Ovarian pain: what is it, is it serious?

In the middle of your menstrual cycle, even though your period is far away and you should be “calm,” a pain in your lower abdomen doubles over. It can feel like menstrual cramps, occur with every menstrual cycle, be felt on the left or right side of your lower abdomen, be very violent or just a pinch: welcome to ovarian pain . You had no idea it existed? Is it serious, what can you do to get rid of it, how to identify it? We talk about it in this article.

What is an ovary?

Chances are you already know that the ovaries are the source of eggs, which in turn play a role in reproduction when they meet sperm. But do you know exactly what the ovaries do? Where they're located? What they're made of? And finally, their role in the menstrual cycle? Let's unpack these topics together!

The functions of the ovaries

The ovaries are the gonads, or reproductive organs, in menstruating people —much like the testicles in non-menstruating people. The primary function of the ovaries is reproduction: their role is to create oocytes, also called “eggs” or “female gametes,” which are necessary for reproduction.

The secondary function of the ovaries is their endocrine function. They respond to estrogen and produce large quantities of progesterone. This is released by the ovaries, more specifically by the corpus luteum, following the expulsion of the dominant egg. It is progesterone that organizes the luteal phase of the menstrual cycle.

Ovaries in anatomy

The ovaries are part of the reproductive system of menstruating people, which consists of the vulva, clitoris, vagina, uterus, and fallopian tubes. There are two of them, shaped and the size of a large almond (4 centimeters long, 2 centimeters wide, and 1 centimeter thick). The ovaries are generally located in the lower abdomen, but not necessarily to the right and left of it. They are mobile organs, and their position tends to change throughout the lives of menstruating people.

The cortex, or ovarian cortex, is the uppermost layer of the ovary. It contains the follicles, the clusters of cells that will produce the eggs. The medulla is the inner part of the ovary. It houses the numerous nerves and blood vessels supplying the various tissues of the organ.

How do the ovaries work?

At birth, the ovaries contain approximately 400,000 follicles . These clusters of cells produce and contain eggs until they mature.

Follicles begin producing eggs at puberty. From then on, they evolve, grow, and die cyclically, through the multiple stages of a complex biological process: folliculogenesis . Only a few follicles mature, giving rise to a fertilizable egg. A fertilizable egg matures and is released during each menstrual cycle: this is ovulation.

💡Did you know? The egg released during ovulation by the ovaries is not yet mature: it continues its development in the genital tract, also called “fallopian tubes”. It is only when fertilized by a sperm that it completes its development and becomes an egg. In this case, it remains in the uterus and produces an embryo. If it is not fertilized, the egg is eliminated at the same time as the uterine wall is expelled during menstruation.

Ovaries in the menstrual cycle

The ovaries are a major player in the menstrual cycle.

During one of the 4 phases of the menstrual cycle: the follicular phase , they see the oocytes develop in the ovarian follicles. Under the effect of sex hormones, one of them becomes the dominant egg: it is this one that will be released during ovulation . If you want to know everything about ovulation , check out our article!

Then, in the first hours of the luteal phase, the egg moves through the fallopian tubes towards the uterus. It dies within 24 to 48 hours. At the same time, the corpus luteum develops in the empty follicle: the corpus luteum releases progesterone into the body of non-menstruating people to prepare it for the possibility of fertilization (thickening of the uterine lining).

How to recognize ovarian pain?

Ovarian pain is, as the name suggests, related to the ovaries. It is therefore generally located in the lower abdomen. But how do you know if your lower abdominal pain is related to the ovaries or for another reason? How can you recognize ovarian pain?

What form does ovarian pain take?

Ovarian pain is usually felt in the lower abdomen, either on the right, left, or both sides. It can be related to various problems affecting the ovaries (hormonal problems or diseases), the uterus, or the fallopian tubes (in the latter two cases, the pain does not originate in the ovaries but radiates to them).

Different types of ovarian pain

Cyclical pain

The most common ovarian pain is ovulation-related pain. It occurs approximately midway through the menstrual cycle, 14 days before your period. Also, if you regularly experience lower abdominal (or lower back) pain in the middle of your menstrual cycle, it's highly likely related to your ovaries and ovulation.

Non-cyclical pain

The ovaries can also suffer from non-cyclical, more occasional pain. Mid-cycle, it is possible to associate this pain with ovulation pain, particularly when a blood vessel gives way to ovulation. The pain then feels like a pinch and may not occur with every cycle. Other non-cyclical pain can be felt in the ovaries. In this case, it can be associated with various pathologies and we recommend that you discuss it with your doctor.

Acute pain

Particularly acute pain can occur during ovulation and thus be normal. Again, if the ovarian pain occurs around the time of your ovulation (mid-cycle, 14 days before your period), there is not necessarily cause for concern. However, if the pain lasts more than 24 to 48 hours and does not subside despite pain medication, it is important to seek medical help. Ovarian torsion is therefore a particularly painful condition that must be treated urgently;

Other symptoms

Generally, ovarian pain is accompanied by many symptoms (ovulation symptoms, infection symptoms, etc.). Monitor any symptoms that add to your pain and seek medical help if painkillers are not enough to alleviate your pain.

Other potential pains

Ovarian pain can result from conditions related to other pathologies and health issues affecting other organs, such as the uterus and fallopian tubes. The stomach and intestines can also experience dull pain in this area.

What are the accompanying symptoms of ovarian pain related to ovulation?

Ovarian pain related to ovulation is usually not serious —in fact, it's common and is quite healthy since it means you're ovulating normally. Beyond occurring in the middle of your cycle, 14 days before your period, it's most often accompanied by other symptoms, calledovulation symptoms . We've written a comprehensive article on the subject.

Typically, ovulation symptoms last from a few hours to two days and are similar to those experienced during menstruation. Here are the main ones:

• Pinching sensation and pain in the ovaries: this is most often explained by the rupture of a small blood vessel at the time of the release of the mature egg;
• Light bleeding also called spotting: this can also be explained by the rupture of a small blood vessel when the egg is released from the ovarian follicle;
• Breast pain and tightness: Heavy and painful breasts can be a symptom of ovulation;
• Catamenial migraines: linked to hormones, migraines experienced during PMS and at the start of menstruation can also occur during ovulation;
• Nausea and vomiting: Some women experience nausea during ovulation.

💡 What if you don't experience any of these symptoms? Not experiencing any of these symptoms doesn't mean you're not ovulating properly. If you have a period, you're ovulating. Some people have no ovulation symptoms and are fine.

What can cause ovarian pain?

Ovarian pain can be normal and related to ovulation (this pain is called " mittelschmerz "), but it can also have pathological or even serious causes. Let's discover them together. In general, don't hesitate to consult a doctor and/or your gynecologist to discuss your pain and symptoms.

Ovulation

The first (and least serious!) cause of ovarian pain is ovulation. When the egg is released from the ovarian follicle, pressure may be exerted on the blood vessels of the ovary. Sometimes, a small blood vessel may be damaged, causing pain.

Ovarian pain related to ovulation:

• occur mid-cycle, 14 days before menstruation;
• are generally cyclical: it often happens that you have pain for several cycles in a row;
• may be associated with small bleedings (spotting) linked to the rupture of a blood vessel;
• may be associated with other ovulation symptoms (nausea, migraines, chest pain, etc.);
• can be mild (light pinching) to acute.

If you experience particularly severe pain, do not hesitate to consult a healthcare professional, even if you think it is related to ovulation: on the one hand, it may be a sign of a pathology and on the other hand, it is not normal to suffer.

Ovarian cysts

Ovarian cysts are cysts that develop on and in your ovaries. They are often associated with polycystic ovary syndrome (PCOS), but not necessarily so—it is possible to have isolated ovarian cysts. PCOS is a common condition that affects 1 in 10 menstruating people. It is the leading cause of infertility for menstruating people of reproductive age.

Generally, ovarian pain linked to ovarian cysts (and more broadly PCOS) is accompanied by:

• irregular periods;
• painful periods;
• heavy periods;
• bleeding outside of periods;
• hormonal imbalances (acne, tendency to hirsutism, etc.)

If your ovarian pain is accompanied by any of the symptoms listed above, don't hesitate to consult a doctor to discuss your concerns and doubts. They will be able to suggest further tests and treatments.

Endometriosis

Endometriosis is a disease of the endometrium, the lining of the uterine wall that develops during the luteal phase of the menstrual cycle to accommodate the egg in case of fertilization. In people with endometriosis, the endometrium develops abnormally in the uterus (adenomyosis or internal endometriosis) or outside the uterus, in nearby organs. The ovaries can become affected and painful.

Usually, ovarian pain related to endometriosis occurs with other symptoms:

• Severe period pain;
• Heavy periods ;
• Irregular periods

If you suspect you have such a condition, consult a doctor and discuss your symptoms. They will suggest further tests based on your medical profile.

Fibroids

Fibroids are benign tumors that can develop anywhere in the reproductive system of menstruating people, including the uterus, fallopian tubes, and ovaries. A fibroid in the ovaries can cause pain. Once diagnosed, it is easily treated with surgery.

Usually, ovarian pain related to fibroids is accompanied by other symptoms such as:

• Bleeding between periods;
• Severe period pain;
• Heavy periods;
• Irregular periods

If these symptoms are similar to those you have, consult a doctor to discuss your symptoms. They will perform further tests if necessary.

Pelvic infections

A pelvic infection, also known as pelvic inflammatory disease (PID), is an infection of the female reproductive organs located in the pelvic region. This can include the uterus, fallopian tubes, or ovaries. Ovarian pain is a common symptom of this condition.

Usually, ovarian pain related to a pelvic infection is accompanied by other symptoms:

• Pelvic pain ;
• Fever ;
• Unusual vaginal discharge, see our article on vaginal discharge ;
• Pain during intercourse;
• Burning sensations during urination;
• Irregular periods;
• Fatigue, nausea and other general symptoms

It is important to consult your healthcare professional as soon as possible if you suspect a pelvic infection, as it can become serious without treatment. Treatment for pelvic infection usually involves antibiotics to clear the infection. Severe infections may require hospitalization.

Ovarian torsion

Ovarian torsion is a medical condition in which an ovary twists and turns , which can lead to obstruction of blood flow to the ovary. Ovarian torsion can cause acute and severe ovarian pain. If left untreated, this condition can lead to the loss of the ovary, which loses its blood supply.

Ovarian pain associated with ovarian torsion is particularly sudden, intense, and acute. It also has the characteristic of lasting more than 24 to 48 hours, unlike ovulation pain. In addition to ovarian pain, ovarian torsion may be accompanied by symptoms such as:

• nausea,
• vomiting,
• chills,
• fever,
• lower abdominal pain
• and an increase in heart rate.

Ovarian torsion is a medical emergency because it can lead to loss of the ovary due to obstruction of blood flow. If you experience sudden and severe pelvic pain, it is essential to seek immediate medical attention. Diagnosis of ovarian torsion often requires immediate medical evaluation, usually through ultrasound or other medical imaging tests. Treatment typically involves surgery to restore blood flow to the ovary and prevent complications.

Ectopic pregnancy

An ectopic pregnancy is a pregnancy that, as the name suggests, occurs outside the uterus. Ectopic pregnancies are facilitated by copper IUDs. In this condition, the early stages of pregnancy are “normal” (stopped periods, heavy vaginal discharge, breast pain, and so on). However, the egg has attached itself to the fallopian tubes, and its development there can lead to tube rupture and internal bleeding. The embryo resulting from an ectopic pregnancy is not viable.

Ovarian pain related to uterine pregnancy is associated with different symptoms such as:

• symptoms of early pregnancy
• heavy bleeding
• powerful pains
• nausea and vomiting
• fever

An ectopic pregnancy is a medical emergency and requires immediate treatment. It may be detected during initial screenings or later, in the event of bleeding. If you are pregnant and experiencing significant pain, consult a healthcare professional immediately.

Displaced/expelled IUD

The IUD (copper or hormonal) is a contraceptive device placed in the uterus by a gynecologist. It can remain in place for three to five years without any problems. However, for various reasons (very heavy periods, uterine contractions, etc.), it may move, very quickly after being inserted or several months / years after its insertion.

Symptoms of a displaced IUD include:

• ovarian and pelvic pain
• bleeding between periods
• symptoms of infection: fever, nausea and vomiting

If you suspect your IUD has moved, make an appointment with your gynecologist as soon as possible and use additional contraception while waiting for your appointment. In fact, beyond causing pain, a displaced IUD may no longer be effective.

Ovarian tumors

Ovarian pain is not necessarily a specific symptom of ovarian cancer – so don't panic!, as we have seen, many medical conditions can cause pain in the pelvic area.

Symptoms of ovarian cancer may include:

• Persistent pelvic or abdominal pain
• Abdominal distension
• Changes in bowel or urinary habits
• Unexplained weight loss
• Significant and persistent fatigue

It's important to note that these symptoms aren't specific to ovarian cancer and may be related to other, more common health issues. However, if you experience persistent or unexplained symptoms, especially if you have risk factors for ovarian cancer (such as a family history of ovarian cancer), it's important to see a healthcare professional for further evaluation. Ovarian cancer is easier to treat when diagnosed early, so it's critical to respond quickly to any unusual symptoms.

Is it normal to have ovarian pain?

Yes and no : Ovarian pain can be “normal” or a sign of illness. Indeed, your ovulation process may be regularly accompanied by ovarian pain . However, various diseases can also be associated with ovarian pain—not to mention that supposed ovarian pain can also be linked to other organs/issues.

How do you know then? When should you worry?

Generally speaking, ovulation pain occurs midway through the menstrual cycle . Since ovulation always occurs fourteen days before your period, ovulation-related pain will occur at that time. If you are experiencing pain at that time, it is very possible that it is related. Even more so, if you experience this pain regularly, with each menstrual cycle, it is even more likely. ⚡Just because your pain is physiological in origin does not mean it is normal: do not hesitate to consult a doctor to find solutions for the pain you feel if it bothers you.

If your ovarian pain is permanent or occasional , but outside of the ovulation phase, it is likely a sign of a pathology. We can only recommend that you consult your doctor or gynecologist. He or she will suggest additional tests to understand the reasons for this pain.

Is it serious to have ovarian pain?

Yes and no: ovarian pain can be completely harmless, or it can be a sign of a more serious illness.

How do you know then? When should you worry?

On the one hand, ovarian pain related to the ovulation process is neither abnormal nor serious, but it can be invasive . If you experience ovarian pain around the time of ovulation, don't worry: there is a good chance that it is related to your ovulation. ⚡As said before, just because your pain is physiological in origin does not mean it is normal to suffer from it ****: do not hesitate to consult a doctor to find solutions to the pain you feel if it bothers you.

On the other hand, ovarian pain can be linked to different pathologies of varying severity . While ectopic pregnancy and ovarian cancer are serious conditions, an ovarian fibroid will cause disabling pain but can be easily treated with a minor surgical procedure. Try not to worry too much and make an appointment with your GP or gynecologist . Based on your medical situation, they will make a diagnosis and suggest associated tests.

How can I relieve this pain?

Once, and only once, you have ruled out pathological causes for your ovarian pain, you can consider relieving the associated pain. Solutions for relieving ovarian pain are similar to solutions for relieving painful periods .

Medical solutions

To relieve your ovulation pain, there are two medical solutions available to you:

• The first solution is to take pain medication , such as nonsteroidal anti-inflammatory drugs (NSAIDs) (ibuprofen, flurbiprofen, naproxen, etc.), analgesics (paracetamol) and antispasmodics (spasfon). However, health authorities consider the latter to be of low effectiveness.
• The second solution is to take hormonal contraception . Hormonal contraception smooths out hormone levels in the body, putting menstruating people into a false state of pregnancy. Smoothing out hormones in this way can help alleviate the effects of the menstrual cycle, including ovulation-related pain and symptoms of premenstrual syndrome (PMS).

Natural solutions

To relieve ovulation pain naturally, we will find, in the same way, the same existing solutions against period pain:

• Heat: Applying heat (hot water bottle, taking a bath) or massaging the painful area to generate heat are solutions that work well to reduce ovarian pain. Indeed, heat causes vasodilation of the blood vessels which helps to reduce pain signals. 🌈 In our store, find in particular a heating massage balm from the Jho brand to help you better manage your ovulation pain;
• Exercise: Exercising while in pain may seem surprising, but it works! Endorphin production helps reduce pain, while focusing your attention on something other than the pain. If you have the energy, give it a try!
• Electrostimulation: Stimulating your painful areas through electrostimulation is a natural solution that helps soothe pain. 🌈 In our store, we recommend the Bluetens device : thanks to electrostimulation, it interrupts the message between pain and the brain to provide instant relief. Its advantages? Its size allows you to take it everywhere with you and it also soothes painful period pain!
• Herbal medicine: Herbal medicine involves using plants to relieve pain or even to treat oneself. It involves using the knowledge accumulated about plants to use them. ⚡Herbal care is not trivial: if you are considering this solution, do not hesitate to talk to a doctor, especially if you are taking treatments or hormonal contraception.
• CBD: Cannabidiol is a molecule derived from a variety of hemp, cannabis sativa sativa. Without psychotropic effects (unlike THC), it is known to soothe pain, particularly various pains related to the menstrual cycle. It is worth taking it as a course of treatment, during several consecutive menstrual cycles, to feel its effects. 🌈 In our shop, discover the sublingual CBD oils from the Équilibre CBD brand , and in particular the 10mg oil, perfect for ovulation pain.
• Relaxation techniques: Sophrology, yoga, or pain management techniques can be used to relieve ovarian pain you experience around ovulation. By focusing on your breathing or your body, you can shift your focus and limit your pain.