Pain from the ovaries may seem like a normal part of the menstrual cycle for some women. Usually it is associated with ovulation. However, it can be a sign of some underlying problem with the ovaries, female reproductive system or even with surrounding organs. Ovarian pain should not be confused with menstrual pain as the latter mainly arises from the uterus (womb). It should always be investigated as sometimes it may be due to a serious underlying disease.
What is ovarian pain?
Ovarian pain is pain arising from the ovaries. Apart from menstruation, ovarian pain may occur with ovulation as well. However, it is not always associated with these normal events in the menstrual cycle. Sometimes ovarian pain may arise independently and persist despite menstrual cycle changes. It is also possible that ovarian pain may in some cases not even be arising from the ovaries.
The ovaries are the main reproductive organs in women, located on either side of the uterus. Not only does it release egg cells during ovulation but the ovaries are also responsible for producing important hormones in a woman’s body. Like any part of the body, the ovaries may become damaged or diseased which can then lead to pain.
Where are the ovaries located?
Pain can be difficult to isolate when it comes to the abdominal and pelvic cavities. There are many organs tightly packed into these cavities. The ovaries are located in the pelvis but most people refer to it as the lower abdomen. It is situation near the top of the pelvic (hip) bones, below the line of the belly button. Ovarian pain is towards the sides or sometimes thought to be towards the lower flanks. Pain that is more centralized is more likely to be due to the uterus or bladder and sometimes even the fallopian tubes rather than the ovaries.
One-Side Ovarian pain
Most of the time ovarian pain is one-sided. This usually indicates that the problem lies with the ovary on the affected side. However, the pain may not always be arising from the ovary but instead from the fallopian tube on the affected side. Bilateral ovarian pain means that the pain is from the ovaries on both sides. This occurs only in a handful of conditions and is usually linked to hormone-related diseases as the circulating hormones in the body affects both ovaries.
Signs and Symptoms
It is important to consider other signs and symptoms that may be present since it is difficult to isolate pain to a specific organ. Generally ovarian pain will present with menstrual and other female reproductive symptoms. Remember that ovarian pain is a symptom and not a disease on its own. Accompanying symptoms with ovarian pain may include:
- Heavy or light menstrual bleeding
- Mid-cycle bleeding (abnormal bleeding)
- Vaginal discharge
- Itching of the vagina
- Menstrual cramps
Sometimes symptoms can be misleading. For example, in gastrointestinal conditions there may be lower abdominal pain with nausea. This is unrelated to the female reproductive system or ovaries specifically. Ovarian pain that is severe with changes in blood pressure, heart rate, dizziness and excessive bleeding should be treated as a medical emergency as this may be an ectopic pregnancy.
Causes of Ovarian Pain
There are several possible causes of ovarian pain and often the symptoms of these conditions tend to overlap. Diagnosis depends on the presentation, medical history and results of relevant diagnostic investigation. Ovarian pain should not be ignored even if it is considered part of menstruation. Pain may be a part of conditions like polycystic ovarian syndrome (PCOS) and early diagnosis and treatment can improve the outlook and minimize complications like difficulty falling pregnant.
This is one of the most serious causes of ovarian pain. Technically the pain is arising from the fallopian tubes. An ectopic pregnancy is a condition where the fertilized egg cell is stuck in the fallopian tube. It can lead to a host of complications some of which are potentially life-threatening for the mother. Emergency surgery is usually necessary.
An ovary infection, also known as infectious oophoritis, is where microbes have infected the tissue o fthe ovary. Most of the time this is due to bacteria or protozoa. It is usually part of pelvic inflammatory disease where infections in the vagina spread beyond the cervix to involves the uterus, fallopian tubes and ovaries. Often these infections are sexually transmitted.
Cysts in the ovaries are usually part of polycystic ovarian syndrome (PCOS). This is a condition where there is an imbalance in the male sex hormones leading to higher levels of these hormones (androgens). The cysts may be solitary or multiple and affect one or both sides. The disturbances tends to lead to very painful periods but the pain may also emanate from the ovaries.
Endometriosis is a condition where the endometrial tissue, normally the inner lining of the uterus, occurs outside of the uterus. This tissue then responds to the hormones that regulate the menstrual cycle and typically causes severe pain. While the tissue may be lodged anywhere, sites around the fallopian tubes and ovaries are oftena ffected.
Ovarian injury is not common but can occur with sharp or blunt force trauma to the lower abdomen and pelvis. It is more likely to occur accidentally during surgery to the pelvic area. Usually it is acute and with appropriate treatment the pain subsides and should not recur. However, depending on the severity of the trauma, the ovarian function can be affected.
Growths in the ovaries may be benign (non-cancerous) or malignant (cancerous). Cysts are one type of benign ovarian growth as are fibromas and cystadenomas. Adhesions are scar tissue that can form on around the ovaries and are usually related to previous trauma to the abdomen and pelvis, as is seen with surgery. It is also benign.
Malignancies are of greater concern. Ovarian cancer is fairly common and can rapidly spread to neighboring organs. In these cases the ovarian cells start multiplying rapidly and are abnormal. It can invade healthy tissue. Once the cancerous cells spread, the prognosis is poor and can even be deadly. Cancers that arise in the ovary are known as a primary cancer but sometimes cancer cells from elsewhere may spread to the ovary (secondary).