Causes of ovarian pain and treatment options

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The ovaries, located on both sides of the woman's pelvis, are responsible for the production and release of the eggs necessary for fertilization. Perhaps unsurprisingly, the most common reasons people think of ovarian pain, which is often felt in the lower abdomen, pelvis, or lower back, are related to ovulation and menstruation . However, the culprit could be a gynecological problem, such as endometriosis or pelvic inflammatory disease, or even a condition that affects your digestive or urinary system. This can make diagnosis difficult.

Illustration by Alexandra Gordon, Get Meds Info

Common causes

It is important to be aware of the various conditions that can affect your well-being. Some may justify your concern, while others may alleviate it.

Menstrual pain

On certain days of their normal menstrual cycle , women may experience pain or discomfort in one or both ovaries. This cramping pain that a woman experiences during or just before her period is called dysmenorrhea and is associated with the release of prostaglandins, hormone-like substances that, among other things, contract the muscles, of the uterus .

Mittelschmerz pain

Some women experience ovarian pain in the middle of their cycle during ovulation, when an egg is released from the ovary, rather than during menstruation. This pain, known as mittelschmerz , can be uncomfortable but harmless .

Ovarian cyst

An ovarian cyst is a benign, usually fluid-filled growth that can cause pain, discomfort, bleeding, menstrual irregularities, or no symptoms. Ovarian cysts are common and can develop at different times in the menstrual cycle.

Follicular cysts form if the egg is not released during ovulation, and corpus luteum cysts develop if the corpus luteum (egg sac) does not dissolve as it should immediately after ovulation.

Small ovarian cysts can heal on their own, but some require urgent treatment, such as a large cyst that ruptures or bursts. This can cause sudden, sharp, and severe unilateral pelvic pain .

Endometriosis

Endometriosis is a condition in which the lining of the endometrium of the uterus can develop in other areas of a woman's reproductive organs, such as the ovaries, fallopian tubes, or bladder.

Endometriosis often causes severe cyclical or episodic cramps in the uterus or ovaries and intermittent bleeding. The pain can be especially severe during a woman's period or during sexual intercourse. Endometriosis can also lead to infertility due to the formation of adhesions (scar tissue) .

Ectopic pregnancy

An ectopic pregnancy is a pregnancy that occurs outside of the uterus, usually in one of the fallopian tubes. It can cause moderate to severe ovarian pain and is a medical emergency .

Pelvic inflammatory disease (PID)

PID is an infection that can affect one or more reproductive organs, including the uterus, ovaries, fallopian tubes, and vagina. This serious condition is often caused by a sexually transmitted infection and can cause pain in various areas of the pelvis, including one or both ovaries, which is often worse with sexual intercourse.

In addition to pain, women with PID may experience fever, chills, abnormal vaginal discharge and / or bleeding, and symptoms that mimic a urinary tract infection, such as burning with urination .

Myoma of the uterus

A uterine fibroid is a benign neoplasm that arises from the lining of the uterus. In addition to pelvic discomfort or pressure, a woman with fibroids may experience abnormal uterine bleeding, back pain, constipation (if the fibroid presses on the intestine), difficulty urinating (if the fibroid presses on the bladder), and infertility .

Rare causes

There are several unusual conditions that can cause ovarian pain. Given the severity of most of these, it is important not to ignore them, regardless of the likelihood that they will occur.

Ovarian cancer

Although ovarian cancer can cause ovarian pain, it is rare. In fact, the disease often does not cause symptoms and, if it does, they are more subtle, such as bloating , feeling full when there is little to eat, and the urge to urinate or urinate frequently .

Understand the symptoms, stages, and treatment of ovarian cancer

Residual ovarian syndrome

This is an unusual condition that can occur if you had surgery to remove your ovaries and some of the tissue was not completely removed. This can happen if you have endometriosis and you have a small area of endometrial or ovarian tissue that was not visible during surgery or that has expanded after a procedure, for example .

Ovarian torsion

This is an unusual condition, but requires urgent surgical care, in which one of the fallopian tubes is twisted, which can cut off the blood supply to it and the ovary. This condition can cause sudden, sharp pain due to ischemia (lack of blood flow) in these areas .

Phantom pain in the ovaries.

With phantom ovarian pain, a woman continues to experience what appears to be ovarian pain, even after one or both ovaries are removed. It is believed to be the result of constant stimulation of the sensory nerves .

When to contact a healthcare provider

You should see your doctor if you develop new or other symptoms in the pelvic area during or between periods.

In particular, if you experience any of these symptoms, be sure to seek medical attention:

  • Persistent or severe pelvic pain
  • Menstrual cycles lasting more than 38 days or less than 24 days
  • Periods longer than seven days
  • Menstrual bleeding that passes through one or more tampons or sanitary pads every hour for several hours in a row.
  • Menstrual cycle with blood clots of a quarter or more
  • Bleeding or spotting between periods
  • Bleeding after menopause
  • Bleeding during or after sexual intercourse
  • Bleeding or cramping if you miss your period or have a positive pregnancy test.
  • Bleeding after menopause
  • Blood in the urine
  • Fever, chills, night sweats, nausea, or vomiting.

Diagnostics

Diagnosing the cause of ovarian pain is challenging because there can be problems with other reproductive organs, such as the uterus or cervix, or even other body systems. (The ovaries are located in the same area as many other organs.)

If you see your doctor for ovarian pain, the first thing to do is take a medical history and perform a physical exam.

Medical and sexual history

During your medical history, your healthcare provider will ask you several questions about your pain, such as when it started, how you feel, what makes it better and worse, and if you have other symptoms such as vaginal bleeding, vaginal discharge, or fever. . …

They will also ask if you have ever been diagnosed with a gynecological condition, such as endometriosis or uterine fibroids, and if you have ever had abdominal or pelvic surgery.

Your healthcare provider may also ask about your sexual history, such as how many partners you have or if you have ever had a sexually transmitted infection .

Physical exam

For ovarian pain, your doctor will examine your abdomen, lower back, and sides. In addition to examining and applying pressure to these areas to check for tenderness, your healthcare provider will also examine your pelvic organs .

During a pelvic exam, samples of your vaginal or cervical fluid may be taken with a Pap smear to check for infection or abnormal cells.

Laboratories and blood tests

Various tests may be ordered to confirm or reject the diagnosis, perhaps the most important of which is a pregnancy test to rule out an ectopic pregnancy.

In addition to a pregnancy test, a urine test may be done to check for blood or infection. Similarly, for PID, your healthcare provider may order inflammatory blood markers, such as C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR) , or a complete blood count to check for an elevated white blood cell count ( a sign of infection). . …

Display

Since your pain can have many medical reasons, don't be surprised if your healthcare provider orders imaging tests, such as a pelvic ultrasound or computed tomography (CT) scan of the abdomen and pelvis.

Pelvic laparoscopy

Pelvic laparoscopy is a surgical procedure sometimes used to determine the cause of a woman's pelvic pain. During a pelvic laparoscopy, your doctor may take a tissue sample (biopsy).

Differential diagnosis

Gastrointestinal problems like constipation or even more serious conditions like appendicitis or diverticulitis can cause pain or discomfort that can be mistaken for ovarian pain.

If your doctor suspects a problem with your gastrointestinal tract rather than pelvic disease (for example, if your pregnancy and pelvic exam are normal, and your abdominal exam reveals focal tenderness), they will perform the appropriate tests. For example, a CT scan of the abdomen can diagnose appendicitis and diverticulitis. Constipation can often be diagnosed by history and digital rectal examination .

Also, a urinary tract infection (UTI) or kidney stone can cause pain similar to ovarian pain. These conditions can often be ruled out early enough with a normal urinalysis, one that shows no signs of infection or blood. CT scan can be used to diagnose a kidney stone if it is still suspected.

Watch out

Once the cause of your ovarian pain is determined, you and your healthcare provider can begin to develop a treatment plan that can be as simple as a few lifestyle changes to more complex ones, such as taking medications. prescription or surgery.

Lifestyle

If ovarian pain is related to your monthly cycle, lifestyle changes, such as getting enough sleep, exercising, using relaxation techniques, and using a heating pad, can often help reduce discomfort.

Medicines

Depending on your diagnosis, your healthcare provider may recommend or prescribe medications.

For example, if simple home remedies like heat and rest don't relieve menstrual cramps, a non-steroidal anti-inflammatory drug (NSAID) , which reduces prostaglandins in the body, often helps. Be sure to talk to your doctor before taking NSAIDs; Women with bleeding disorders, aspirin allergy, kidney or liver disease, or stomach problems should not take these medications. In addition to NSAIDs, birth control pills, patches, rings, or intrauterine devices can also reduce menstrual cramps.

Another gynecological disease that requires medication is pelvic inflammatory disease. If you are diagnosed with PID, your doctor will prescribe antibiotics. In more severe cases, the woman may need to be hospitalized and given antibiotics intravenously (through a vein).

Operation

For emergencies such as ovarian torsion or ectopic pregnancy, surgery is required. Surgery is also often done as part of ovarian cancer treatment and can be used to remove uterine fibroids or endometrial tissue in severe endometriosis.

Get the word of drug information

In conclusion, women who experience ovarian pain are often concerned about ovarian cancer . While ovarian pain can indicate a medical condition, it is not common and other possible causes are much more likely to exist. However, it is important not to ignore ovarian pain and to be examined by a doctor.

Also, remember to get regular check-ups and gynecological exams and report ovarian pain to your doctor so that the disease, ovarian cancer, or other condition can be found and treated early when treatment is underway. more likely to be successful.

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