rep. 2015;15:16‐19. doi:10.1016/j.gore.2015.12.003

  20. Sarkar M, Konar H, Raut D. Clinico-pathological features of gynecological malignancies in a tertiary care hospital in eastern India: importance of strengthening primary health care in prevention and early detectionAsian Pac J Cancer Prev. 2013;14(6):3541-3547. doi:10.7314/apjcp.2013.14.6.3541

  21. Calcaterra V, Nakib G, Pelizzo G, et al. Central precocious puberty and granulosa cell ovarian tumor in an 8-year old femalePediatric Reports. 2013;5(3):e13. doi:10.4081/pr.2013.e13

  22. Stanford Children's Health. Precocious puberty.

  23. Huang C, Hong MK, Ding DC. A review of ovary torsionCi Ji Yi Xue Za Zhi. 2017;29(3):143‐147. doi:10.4103/tcmj.tcmj_55_17

  24. Memorial Sloan Kettering Cancer Center. Ovarian cancer.

  25. Garg G, Massad LS, Pourabolghasem S, et al. Intestinal perforation in gynecologic oncology: do all patients benefit from surgical management?Gynecol Oncol. 2013;129(3):538‐543. doi:10.1016/j.ygyno.2013.03.004

  26. Odoemene, C. , Ezeome, I. and Okafor, O. Primary presentation of ovarian cancer with bladder outlet obstruction/chronic urinary retention in a 12-year old femaleOpen Journal of Urology. 2021;11(7):233-239. doi:10.4236/oju.2021.117021

  27. Porcel JM, Diaz JP, Chi DS. Clinical implications of pleural effusions in ovarian cancer. Respirology. 2012;17(7):1060-7. doi:10.1111/j.1440-1843.2012.02177.x

  28. Skok K, Hladnik G, Grm A, Crnjac A. Malignant pleural effusion and its current management: a reviewMedicina (Kaunas). 2019;55(8):490. doi:10.3390/medicina55080490

  29. American Cancer Society. Bone metastases.

  30. Ebell MH, Culp MB, Radke TJ. A systematic review of symptoms for the diagnosis of ovarian cancer. Am J Prev Med. 2016;50(3):384-394. doi:10.1016/j.amepre.2015.09.023

  31. National Cancer Institute. Cancer fast stat: ovarian cancer.

  32. American Cancer Society. Survival rates for ovarian cancer.

  33. CDC. How is ovarian cancer treated?

  34. Shetty M. Imaging and differential diagnosis of ovarian cancer, Semin Ultrasound CT MR. 2019 Aug;40(4):302-18. doi: 10.1053/j.sult.2019.04.002

  35. Mold JW, Holtzclaw BJ, Mccarthy L. Night sweats: a systematic review of the literatureJ Am Board Fam Med. 2012;25(6):878-93. doi:10.3122/jabfm.2012.06.120033

Additional Reading

By Lisa Fayed
Lisa Fayed is a freelance medical writer, cancer educator and patient advocate.