Introduction
There are a variety of causes that can cause pain in the ovaries. Often, these symptoms can occur in connection with menstruation, but also serious causes such as inflammation, tissue growths or tumors can cause pain.
Causes of ovarian pain
There are a variety of causes that can lead to discomfort or pain in the ovaries, including
- Cycle-related complaints
- Inflammation of the ovaries
- Pregnancy
- Tissue growths
- Shaft rotation
- Cancer
- Ovarian thrombosis
- Psychosomatic complaints
During a woman’s monthly cycle, hormonal influences cause an egg and its surrounding follicle (envelope) to mature. When ovulation occurs in the middle of the cycle, some women experience what is known as mid-cycle pain, which is caused by the bursting of the mature follicle. They typically occur on one side of the currently active ovary.
Even during menstruation, some women experience pain in the area of the ovaries caused by the contractions of the uterus. Pain at ovulationDuring pregnancy, many women experience occasional pulling in the ovaries. This can be caused by the baby’s pressure on the pelvic organs.
However, a stronger pain in an ovary can also be caused by a so-called ectopic pregnancy. In this case, the fertilised egg nests in the fallopian tube instead of in the uterus. This is dangerous and must be repaired, as the fallopian tube can tear as soon as the embryo has become too large.
The ovaries can also become inflamed. This is called pelvic inflammatory disease. This is caused by pathogens that have penetrated through the vagina via the uterus and fallopian tubes into the ovaries.
The pelvic inflammatory disease can lead to severe pain, which can also be very acute. Adnexitis is an inflammation of the appendages, i.e. an inflammation of the fallopian tubes (tuba uterina) and ovaries (ovary). Such an inflammation can occur on one or both sides and is then associated with severe pain in the lower abdomen.
If this acute inflammation does not heal properly or is not treated correctly, chronic pelvic inflammation can develop. This is accompanied by recurring back pain and pain in the lower abdomen, especially during menstruation or sexual intercourse. Chlamydia is usually the cause of this chronic inflammation.
In most cases, patients complain of acute onset of lower abdominal pain, which usually occurs on the sides. These pains often occur after menstrual bleeding. However, abdominal pain also occurs during ovulation.
In some cases, chlamydia-induced pelvic inflammatory disease (perihepatitis) can accompany inflammation of the liver. In such cases, patients also experience pain in the right upper abdomen. In this case, the liver enzymes are elevated.
The therapy is usually antibiotic and can be carried out on an outpatient basis. Only if major complications occur, such as peritonitis, sepsis or abscess formation, does the pelvic inflammatory disease require surgical treatment. After an inflammation of the ovary, adhesions can occur.
These can also lead to chronic lower abdominal pain, which occurs mainly during sexual intercourse. The therapy is very difficult in this case, as only surgery can help. However, the operation itself can cause new adhesions.
Such a stem rotation often occurs in the context of a cyst. It can be benign and hormone-induced, as well as of tumorous origin. The cysts are usually filled with fluid and can be several centimeters in size.
Due to a fast and unfavorable movement, such a cyst can rotate at its suspension, thus cutting off the blood supply to the ovary. Such a stem rotation leads to acute, severe pain on the affected side. The only possible therapy is then the surgical restoration of the original anatomy and the possible removal of the cyst.
The danger of such a rotation of the stem is the loss of function of the ovary and the resulting infertility on the affected side. The tissue of the ovaries can also change and thus cause pain. One example is endometriosis.
In this case, scattered uterine lining is found in other organs, often in the ovaries.Nevertheless, this mucous membrane is subject to the changes caused by the cycle and thus sometimes causes severe, cramp-like complaints. Benign changes, such as cysts, can also cause ovarian pain above a certain size. Cysts are usually filled with fluid or blood and in most cases disappear on their own.
Sometimes, however, they have to be removed surgically. In an advanced stage, ovarian cancer can also cause pain through the infiltration of nerves. In the early stages, however, it usually causes no symptoms.
Therefore, ovarian pain is not primarily associated with ovarian cancer, although this diagnosis should of course be clarified by a doctor after other causes have been excluded. If the supplying vein of the ovary is completely or incompletely closed by a blood clot (thrombus), this is called ovarian vein thrombosis. This causes an acute blood deficiency, which is accompanied by severe, sudden, colicky pain.
The pain is limited to the affected side and often occurs on the right side. In some cases, high fever can be associated with this clinical picture. If the disease takes a septic course, there is a danger to life.
In most cases, this disease occurs 2 to 6 days after birth and can then be diagnosed by means of computer tomography (CT) and appropriate laboratory tests. The treatment consists of intravenous anticoagulation, for example with heparin, and antibiotic therapy. Chronic pain is a common complaint of psychosomatic clinical pictures.
The term “psychosomatic” in no way means that the pain is not real. Rather, it means that psychological conflicts manifest themselves in physical symptoms, such as pain. Ovarian pain, which is perceived as pain in the lower abdomen, can also be of a psychosomatic nature.
However, this is a diagnosis of exclusion. First of all, all physical causes, such as inflammation, cysts and tumors, are diagnostically clarified. In most cases, psychosomatic clinical pictures are only found and treated after such somatic clarification. This can be a lengthy process, usually lasting several years, which often takes a lot of effort on the part of those affected. A psychosomatically caused pain requires specialized psychological or psychotherapeutic therapy and cannot be treated with conventional painkillers.
