Ovarian Pain: When Is It a Cause for Concern?

Ovarian pain is pain felt in the pelvic area. Ovarian pain can be caused by a variety of factors—ranging from temporary, harmless conditions to more serious gynecological diseases. In some cases, the pain may be related to ovulation, menstruation, or functional cysts, but it can also indicate inflammation, infection, or other health problems. If ovarian or pelvic pain is severe, long-lasting, recurrent, or tends to worsen, it is recommended to see a doctor. Identifying the cause in a timely manner allows for the selection of appropriate treatment and helps prevent potential complications.

What are the possible causes of ovarian pain?

Ovulation pain is pain that occurs during ovulation, when an egg is released from the ovary. Ovulation usually takes place in the middle of the menstrual cycle. During ovulation, ovarian pain is most often felt as a dull or aching pain on one side of the pelvis. In addition to pain, other symptoms may occur during ovulation, such as changes in vaginal discharge or light bleeding;
Menstruation—some women experience pain in the ovarian area before or during their periods. Like ovulation pain, this is not a cause for concern. This happens because the uterus contracts to shed the uterine lining;
Ovarian cysts—these are benign growths in which fluid-filled sacs form in one or both ovaries. Most ovarian cysts are harmless and do not cause symptoms and eventually disappear without treatment. In rare cases, ovarian cysts can lead to serious complications (rupture or torsion);
Endometriosis is a chronic, progressive disease in which tissue similar to the inner lining of the uterus grows outside the uterine cavity and causes an estrogen-dependent chronic inflammatory reaction. Endometriosis often affects the peritoneum, ovaries, and fallopian tubes. In rare cases, endometriosis can also be found in other organs, such as the breasts or lungs. This condition most commonly affects women of childbearing age and disrupts not only their physical but also their psychosocial well-being;
Uterine fibroids are benign, well-defined, and hormone-dependent tumors composed of smooth muscle and connective tissue cells. Uterine fibroids are the most commonly diagnosed benign tumors of the female reproductive organs. Fibroids may be solitary, but are most often multiple. During the premenopausal period, 30–50% of women are affected;
Pelvic inflammatory disease (PID) is an infectious disease that affects a woman’s pelvic organs, including the uterus, fallopian tubes, and ovaries. If left untreated, PID can cause long-term tissue damage and negatively affect fertility, including an increased risk of infertility or ectopic pregnancy;
An ectopic pregnancy is a pregnancy that develops outside the uterus. This occurs when a fertilized egg implants in a location unsuitable for pregnancy. Most commonly, this happens in the fallopian tubes, which connect the ovaries to the uterus. Less commonly, an ectopic pregnancy may develop in the ovary. in the abdominal cavity, or in the cervix. This condition is most often diagnosed in the early stages of pregnancy—during the first trimester (up to 12 weeks of pregnancy). It occurs in approximately 2% of all pregnancies. An ectopic pregnancy cannot develop normally and is life-threatening to the woman, so it requires urgent medical attention;
Ovarian cancer is a disease in which abnormal cells in the ovaries or fallopian tubes grow uncontrollably, multiply, invade surrounding tissues, and may spread (metastasize) to other organs. It is one of the five most commonly diagnosed cancers among women in Lithuania. Current estimates show that 366 women in Lithuania are diagnosed with ovarian cancer each year, and 241 die from the disease;
Ovarian torsion is a condition in which the ovary twists around the ligaments that hold it in place, thereby disrupting blood flow to the ovary. This condition most often develops in the presence of an ovarian cyst, a tumor, or polycystic ovary syndrome. The risk of ovarian torsion also increases in women undergoing fertility treatment, as the ovaries may enlarge due to hormonal stimulation.

What does ovarian pain feel like?

Ovarian pain can be mild or severe, sudden or constant. It is most commonly felt in the lower abdomen or pelvic area, may intensify during urination or sexual intercourse, and can interfere with daily activities. Regardless of the nature of the pain, it is important to see a doctor to determine the cause and receive appropriate treatment.

What can be mistaken for ovarian pain?

There are many other organs in the pelvic area, so ovarian pain can be mistaken for pain caused by other organs. Sometimes pain in this area is not related to the ovaries at all. The most common conditions that can be mistaken for ovarian pain are:

Appendicitis;
Kidney stones;
Urinary tract infection;
Constipation;
Diverticulitis.

How does a doctor diagnose ovarian pain?

Medical history and gynecological exam: To diagnose ovarian pain, the doctor will ask about your symptoms, past medical history, and perform a gynecological exam of the abdomen and pelvis;
Laboratory tests: A complete blood count or urinalysis can help diagnose an infection, inflammation, or other possible causes;
Ultrasound: This can determine the size and location of the ovaries and assess their structure and any possible abnormalities;
Magnetic Resonance Imaging (MRI): This is performed to assess the size, exact location, and surrounding tissues of the ovaries in greater detail.

What are the treatment options for ovarian pain?

Hormonal medications—birth control pills, patches, or vaginal rings—can reduce cramps and regulate the menstrual cycle;
Nonsteroidal anti-inflammatory drugs (NSAIDs)—help reduce pain and inflammation;
Antibacterial treatment—prescribed if pelvic inflammatory disease (PID) or a sexually transmitted infection (STI) is diagnosed;
Surgical treatment—minimally invasive surgery or open surgery It may be necessary to treat cysts, tumors, or ovarian torsion.