Ovarian pain, a discomfort or ache in the lower abdomen often localized to one side, is a common symptom. While it can be concerning, it does not always indicate a serious underlying problem. Causes range from normal physiological processes to conditions requiring prompt medical attention.
Normal Ovulation Pain
Many individuals experience Mittelschmerz, a type of lower abdominal pain occurring during ovulation. This pain typically manifests mid-cycle, around 14 days before the next menstrual period. It can be felt on one side of the lower abdomen, corresponding to the side of ovulation, and may be sharp or dull, similar to menstrual cramps.
Mittelschmerz usually lasts from a few minutes to a few hours, though it can extend up to one or two days. It arises from the stretching of the ovarian surface by the growing follicle, or from irritation of the abdominal lining by fluid or blood released when the follicle ruptures. This pain is generally harmless and often manageable with over-the-counter pain relievers.
Ovarian Cysts
Ovarian cysts are fluid-filled sacs that develop on or within an ovary, a frequent cause of pain. These cysts vary in type, with functional cysts being the most common and typically harmless. Functional cysts include follicular cysts, which form when a follicle fails to rupture, and corpus luteum cysts, which develop if the follicle reseals after egg release and fills with fluid or blood.
Pain from functional cysts stems from their growth, causing the ovarian capsule to stretch, or from their rupture, releasing fluid that irritates the abdominal lining. A ruptured corpus luteum cyst, for instance, can lead to sudden, sharp pelvic pain and, in some cases, internal bleeding. Pathological cysts, such as endometriomas or dermoid cysts, can also cause pain due to their presence, growth, or potential to twist the ovary.
Larger cysts carry an increased risk of ovarian torsion, where the ovary twists on its supporting ligaments, cutting off blood supply. This can cause severe, sudden pain, often accompanied by nausea and vomiting. While many cysts resolve on their own, those causing persistent pain, growing in size, or suspected of being cancerous may require medical intervention.
Chronic Gynecological Conditions
Several ongoing gynecological conditions lead to persistent or recurring ovarian pain. Endometriosis involves the growth of tissue similar to the uterine lining outside the uterus, often on or near ovaries. These implants respond to hormonal changes, leading to inflammation and localized bleeding, which can cause chronic pain, particularly during menstruation.
Polycystic Ovary Syndrome (PCOS) is a hormonal disorder characterized by enlarged ovaries containing multiple small follicles. While not always directly painful, hormonal imbalances associated with PCOS contribute to pelvic discomfort. Some individuals with PCOS may experience pain related to larger cysts or other gynecological issues.
Pelvic Inflammatory Disease (PID) is an infection of the female reproductive organs, including the ovaries. This infection causes acute or chronic pain in the pelvic region, including ovarian discomfort. PID results from sexually transmitted infections and, if left untreated, leads to scarring and long-term pelvic pain.
Urgent Medical Concerns
Certain causes of ovarian pain signal medical emergencies, requiring immediate attention. Ovarian torsion, where an ovary twists around its supporting ligaments, cutting off its blood supply. This typically presents with sudden, severe, sharp pain on one side of the lower abdomen, often accompanied by nausea and vomiting. If blood flow is not restored quickly, the ovarian tissue can die, potentially leading to the loss of the ovary.
Severe complications of ovarian cysts also warrant urgent medical care. While many cyst ruptures cause mild symptoms, a rupture may lead to significant internal bleeding or severe peritonitis, which is inflammation of the abdominal lining. This results in intense, acute pain, and may manifest with symptoms like dizziness, fever, or heavy vaginal bleeding, requiring prompt evaluation and potentially surgery.
Ovarian cancer, though less common as a cause of early pain, is serious. Pain associated with ovarian cancer is often persistent pelvic or abdominal discomfort, a dull ache, or a feeling of pressure. Other symptoms may include bloating, changes in bowel or bladder habits, and difficulty eating. These symptoms, when persistent and new, can indicate advanced stages of the disease.
When to Seek Medical Care
Understanding when to seek medical care for ovarian pain is important for diagnosis and treatment. Consult a healthcare professional for persistent or worsening pain, especially if it is sudden and severe. Pain accompanied by other symptoms such as fever, vomiting, dizziness, unusual vaginal bleeding, or pain that interferes with daily activities also warrants medical evaluation.
A doctor may perform a physical exam, including a pelvic exam, to assess the pain source. Diagnostic tools such as an ultrasound, providing images of the ovaries, or blood tests may identify the cause. Consulting a healthcare professional for any unexplained or concerning ovarian pain allows for an accurate diagnosis and the most appropriate course of treatment.