What’s Causing My Ovary Pain?

Medically reviewed by Suzanne Falck, MD on June 20, 2017Written by Ashley Marcin

Is this cause for concern?

Your ovaries are reproductive glands located on each side of your pelvis. They’re responsible for making eggs. Your ovaries also serve as your body’s primary source of the hormones estrogen and progesterone. Many women experience pain in their ovaries from time to time, typically related to their menstrual cycle.

Sometimes, though, ovary pain can be a sign of an underlying condition. Keep reading to learn more about what may be causing your symptoms.

1. Mittelschmerz

Some women 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 bursts from the ovary and into your fallopian tube.

You may feel the discomfort in your pelvis on one or both sides. It can be mild or severe, lasting from a few minutes to several hours. Some women experience bleeding or discharge during ovulation. Others may have nausea along with pain.

There are different theories for why ovulation might hurt. One is 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 the enlargement of the egg in the ovary just prior to ovulation may cause the pain.

Mittelschmerz pain generally goes away in a day. It doesn’t require treatment, though some women may get relief by starting a birth control pill regimen.

Check out: Which birth control pills are right for you? »

2. Ovarian cysts

Ovarian cysts are sacs or pockets filled with fluid that can form on the surface of an ovary. Most cysts don’t cause pain or other symptoms. Even large cysts may go unnoticed for long periods of time.

Symptoms include pelvic pain as well as pain in your lower back and thighs. You may also have pelvic pain around the time of your period or during sex.

Other symptoms include:

  • pain during bowel movements
  • nausea
  • vomiting
  • breast tenderness
  • fullness in your abdomen
  • pressure on your bladder and frequent urination

Ovarian cysts may grow large and risk rupturing. Signs that your cyst has ruptured include:

  • sudden and severe abdominal pain
  • fever
  • vomiting

You may also go into shock and experience:

  • cold or clammy skin
  • rapid breathing
  • lightheadedness

If you believe a cyst has ruptured, contact your doctor or head to the emergency room for immediate medical attention.

Learn more: Ovarian cysts »

3. Endometriosis

Another cause of ovary pain may be a condition called endometriosis. With this disorder, the tissue that lines the inside of the uterus grows outside the uterus. This tissue is called the endometrium. When it lines the uterus, the endometrium typically sheds each month with your menstrual cycle. When it 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 with endometriosis, causing anything from discomfort to severe pain.

Other symptoms of endometriosis include:

  • painful periods, intercourse, or bowel movements
  • excessive bleeding
  • fatigue
  • diarrhea
  • constipation
  • nausea

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.

Learn more: Endometriosis »

4. Pelvic inflammatory disease

Pelvic inflammatory disease (PID) is an infection of the genital tract and reproductive organs in women. It affects the uterus, fallopian tubes, and ovaries. This infection may happen naturally or be sexually transmitted. PID is most common in women ages 15 to 25.

You may have PID with or without symptoms. Your symptoms may also be mild or confused with conditions like appendicitis, ectopic pregnancy, or ovarian cysts.

PID may cause:

  • pain or tenderness in your pelvis
  • burning during urination
  • nausea
  • vomiting
  • irregular bleeding
  • changes to vaginal discharge
  • pain during intercourse
  • fever
  • chills

According to the American Sexual Health Association, PID is the leading cause of infertility for women in the United States. It can be diagnosed during a pelvic exam or through pelvic ultrasound or laparoscopy. Treatment involves antibiotics and antimicrobial agents. You may need more than one cycle of treatment to clear PID from your system.

5. Phantom pains

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.

Some of these conditions include:

Appendicitis: In this case, the pain 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: The pain may be severe and focused on your side and back, near your ribs. You may also have blood in your urine, pain that comes in waves, and fever or chills.

Pregnancy: If you’ve missed your period, pregnancy is possible. You may also experience breast tenderness, nausea and vomiting, or fatigue. Ectopic pregnancy is another possibility, especially if the pain is severe, you feel it in your shoulder, or you feel lightheaded.

Urinary tract infection: 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, burning sensation while peeing, or cloudy urine.

6. Ovarian remnant syndrome

If you’ve had recent surgery on your ovaries, you may want to ask your doctor about ovarian remnant syndrome (ORS). After an oophorectomy, you may have tissue left over for a number of reasons. Bleeding during surgery, adhesions, anatomic variations, even poor technique may all be factors.

Pelvic pain is the most common symptom with ORS. You may also feel a pelvic mass or not develop the expected menopausal symptoms after your oophorectomy. Some women even have symptoms that are similar to those of endometriosis. Regardless, most women will experience some type of symptoms within the first five years after surgery.

Treatment includes surgery to remove the tissue or hormone therapy to suppress ovulation.

Learn more: Hormone replacement therapy »

Is it ovarian cancer?

You may worry that your ovary pain means you have ovarian cancer. While you shouldn’t ignore the possibility, ovarian cancer is relatively rare. It affects about 11 women out of every 100,000. The average age of women diagnosed with ovarian cancer is 63 years.

The key with cancer is early detection, so if you’re concerned about it, it’s worth a visit to your doctor. Early stages of ovarian cancer often have no symptoms. Even advanced cancer may not show many symptoms, or you may confuse them with less serious conditions, such as constipation.

Possible symptoms of ovarian cancer include:

  • bloating or swelling in your abdomen
  • fullness while eating
  • weight loss
  • pain in your pelvis
  • changes in bowel habits
  • frequent urination

Risk factors for ovarian cancer include having a family history of it, taking certain medications, and having certain genetic mutations. Your doctor or a genetic counselor may be able to help you learn more about your individual risk.

Learn more: The link between ovarian cancer and age »

When to see your doctor

If you’ve suddenly noticed ovary pain along with symptoms of infection — such as fever, bleeding, or vomiting — it’s a good idea to see your doctor as soon as possible. If your pain is less severe, consider keeping a diary to log when you have it, 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 your pain doesn’t affect your everyday activities, it’s best to get help sooner rather than later. Conditions such as endometriosis and PID can lead to infertility if left untreated. Appendicitis or a ruptured ovarian cyst may be life-threatening. Your doctor can give you a pelvic exam and other tests to help identify the specific issue you’re having and to target a treatment that will help you feel better soon.

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