Cancer Ovarian Cancer Causes of Ovary Pain and Treatment Options Everything you need to know about pain from your ovaries By Lisa Fayed Lisa Fayed is a freelance medical writer, cancer educator and patient advocate. Learn about our editorial process Lisa Fayed Medically reviewed by Medically reviewed by Doru Paul, MD on November 18, 2020 Doru Paul, MD, is triple board-certified in medical oncology, hematology, and internal medicine. He is an associate professor of clinical medicine at Weill Cornell Medical College and attending physician in the Department of Hematology Oncology at the New York Presbyterian Weill Cornell Medical Center. Learn about our Medical Review Board Doru Paul, MD on November 18, 2020 Print Table of Contents View All Common Causes Rare Causes When to See a Doctor Diagnosis Treatment The ovaries, located on each side of a woman's pelvis, are responsible for producing and releasing eggs needed for fertilization. It's perhaps not surprising, then, that the most common causes of what people consider ovary pain, which is often felt in the lower abdomen, pelvis, or lower back, are related to ovulation and menstruation. However, a gynecological problem like endometriosis or pelvic inflammatory disease, or even a medical condition affecting your digestive or urinary system can be to blame. This can make the diagnosis tricky. Illustration by Alexandra Gordon, Verywell Common Causes It's important to know about the variety of conditions that can be responsible for how you are feeling. Some may warrant your concern, while others may relieve it. Menstrual Pain Women may experience pain or discomfort in one or both ovaries on certain days during a normal menstrual cycle. This cramping pain that a woman experiences during or just prior to menstruation is called dysmenorrhea and is due to the release of prostaglandins—hormone-like substances that, among other things, contract muscles—from the uterus. Mittelschmerz Pain Some women experience ovarian pain mid-cycle during ovulation, when an egg is released from the ovary, instead of during menstruation. Known as mittelschmerz pain, it may be uncomfortable but is harmless. Ovarian Cyst An ovarian cyst is a benign growth, usually filled with fluid, that may cause pain, discomfort, bleeding, menstrual irregularities, or no symptoms at all. Ovarian cysts are common and can develop at different points during the menstrual cycle. Follicular cysts are formed if an egg is not released during ovulation, and corpus luteum cysts develop if the corpus luteum (egg sac) does not dissolve as it should right after ovulation. Small ovarian cysts may improve on their own, but some require urgent medical treatment, like a large cyst that ruptures or bursts. This may cause sudden, sharp, and severe one-sided pelvic pain. Endometriosis Endometriosis is a condition in which the endometrial lining of the uterus can develop in other areas of a woman's reproductive organs, like the ovaries, fallopian tubes, or on the bladder. Endometriosis often causes severe cyclical or episodic uterine or ovarian cramping pain and intermittent bleeding. The pain may be particularly intense during a woman's period or while having sex. Endometriosis may also lead to infertility due to adhesion (scar tissue) formation. Ectopic Pregnancy An ectopic pregnancy is a pregnancy that takes place outside the uterus, usually in one of the fallopian tubes. It may cause moderate to severe ovarian pain and warrants emergency treatment. Pelvic Inflammatory Disease (PID) PID is an infection that may affect one or more reproductive organs including the uterus, ovaries, fallopian tubes, and vagina. This serious condition is often caused by a sexually transmitted infection and may lead to pain in various regions of the pelvis, including one or both ovaries, that is often worse with sex. Besides pain, women with PID may experience fevers, chills, an abnormal vaginal discharge and/or bleeding, as well as symptoms that mimic that of a urinary tract infection, like burning with urination. Uterine Fibroids Uterine fibroids are benign growths that arise from the lining of the uterus. Besides pelvic discomfort or pressure, a woman with fibroids may experience abnormal uterine bleeding, back pain, constipation (if a fibroid is pressing on the bowel), urinary difficulties (if the fibroid is pressing on the bladder), and infertility. Rare Causes There are a few uncommon conditions that may cause ovarian pain. Given the seriousness of most of these, it's important not to ignore these symptoms, no matter the likelihood of these issues. Ovarian Cancer Although ovarian cancer can cause ovary pain, it is not common. In fact, the disease often doesn't cause any symptoms or, if it does, they are more subtle ones like bloating, feeling full without eating much, and urinary urgency or frequency. 2:12 Understanding Ovarian Cancer Symptoms, Stages, and Treatment Ovarian Remnant Syndrome This is an unusual condition that can result if you have had surgery to take out your ovaries and some tissue was not completely removed. This could happen if you have endometriosis and there was a small area of endometrial or ovarian tissue that was not visualized during your surgery or that expanded after your procedure, for example. Ovarian Torsion This is an uncommon condition, but a surgical emergency in which one of the fallopian tubes becomes twisted, potentially interrupting its blood supply and that of the ovary. This condition can cause severe and sudden pain due to ischemia (lack of blood flow) to these areas. Phantom Ovary Pain With phantom ovary pain, a woman continues to experience what seems like ovarian pain even after one or both of her ovaries has been removed. This is believed to be the result of persistent sensory nerve stimulation. When to See a Doctor You should see your doctor if you have new or different symptoms in the pelvic region, either with your period or in between periods. More specifically, if you experience any of these symptoms, be sure to seek out medical care: Persistent or severe pelvic painMenstrual cycles that are longer than 38 days or shorter than 24 daysPeriods that last longer than seven daysMenstrual bleeding that soaks through one or more tampons or pads every hour for several hours in a rowMenstrual flow with blood clots that are a quarter size or largerBleeding or spotting between periodsBleeding after menopauseBleeding during or after sexBleeding or cramping if you have missed a period or have tested positive on a pregnancy test Bleeding after menopause Blood in your urineFevers, chills, night sweats, nausea, or vomiting Diagnosis Diagnosing the cause of your ovary pain isn't straightforward, as issues with other reproductive organs, like your uterus or cervix, or even other body systems may be at play. (The ovaries are located in the same general area as many other organs.) If you see your doctor for ovarian pain, the first thing she will do is perform a medical history and physical examination. Medical and Sexual History During your medical history, your doctor will ask you several questions about your pain, like when it started, how it feels, what makes it better and worse, and whether or not you have other symptoms like vaginal bleeding, vaginal discharge, or fever. She will also ask you whether you have ever been diagnosed with a gynecological condition, such as endometriosis or uterine fibroids, and whether you have ever undergone abdominal or pelvic surgery before. Your doctor may also inquire about your sexual history, like how many partners you have or whether you have ever had a sexually transmitted infection. Physical Examination For ovarian pain, your doctor will examine your abdomen and lower back and sides. In addition to inspecting and pressing on these areas to check for tenderness, your doctor will also perform a pelvic exam. During the pelvic exam, samples of your vaginal fluid or from your cervix may be taken via a Pap smear to evaluate for infection or abnormal cells. Labs and Blood Tests A variety of tests may be ordered to confirm or discount a diagnosis, perhaps the most important one being a pregnancy test to rule out ectopic pregnancy. Besides a pregnancy test, a urinalysis may be ordered to check for blood or an infection. Likewise, for PID, your doctor may order inflammatory blood markers, like C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR), or a complete blood count to check for an elevated white blood cell count (a sign of infection). Imaging Because there can be a variety of medical causes for your pain, do not be surprised if your doctor orders imaging tests, such as a pelvic ultrasound or a computed tomography (CT) scan of your abdomen and pelvis. Pelvic Laparoscopy A pelvic laparoscopy is a surgical procedure sometimes used to determine what is causing a woman's pelvic pain. During a pelvic laparoscopy, your doctor may take a tissue sample (biopsy). Differential Diagnoses Gastrointestinal issues, like constipation or even more serious conditions, like appendicitis or diverticulitis, can result in pain or discomfort that can be mistaken for ovarian pain. If your doctor suspects a gastrointestinal problem instead of a pelvic problem (for example, if your pregnancy and pelvic exam are normal, and your abdominal exam reveals focal tenderness), she will proceed with appropriate tests. For example, a CT scan of the abdomen can diagnose appendicitis and diverticulitis. Often, a clinical history and digital rectal exam can diagnose constipation. Likewise, a urinary tract infection (UTI) or kidney stone can cause pain that feels like ovarian pain. These conditions can often be ruled out fairly early with a normal urinalysis—that is, one that reveals no signs of infection and no evidence of blood. A CT scan can be used to diagnose a kidney stone if one is still suspected. Treatment Once the "why" behind your ovary pain is determined, you and your doctor can move forward with devising a treatment plan that may be as simple as a few lifestyle changes to more involved, like taking a prescription medication or undergoing surgery. Lifestyle Therapies If your ovary pain is related to your monthly cycle, lifestyle changes like getting adequate sleep, exercising, using relaxation techniques, and applying a heating pad can often help soothe your discomfort. Medications Depending on your diagnosis, your doctor may recommend or prescribe medication. For example, if simple home remedies like heat and rest are not easing your menstrual cramps, a nonsteroidal anti-inflammatory (NSAID) drug, which decreases the prostaglandin levels in your body, often helps. Be sure to talk to your doctor before taking an NSAID; women with bleeding disorders, an aspirin allergy, kidney or liver disease, or stomach problems should not take these drugs. Besides NSAIDs, birth control methods like the Pill, patch, ring, or the intrauterine device can also decrease menstrual cramps. Another gynecological condition that requires medication is pelvic inflammatory disease. If diagnosed with PID, your doctor will prescribe you antibiotics. In more severe cases, a woman may need to be hospitalized and receive the antibiotics intravenously (through her vein). Surgery For emergent conditions, like ovarian torsion or ectopic pregnancy, surgery is warranted. Surgery is also often performed as part of the treatment of ovarian cancer and may be used to remove uterine fibroids or endometrial tissue in severe endometriosis. A Word From Verywell On a final note, it's common for women who experience ovary pain to be concerned about ovarian cancer. While ovarian pain can be indicative of the disease, it's not typical, and other possible causes are far more likely. Even so, it's important not to ignore ovary pain and to be evaluated by a physician. In addition, be sure to keep up with your regular physicals and gynecological check-ups, and to inform your doctor if ovary pain occurs so that a medical condition, ovarian cancer or otherwise, can be detected and treated in early stages when treatment is more likely to be successful. Was this page helpful? Thanks for your feedback! Limiting processed foods and red meats can help ward off cancer risk. These recipes focus on antioxidant-rich foods to better protect you and your loved ones. Sign up and get your guide! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Dawood MY. Dysmenorrhoea and prostaglandins: pharmacological and therapeutic considerations. Drugs. 1981;22(1):42-56. doi:10.2165/00003495-198122010-00003 Won HR, Abbott J. Optimal management of chronic cyclical pelvic pain: an evidence-based and pragmatic approach. Int J Womens Health. 2010;2:263-77. doi:10.2147/IJWH.S7991 InformedHealth.org. Ovarian cysts: Overview. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG). Updated March 28, 2019. Parasar P, Ozcan P, Terry KL. 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Curr Opin Obstet Gynecol. 2012;24(4):210-4. doi:10.1097/GCO.0b013e3283558539 Sukkong K, Sananpanichkul P, Teerakidpisan P, Bhamarapravatana K, Suwannarurk K. High Rate of Gangrenous Adnexal Torsion: Dilemma of a Missing Silent Cancer. Asian Pac J Cancer Prev. 2016;17(11):4981-4984. doi:10.22034/APJCP.2016.17.11.4981 Imai A, Matsunami K, Takagi H, Ichigo S. Malignant neoplasia arising from ovarian remnants following bilateral salpingo-oophorectomy (Review). Oncol Lett. 2014;8(1):3-6. doi:10.3892/ol.2014.2089 Vercellini P, Trespidi L, Panazza S, Bramante T, Mauro F, Crosignani PG. Laparoscopic uterine biopsy for diagnosing diffuse adenomyosis. J Reprod Med. 1996;41(4):220-4. Gunaydin C, Bilge SS. Effects of Nonsteroidal Anti-Inflammatory Drugs at the Molecular Level. Eurasian J Med. 2018;50(2):116-121. doi:10.5152/eurasianjmed.2018.0010 Hörl WH. Nonsteroidal Anti-Inflammatory Drugs and the Kidney. Pharmaceuticals (Basel). 2010;3(7):2291-2321. doi:10.3390/ph3072291 Trent M. Pelvic inflammatory disease. Pediatr Rev. 2013;34(4):163-72. doi:10.1542/pir.34-4-163 Doubeni CA, Doubeni AR, Myers AE. Diagnosis and Management of Ovarian Cancer. Am Fam Physician. 2016;93(11):937-44. Additional Reading American College of Obstetrics and Gynecology. (2015). Frequently Asked Questions: Dysmenorrhea. Kruska PS, Kruszka SJ. Evaluation of acute pelvic pain in women. Am Fam Physician. 2010 Jul 15;82(2):141-47. Sofic A et al. Magnetic Resonance Imaging (MRI) and Transvaginal Ultrasonography (TVU) at Ovarian Pain Caused by Benign Ovarian Lesions. Acta Inform Med. 2018;26(1):15-18.