Ovary pain can result from certain health conditions, including endometriosis, ovarian cysts, and referred pain from other organs, such as kidney stones. Treatment depends on the cause.

If you have ovaries, you’ve probably experienced pain in them from time to time, typically related to your menstrual cycle. Sometimes, though, ovary pain can occur because of an underlying condition.

In this article, we take a look at 7 potential causes of ovary pain, along with their symptoms, diagnosis, and treatment.

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Illustration by Alyssa Kiefer

Some people experience ovary pain during regular ovulation each month. This condition is called mittelschmerz. The name comes from the German words for “middle” and “pain.”

Ovulation generally happens in the middle of your menstrual cycle, so you may feel the pain most around day 14 or so, as the egg releases from the ovary and into your fallopian tube.

Different theories explain why ovulation might hurt. One theory suggests that because there isn’t an opening in the ovary, your egg has to go through the wall of the ovary, which may hurt. Some doctors think that the enlargement of the egg in the ovary just prior to ovulation may cause pain.

Symptoms

You’ll typically feel discomfort in your pelvis on one side. This corresponds to which ovary is releasing the egg. Ovulation pain is often mild, feeling like a dull ache, though sometimes the pain will be sharp and sudden. Overall, ovulation pain can last from a few minutes to several hours.

Some people experience bleeding or discharge during ovulation. Others may have nausea along with pain.

Ovulation pain typically isn’t anything to be concerned about. However, in some cases, it may be a sign of other health conditions, such as endometriosis or a sexually transmitted infection (STI).

If your pain is severe or worrying, consider making an appointment with a doctor, such as a gynecologist.

Diagnosis

A doctor may diagnose ovulation pain based on the timing of the pain and a pelvic exam that doesn’t show any problems. Keeping a diary about when you’re have pain can also help with the diagnosis.

Treatment

Mittelschmerz pain generally goes away in 1 or 2 days. It doesn’t require treatment, though some people may get relief by using an over-the-counter (OTC) pain medication like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin).

If you’re not trying to get pregnant, starting a birth control pill regimen can get rid of ovulation pain. This is because, when taken as directed, birth control pills stop ovulation.

Ovarian cysts are sacs or pockets filled with fluid that can form on the surface of an ovary. The most common types form during the menstrual cycle. These functional cysts often go away over a period of weeks or months.

Other types of ovarian cysts that aren’t associated with the menstrual cycle can include:

  • endometriomas, also called chocolate cysts, which can form on the ovaries of people with endometriosis
  • dermoid cysts, also called teratomas, which grow from cells present from birth and can contain tissues like skin and hair
  • cystadenomas, which are filled with a watery or mucus-like fluid and can potentially grow large

Most ovarian cysts are benign (not cancerous). Generally speaking, older, postmenopausal people have a higher risk of an ovarian cyst being malignant (cancerous).

Symptoms

Most cysts don’t cause pain or other symptoms. Even large cysts may go unnoticed for long periods. When symptoms are present, they can include:

  • pain, including pelvic pain, dull pain in your lower back and thighs, pelvic pain around the time of your period, and pain during sex
  • fullness in your abdomen
  • unusual vaginal bleeding
  • breast tenderness
  • pressure on your bladder and frequent urination
  • difficulty emptying your bladder or bowel completely

Ovarian cysts may grow large and risk rupturing. A ruptured ovarian cyst can cause potentially heavy bleeding. Get immediate medical attention if you have:

Diagnosis

If you’re having symptoms of an ovarian cyst, a doctor typically performs a pelvic exam to feel for a cyst on your ovary.

If one is detected, they’ll often order additional tests, such as:

  • a pregnancy test
  • a transvaginal ultrasound to help characterize the size, location, and contents of the cyst
  • blood tests for an ovarian cancer marker called CA125, if you’re in postmenopause

Treatment

Many ovarian cysts go away on their own without treatment, so the doctor may adopt a “wait and see” approach. If your cyst causes discomfort, OTC pain medications may help.

For frequent ovarian cysts, doctors may recommend using hormonal birth control. This stops ovulation from happening and can reduce the likelihood of cyst formation.

Some types of ovarian cysts require surgical removal. This is often done using a minimally invasive laparoscopy. Surgery may be recommended for ovarian cysts that:

  • don’t go away on their own after several menstrual cycles
  • cause significant pain
  • are large or getting larger
  • appear atypical in an ultrasound

In endometriosis, tissue similar to the endometrium, which lines the inside of the uterus, grows outside the uterus.

When it lines the uterus, the endometrium typically sheds each month with your menstrual cycle. When similar tissue grows outside the uterus, however, it can become trapped and form scar tissue and adhesions. The ovaries are often one area where this tissue grows.

Symptoms

The main symptom of endometriosis is pain. This can show up as:

Endometriosis pain can vary in intensity. Some people experience mild discomfort, while others can have severe pain that greatly affects their daily life.

The amount of pain you experience may not speak to the extent of the endometriosis. For example, you may experience severe pain but have a mild case of endometriosis.

Other symptoms of endometriosis include:

It’s important to make an appointment with a doctor if you’re having symptoms consistent with endometriosis. Endometriosis can be hard to diagnose, so connecting with a doctor early can be beneficial.

Diagnosis

Endometriosis is difficult to diagnose, as its symptoms are similar to many other health conditions. A 2017 study showed that this can lead to delays in diagnosis, with most diagnoses taking an average of 6.7 years for women between the ages of 18 and 45.

The initial steps in diagnosing endometriosis include:

  • a thorough personal medical and family history
  • a pelvic exam to feel for cysts or scarring
  • imaging tests, such as ultrasound and possibly MRI
  • laparoscopy to look inside your pelvic area for the presence of endometriosis lesions or adhesions

Treatment

There’s currently no cure for endometriosis. Because of this, treatment focuses on relieving symptoms and improving quality of life.

Some medications may help to reduce symptoms. These include:

  • hormonal birth control, which can work to ease pain and bleeding
  • gonadotropin-releasing hormone agonists, which treat endometriosis by affecting the hormones of your menstrual cycle, introducing a temporary menopause
  • OTC pain medications, which may reduce mild endometriosis pain

Surgery can also help treat endometriosis. During endometriosis surgery, a doctor typically removes endometriosis lesions in your pelvic area. Surgery is typically recommended for endometriosis that:

  • causes severe symptoms
  • hasn’t responded to other types of treatment
  • is affecting fertility

Other interventions may help with endometriosis symptoms. Some examples include:

Pelvic inflammatory disease (PID) is an infection of the reproductive organs in people with ovaries. It affects the:

  • cervix
  • uterus
  • fallopian tubes
  • ovaries

This infection may, but not always, be sexually transmitted.

Many different bacteria can cause PID. However, the bacteria that cause the STIs gonorrhea and chlamydia commonly cause PID.

PID can lead to permanent damage to your reproductive organs. This can lead to serious complications like infertility and an increased risk of ectopic pregnancy.

Symptoms

You may have PID with or without symptoms. Your symptoms may also be mild or confused with other health conditions. When PID causes symptoms, they may include:

  • pain or tenderness in your pelvis or abdomen
  • burning during urination
  • frequent urination
  • irregular bleeding
  • changes to vaginal discharge
  • pain during sex
  • fever, with or without chills

Because PID can lead to potentially serious complications, it’s important to visit a doctor if you have symptoms of PID. Early treatment can help prevent or reduce the damage due to PID.

Diagnosis

Tests that may help diagnose PID include:

  • a pelvic exam to check for inflammation and tenderness of your reproductive organs
  • culturing of a sample from your vagina or cervix to test for an infection
  • tests for STIs like gonorrhea and chlamydia
  • blood and urine tests to check for signs of inflammation and help rule out other health conditions

A doctor might also use additional procedures to confirm a diagnosis of PID or assess damage to the reproductive organs, such as:

Treatment

Treatment involves taking a course of antibiotics. To clear the infection, doctors recommend taking your entire course of antibiotics as directed, even if you begin to feel better.

Doctors recommend sexual partners get treatment as well. This helps to reduce the chance of the infection coming back.

In rare situations, surgery may be needed to help treat PID. This is typically the case if a pocket of pus called an abscess has formed or ruptured in your pelvic area due to the infection.

Ovarian torsion occurs when your ovary twists around the ligaments that hold it in place. This can cut off the blood supply to the ovary and cause the ovarian tissue to die.

Most often, ovarian torsion happens due to a mass on the ovary. This can be due to:

Being pregnant or undergoing fertility treatments are also risk factors for ovarian torsion due to the enlargement of the follicles of the ovary. Research into people diagnosed with ovarian torsion found that 8–15% were pregnant.

Symptoms

Symptoms of ovarian torsion can include:

  • sudden, severe pelvic pain that may radiate to the abdomen, back, or side (flank)
  • nausea
  • vomiting

Symptoms can also come and go over days to weeks. This can happen if the ovary twists and then returns to its usual position.

Ovarian torsion is a medical emergency and requires immediate treatment.

Diagnosis

The diagnosis of ovarian torsion typically involves:

  • laboratory blood and urine tests to help rule out other health conditions
  • a pregnancy test
  • a transvaginal or pelvic ultrasound to allow your doctor to view the affected ovary

While all of the above tests can help to point to ovarian torsion, a definitive diagnosis is made during corrective surgery.

Treatment

Ovarian torsion is treated using surgery. During this procedure, a surgeon carefully untwists your ovary. If an ovarian cyst is present, they may also remove it. They’ll often do this using laparoscopy.

If the ovarian tissue has begun to die or the ovarian mass appears cancerous, the surgeon may remove the ovary and associated fallopian tube. This procedure is called a salpingo-oophorectomy.

If you’ve had recent surgery on your ovaries, you may be at risk of ovarian remnant syndrome (ORS). This condition happens when ovarian tissue remains in your pelvic area following ovary surgery, such as oophorectomy or salpingo-oophorectomy.

Reasons tissue may be left over after surgery include:

  • adhesions
  • bleeding during surgery
  • anatomic variations
  • poor surgical technique

Symptoms

Pelvic pain is the most common symptom of ORS. Additional symptoms can include:

  • feeling a pelvic mass
  • not developing the expected menopausal symptoms after your surgery
  • endometriosis-like symptoms, such as pain during sex, pain during urination or a bowel movement, or digestive symptoms

Some individuals may not experience any symptoms at all. However, most will experience some symptoms within the first 5 years after surgery.

If you’ve previously had surgery on your ovaries and are experiencing pelvic pain, consider making an appointment with a doctor. ORS may be the cause.

Diagnosis

To diagnose ORS, a doctor will note your history of previous surgery to your ovaries. They’ll also perform a pelvic ultrasound to look for a mass.

Doctors make a definitive diagnosis through laparoscopy when they collect and test a sample of the remaining ovarian tissue.

Treatment

The treatment of ORS often involves surgery to remove the remaining ovarian tissue. If surgery isn’t recommended or desired, hormone therapy can help. This therapy works to suppress ovulation and reduce ORS symptoms.

The ovaries are located near many other organs and parts of your body. As a result, you may experience pelvic and ovary pain from other medical conditions.

When you experience pain in one part of your body that’s actually due to pain in another area, it’s called referred pain. Doctors are still trying to figure out why exactly referred pain happens.

Referred pain likely occurs due to how nerves are connected in your body. A pain sensation in one area must travel to the brain through your network of nerves. Nerve pathways may overlap or converge, leading you to feel pain at a different location.

An example of referred pain happens during a heart attack. While the body reacts to a blockage of blood vessels serving the heart, some people feel referred pain in the neck, shoulders, or jaw.

Symptoms

Some examples of conditions that may cause referred pain in the area of the ovaries include:

  • Appendicitis: Pain from appendicitis would be near your belly button or on your right side. You may also experience loss of appetite, constipation, or signs of infection, like fever, chills, and vomiting.
  • Constipation: Constipation is likely if you’ve had fewer than three bowel movements in the last week. You may also experience hard stools, straining while on the toilet, and feeling like you haven’t completely emptied your bowels.
  • Kidney stones: Pain that’s severe and focused on your side, back, and near your ribs may be kidney stones. Additional symptoms may include blood in your urine, pain that comes in waves, and fever or chills.
  • Pregnancy: If you’ve missed your period and are sexually active, pregnancy is possible. You may also experience breast tenderness, nausea, vomiting, or fatigue. Ectopic pregnancy is another possibility, especially if the pain is severe. You may also feel pain in your shoulder, or you may feel lightheaded.
  • Urinary tract infection (UTI): If your pain is more in the center of your pelvis, you may have a UTI. A UTI can also cause frequent or urgent urination, a burning sensation while peeing, or cloudy urine.

Consider contacting a doctor if your pelvic pain happens with other symptoms. They can help to determine the cause and develop a treatment plan.

Diagnosis

In addition to taking your medical history and doing a physical exam, they may also:

  • perform a pelvic exam
  • order tests of your blood or urine
  • administer a pregnancy test
  • use imaging methods like ultrasound, CT scan, or MRI to view the tissues of your pelvis or abdomen

The specific tests ordered can depend on your other symptoms.

Treatment

There’s no one specific treatment for referred pain. Once a doctor has identified the cause, they’ll work to treat it.

You may worry that your ovary pain means you have ovarian cancer. While you shouldn’t ignore the possibility, ovarian cancer is relatively rare.

The American Cancer Society says that the lifetime risk of getting ovarian cancer is about 1 in 78. The rate at which people are diagnosed with ovarian cancer has also been falling over the past couple of decades. Ovarian cancer most often affects older people, with most receiving a diagnosis at 63 or older.

Risk factors for ovarian cancer can include:

If you have a family history of ovarian cancer, there are resources available to you. A doctor or a genetic counselor may be able to help you learn more about your risk.

Symptoms

The very early stages of ovarian cancer may not have any symptoms. Symptoms might not occur until the cancer has spread. The most common symptoms of ovarian cancer include:

Some additional symptoms that may happen with ovarian cancer are:

The symptoms of ovarian cancer are similar to those of several other health conditions. However, when they’re due to ovarian cancer, these symptoms are often persistent and noticeably different from what’s normal for you.

One key to treating cancer is early detection. If you’re experiencing persistent, concerning symptoms, make an appointment with a doctor to discuss them. Even if they’re not due to ovarian cancer, they may be caused by another health condition that needs attention.

Diagnosis

The diagnostic process for ovarian cancer typically includes:

  • your medical history
  • a physical exam
  • a pelvic exam to check for lumps or masses
  • imaging tests, such as ultrasound, MRI, CT scan, or PET scan
  • blood test for a marker called CA125

A biopsy of ovarian tissue is vital for diagnosing and staging ovarian cancer. The sample will be taken to a lab and viewed under a microscope for signs of cancer.

Treatment

Treatment of ovarian cancer typically includes surgery. This often involves removing the affected ovary. Depending on how far the cancer has spread, it can also include the removal of surrounding tissues, which may include:

  • nearby lymph nodes
  • omentum
  • fallopian tubes
  • uterus
  • cervix

Chemotherapy can also help treat ovarian cancer. This treatment uses drugs that can kill cancer cells or stop them from growing. It may also be used after surgery to help eliminate any remaining cancer cells.

In some situations, ovarian cancer can be treated with targeted therapy. This involves the use of drugs that target specific proteins in cancer cells. Examples of targeted therapy drugs for ovarian cancer include the monoclonal antibody bevacizumab (Avastin) and drugs called PARP inhibitors.

Which treatment is recommended depends on many factors, including, but not limited to:

  • the type of ovarian cancer
  • the stage of the cancer
  • your age and overall health

A doctor will work with you to decide on a care plan for your situation.

Ovary pain can have multiple causes. Some aren’t serious, while others can cause potentially severe health complications.

If your pain is mild, consider keeping a symptom diary to log when it occurs, how much it hurts, and any other things you notice. For example, you may find that you have recurring ovary pain only around the middle of your menstrual cycle, such as with Mittelschmerz.

Even if pain doesn’t affect your everyday activities, you may want to get help sooner rather than later. Without treatment, conditions such as endometriosis and PID can lead to infertility.

If you’ve suddenly noticed ovary pain along with symptoms like sudden severe pain, fever, or vomiting, seek prompt medical care. You may have a ruptured ovarian cyst or ovarian torsion.

It’s a good rule of thumb to visit a doctor if you have persistent or recurring pelvic pain. They can help identify the specific issue you’re having and recommend treatment.