Introduction
Ovary pain, also referred to as pelvic pain, is when you feel pain or discomfort in your lower abdomen (just below your belly button) and is a widespread concern for many people with vaginas. The pain experienced varies for each individual and can be chronic or severe/acute. Chronic pain tends to happen more frequently and can last up to a few months, whereas severe/acute pain occurs suddenly and comes and goes. Understanding what causes ovary pain is crucial for both you and healthcare professionals. This article aims to delve into the anatomy of the ovaries, various causes of ovary pain, associated symptoms, ways to diagnose, preventive measures and treatments available to alleviate the pain.
The anatomy of your ovaries
Your ovaries are small and have an egg-shaped appearance. They are located on either side of your uterus (Figure 1) and play an important role in releasing hormones and making/storing your eggs.1
Figure 1. Anatomy of the female reproductive system
The ovaries are small glands located on each side of the uterus and enable the production of eggs and hormones. Two ovaries are connected by the fallopian tubes to the uterus. You can read more about other parts of the internal female reproductive system here: https://my.clevelandclinic.org/health/articles/9118-female-reproductive-system (Image created by Victoria Vandy using BioRender)
Why do I feel pain or discomfort in my ovaries?
There are different causes of ovary pains. Pains caused during your period or ovulation aren’t a serious cause for concern. However, certain pain levels can also mean something more serious, and a medical professional must look further into this. Examples of why your ovaries may hurt are described below.
Menstruation
- During the menstrual cycle, ovulation occurs by releasing an egg from the ovary.2 Ovulation happens midway through a woman's menstrual cycle. Ovary pain, when ovulating usually feels like a mild, lingering ache on one side of your pelvis. It happens because only one ovary lets out an egg at a time. This process can sometimes cause mild discomfort, which is common in most women.
Reproductive conditions that could lead to ovary pain
- Ovarian cysts are fluid-filled sacs in the ovaries. Although these sacs are not always concerning, they can cause discomfort in your ovaries, pain during intercourse and irregular menstrual cycles. 3 Cysts have the potential to burst, which would cause internal bleeding and abdominal pain
- Ovarian torsion is when the ovary and fallopian tubes twist. It is recognised as an emergency and usually accompanied by a sudden onset of pain 4
- Polycystic Ovary Syndrome (PCOS) is a hormonal disorder that affects the way your ovaries function.
- Endometriosis is when tissue grows outside the uterus.5 This causes severe pain and cramping in your ovaries. It is estimated that endometriosis can affect 1 in 10 people with uteruses.
- Pelvic Inflammatory Disease (PID) is an infection of your reproductive organs.6 This can lead to permanent damage and may even affect your ability to get pregnant
- Uterine fibroids are noncancerous growths that develop around your uterus, including your ovaries7
- Ectopic pregnancy is where the fertilised egg implants outside of the uterus; this would usually be in your fallopian tubes.8 It causes severe pain in your ovaries and is a medical emergency
- Miscarriage is when you lose your pregnancy. 4
Symptoms of ovary pain
Ovary pain ranges from mild to severe and can be noticeable in many different ways, including:
- Pelvic discomfort
- Changes or irregular menstrual cycles
- Pain during intercourse
- Sharp or dull pains in the lower abdomen, sometimes only on the left or right sides of the pelvis.4
However, it is worth noting that pain in the lower abdomen can indicate a different health condition that could be mistaken for ovary pain. This can include bladder infections, bowel problems, or problems with your muscles, skeleton, or nerves when the pain is chronic and lasts a long time.9 It’s important that a GP examines you and determines the source of pain, especially when other symptoms are present, for example, bleeding.
Diagnosis of ovary pain
To pinpoint the source of your ovary pain, your healthcare professional will conduct some tests. Your medical history will be checked to see if there have been any previous occurrences that could have contributed to the pain. Physical examinations, such as a pelvic exam, may be performed to assess for any abnormalities. Imaging tests, including pelvic ultrasound or CT scans, can visualise the ovaries.9 Additionally, lab tests such as blood tests or urine analysis can help measure hormone levels and identify any imbalances that might contribute to ovary pain. Based on the individual’s history and initial results, they may be referred further to a specialist. 9
Treatment
Depending on the underlying cause of the pain felt, the treatment plan provided will be unique to your diagnosis and symptoms. Ovary pain is usually treated with:
Pain management
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are pain relievers that can be used to reduce inflammation and pain. These can be purchased over the counter 11
- Heat therapy can be used by applying heat to your lower abdomen to relieve your discomfort and muscle tension associated with ovary pain11
Medications
- Birth control pills are hormonal contraceptives used to regulate your hormones 11
- Antibiotics are prescribed if a bacterial infection is associated with the pain 11
Surgical procedures
- Ovarian cyst removal in cases where cysts are the cause of pain. This is usually removed surgically, and this is to alleviate symptoms and prevent complications.12 Smaller cysts will usually disappear spontaneously and require no treatment
- In cases where endometriosis is diagnosed in women, laparoscopic surgery is advised. This surgical procedure involves minimal invasiveness. The endometrial tissue outside the uterus is removed during this process to help reduce pain and improve overall reproductive health. 12
What are some complications that can occur if ovary pain is left untreated?
Untreated ovarian pain may result in worsening symptoms. This implies that the longer your symptoms are ignored, the worse they may get and the more pain and suffering you will experience. It's crucial to discuss your symptoms with your doctor, even though the majority of ovarian pain cases do not pose a serious risk to your life. They can examine your symptoms and perform tests to determine the best course of action for you.
When to seek medical attention
If you are experiencing persistent or severe pain, call your doctor. Certain pains are not a cause for alarm and don't need medical attention, but it's always best to be careful. If you are experiencing any pain, inform your doctor of the symptoms you are experiencing. Here are some examples of symptoms you should contact your doctor about:
- Pelvic pain not responding to over-the-counter painkillers
- Cycles longer or shorter than usual
- Irregular bleeding or bleeding between periods
- Bleeding after menopause
- Heavy menstrual cycles
- Pain during sexual intercourse
- Suspected pregnancy.
Prevention and lifestyle considerations
Ensuring that you take a proactive approach through preventive measures and lifestyle choices. Emphasising the following aspects can significantly contribute to the prevention of ovary pain.
Regular gynaecological Check-ups
- Visiting your gynaecologist is essential for early detection and management of any potential issues relating to the health of your ovaries.
Safe Sex Practices
- It is crucial to practise safe sex to avoid STIs, which have the potential to cause pelvic inflammatory disease (PID) and other reproductive problems 13
Healthy Lifestyle Choices
- Your general well-being will benefit from a healthy lifestyle.
- A diet rich in fruits, vegetables, and whole grains will enhance reproductive and general health13
- Exercising frequently can help you control hormones and increase your blood flow. Exercise also helps to reduce inflammation, which will, in turn, reduce the risk of polycystic ovarian syndrome (PCOS) occurring13
- Managing your stress through yoga or medication can be beneficial; chronic stress can have an impact on your reproductive health13
- Avoid excessive consumption of alcohol and tobacco as this can affect reproductive health and fertility.
Ovary pain is not something that should be ignored. In most cases, ovary pain isn’t cancer. In any event, your doctor is the best person to evaluate your symptoms and determine an underlying cause of your ovary pain. Keeping up with your annual wellness and gynaecological exams can be helpful because these visits help your provider spot potential problems before they become something more serious.
Summary
Ovary pain, or pelvic pain, is a common concern among individuals with vaginas, manifesting as discomfort in the lower abdomen. The causes vary, including menstrual cycles, ovarian cysts, torsion, PCOS, endometriosis, PID, fibroids, ectopic pregnancy, and miscarriage. Symptoms range from mild to severe, including pelvic discomfort, irregular cycles, pain during intercourse, and abdominal pains.
Proper diagnosis involves medical history, physical exams, and imaging/lab tests. Treatment options include pain management, medications like NSAIDs and antibiotics, and surgical procedures such as cyst removal or laparoscopy for endometriosis. Untreated pain can lead to worsening symptoms, warranting medical attention for persistent or severe pain, irregular bleeding, or suspected pregnancy.
Preventive measures include regular gynaecological check-ups, safe sex practices, healthy lifestyle choices, and stress management. Overall, consulting with a healthcare professional is vital for accurate diagnosis and tailored treatment plans, emphasizing the importance of proactive healthcare practices.
References
- Gibson E, Mahdy H. Anatomy, abdomen and pelvis, ovary. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2023 Nov 20]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK545187/
- nhs.uk [Internet]. 2018 [cited 2023 Nov 20]. Periods and fertility in the menstrual cycle. Available from: https://www.nhs.uk/conditions/periods/fertility-in-the-menstrual-cycle/
- Ovarian cyst [Internet]. NHS inform. [cited 2023 Nov 20]. Available from: https://www.nhsinform.scot/healthy-living/womens-health/middle-years-around-25-to-50-years/periods-and-menstrual-health/ovarian-cyst/
- Di Serafino M, Iacobellis F, Schillirò ML, Verde F, Grimaldi D, Dell’Aversano Orabona G, et al. Pelvic pain in reproductive age: us findings. Diagnostics (Basel) [Internet]. 2022 Apr 9 [cited 2024 Mar 11];12(4):939. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9026765/
- Endometriosis [Internet]. NHS inform. [cited 2023 Nov 20]. Available from: https://www.nhsinform.scot/healthy-living/womens-health/girls-and-young-women-puberty-to-around-25/periods-and-menstrual-health/endometriosis/
- Pelvic inflammatory disease [Internet]. NHS inform. [cited 2023 Nov 20]. Available from: https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/pelvic-inflammatory-disease/
- Fibroids [Internet]. NHS inform. [cited 2023 Nov 20]. Available from: https://www.nhsinform.scot/healthy-living/womens-health/girls-and-young-women-puberty-to-around-25/periods-and-menstrual-health/fibroids/
- Ectopic pregnancy [Internet]. NHS inform. [cited 2023 Nov 20]. Available from: https://www.nhsinform.scot/illnesses-and-conditions/pregnancy-and-childbirth/ectopic-pregnancy/
- Ayorinde AA, Macfarlane GJ, Saraswat L, Bhattacharya S. Chronic pelvic pain in women: an epidemiological perspective. Womens Health (Lond Engl) [Internet]. 2015 Nov [cited 2024 Mar 11];11(6):851–64. Available from: http://journals.sagepub.com/doi/10.2217/whe.15.30
- nhs.uk [Internet]. 2017 [cited 2023 Nov 20]. Ovarian cyst. Available from: https://www.nhs.uk/conditions/ovarian-cyst/
- Castillano G. How to treat ovarian cyst pain? [Internet]. NJ Best OBGYN. 2023 [cited 2023 Nov 20]. Available from: https://www.njbestobgyn.com/2023/02/24/how-to-treat-ovarian-cyst-pain/
- Udoji MA, Ness TJ. New directions in the treatment of pelvic pain. Pain Manag [Internet]. 2013 Sep [cited 2024 Mar 11];3(5):387–94. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3979473/
- Ball E, Khan KS. Recent advances in understanding and managing chronic pelvic pain in women with special consideration to endometriosis. F1000Res [Internet]. 2020 Feb 4 [cited 2024 Mar 11];9:F1000 Faculty Rev-83. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7001750/