Why Does My Ovary Hurt?

Why Does My Ovary Hurt?

The ovaries are an important part of the female reproductive system: they release at least one egg monthly for potential fertilization and they produce the hormones that trigger your period. Most ovarian pain is felt in the lower abdomen as this is where your ovaries are located, but the pain can extend to the general pelvic region.

Ovulation

The most common cause of ovary pain is ovulation. What’s known as Mittelscherz is a dull abdominal pain occurring at the time of ovulation. It is thought to be caused by the presence of free blood in the peritoneal cavity from the ruptured ovarian follicle. When the egg is released from the ovary, a small amount of fluid and blood comes with it. This fluid may cause irritation to the inside of your pelvis, resulting in a quick, piercing pain that fades into a mild ache.

woman experiencing ovary pain

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What Else Can Cause Ovarian Pain?

There are several other causes of pain in the ovaries. The pain may be acute or chronic. Acute ovarian pain comes on quickly and resolves in a short period of time. Chronic ovarian pain usually starts more gradually and lasts for several months or possibly longer.

Ovarian pain may be continuous or it may come and go. The pain may be more intense with exercise or other activities. It can vary in intensity depending on its cause: the pain may be so mild that it really doesn’t cause you any problems. Conversely, it can also be severe enough to interfere with your daily life and hamper your ability to function.

The methods your doctor uses to diagnose the cause of your ovarian pain wjll vary based on what the suspected cause might be. Ultrasound, imaging tests, or other diagnostic tests can be extremely helpful in determining the cause of the pain. Here is a rundown of some possible causes of ovarian pain and how they are diagnosed and treated.

Other Causes of Ovarian Pain

Ovarian Cysts

Cysts are fluid-filled sacs that can develop in the ovaries, often during the process of ovulation. A cyst can develop when the egg is not released from the ovary or when the follicle holding the egg doesn‘t dissolve after the egg is released. They are common, especially for women in their childbearing years.

Symptoms of an ovarian cyst:

  • Dull ache
  • Irregular menstrual periods
  • Bloating
  • Pain during intercourse
  • Pain during bowel movements
  • Feeting full after eating a small amount
  • Nausea or vomiting
  • Sharp pain if cyst ruptures

How ovarian cysts are diagnosed

Ovarian cysts usually cause no symptoms, but can cause a dull ache. You could also experience a sharp pain if the cyst is large and ruptures. They can be detected during a pelvic exam when your provider feels a lump in the lower pelvic area. An ultrasound will reveal the size and exact location of the cyst.

Treatment of ovarian cysts

Most ovarian cysts will resolve on their own without intervention. If your symptoms are mild, the doctor may check you periodically to see if there has been any change to the cyst. This is often referred to as “watchful waiting.” After the pain resolves, your doctor may suggest birth control pills: they prevent ovulation, thus preventing the formation of new cysts.

Ovarian cyst diagramIf the cyst does not resolve on its own, your doctor may suggest laparoscopy, a surgery utilizing a small incision and a tiny, lighted camera on the end of a metal tube. It can be inserted into the abdomen to remove a small cyst. Larger cysts require a bigger incision using a technique called laparotomy.

f the cyst does not resolve on its own, your doctor may suggest laparoscopy, a surgery utilizing a small incision and a tiny, lighted camera on the end of a metal tube. It can be inserted into the abdomen to remove a small cyst. Larger cysts require a bigger incision using a technique called laparotomy.”watchful waiting.” After the pain resolves, your doctor may suggest birth control pills: they prevent ovulation, thus preventing the formation of new cysts.

Ovarian Tumors

Noncancerous (benign) or cancerous (malignant) tumors can form in the ovaries, just as they can form in other parts of the body.

Symptoms of ovarian tumors include:

  • Ovarian pain
  • Bloating or pressure in the abdomen
  • Urination urgency
  • Indigestion
  • Diarrhea or constipation
  • Loss of appetite/feeling full after eating a small amount
  • Unintentional weight loss or gain in the stomach area

How ovarian tumors are diagnosed

Ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography(PET) are imaging scans that your doctor may order to determine the exact location and size of an ovarian tumor. They also allow the doctor to determine if any tumors have spread to other areas of your body. Your provider may also order a test called a CA-125 if you have symptoms that may indicate ovarian cancer. This is a blood test to look for a protein that tends to be higher in some (but not all) women who have ovarian cancer.

Treatment of ovarian tumors

  • Laparosco v involves inserting a thin tube with a light and a camera (laparoscope) through a small cut in v° ur Your surgeon will check your ovaries and the surrounding area. Yourprovider will also do biopsies, which means to take tissue samples. Your tissue samples will be sent to a laboratory where a pathologist will determine if they have cancerous cells.
  • Laparotomy is a surgery performed by making an incision into the abdomen and removing as much of the tumor as The removal of tumor tissue is called debulking. If the tumor has been determined to be cancerous and/or has spread, the surgeon may also remove the ovaries, uterus, fallopian tubes, omentum (fatty tissue covering the intestines), and lymph nodes located nearby.

Endometriosis

The uterine lining builds up each month in preparation to nourish a pregnancy and if an egg is not fertilized, this lining is eliminated from the body by menstruation. Endometriosis is the growth of this tissue elsewhere in the body, but it has no way to be dispelled from the body. The tissue swells and bleeds each month and may form scar tissue that can be very painful.

Symptoms of endometriosis include:

  • Painful periods
  • Pain during intercourse
  • Heavy menstrual periods
  • Pain with bowel movements
  • Infertility

How is endometriosis diagnosed?

  • Medical history and physical exam
  • Ultrasound
  • MRI
  • Laparoscopy

Treatment of endometriosis

Some cases of endometriosis can be managed with over-the-counter pain medications such as ibuprofen or acetaminophen. Others may require surgical procedures such as laparoscopy or laparotomy to remove endometriosis. If the endometriosis is extensive, the doctor may recommend a hysterectomy, which removes the uterus and possibly the ovaries and fallopian tubes.

Birth control pills and GnRH agonists are other methods of endometriosis treatment. Birth control pills suppress ovulation, thus preventing the monthly buildup of endometrial tissue in the uterus, on the ovaries, or anywhere else the endometriosis may be in located. Gonadotropin-releasing hormone agonists (GnRH agonists) are drugs that reduce the amount of estrogen in the body. This slows the growth of endometriosis and reduces its symptoms.

Pelvic Inflammatory Disease

Pelvic inflammatory disease (PID) is one of the most common causes of pelvic pain in women. PID is an infection in the ovaries, uterus, or fallopian tubes. It is frequently caused by sexually transmitted diseases such as gonorrhea or chlamydia.

Symptoms of PID

  • Ovarian pain
  • Irregular menstrual bleeding
  • Pain during intercourse
  • Vaginal discharge that may or may not have a smell
  • Fatigue
  • Fever
  • Diarrhea
  • Vomiting
  • Difficulty urinating

How is PID diagnosed?

  • Pelvic exam allows the doctor to look for any lumps, abnormal discharge, or tenderness in the pelvis
  • Blood and urine lab tests to help identify the infection
  • Cultures of any discharge seen during a pelvic exam
  • Ultrasound will allow the doctor to see if the reproductive organs are enlarged or note the presence of an abscess
  • Laparoscopy

How is PID treated?

Antibiotics drugs are usually given by mouth, but occasionally will be administered via an injection. Antibiotics can kill the bacteria that are causing the infection. It is likely that any sexual partner has the same infection, so if you are taking antibiotics for PID, your sexual partner(s) should also get treated.

Ovarian Remnant Syndrome

Surgery to remove the uterus and ovaries is known as hysterectomy and oophorectomy. It is possible, though rare, that a small piece of an ovary may be accidentally left behind. This ovarian remnant can grow and form painful cysts. Symptoms include ovarian pain, pain during intercourse, and difficulty urinating. Ultrasound, CT, and MRI scans create images of your pelvic region and help the doctor locate the remaining piece of ovary tissue. Treatment includes laparotomy or laparoscopy.

Conclusion

While the most common cause of ovarian pain is ovulation, if you are on fertility medications or if your ovarian pain is severe or accompanied by any of the following symptoms, it may have a different cause.

  • Nausea and/or vomiting
  • Diarrhea
  • Pain that radiates to your back or groin
  • Pain during intercourse
  • Pain during urination or having a bowel movement
  • Burning sensation or numbness
  • Located under or around an old incision (like from a C-section)
  • Affects your ability to function

It is important to have any pelvic pain investigated by your healthcare provider. Many women in Frisco and the surrounding areas trust Dr. Kathryn White with their reproductive health. To make an appointment with Dr. White, please call 972-294-6992.

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For questions call: 972-294-6992