Pain in the ovaries
Pain in the ovaries can project into the right or left abdomen in women and can have various causes. Especially during pregnancy, pain in the ovaries occurs. You can read more about this topic under Pain in the ovaries during pregnancy.
The most common is a pulling in the lower abdomen during physiological ovulation. Some women can really feel the ovulation when the mature egg cell bursts from the ovary and pain occurs. Ovulation takes place approximately halfway through the cycle, 14 days after the start of the last menstrual period, and is therefore between periods (menstruation).
At the time of bleeding, many women experience pain in the abdomen, which is often crampy and is caused by the contractions of the uterus. Although these are unpleasant, they are not serious. Relief is provided by warmth, tightened legs to relax the abdominal wall and spasmolytics such as drugs with the active ingredient “butylscopolamine” (Buscopan).
Also at the time of menstruation, pain can occur in the context of endometriosis, a condition in which bleeding occurs in the body because the lining of the uterus (endometrium) has developed in the wrong places in the body or has reached the wrong place. Possible places are, for example, the ovaries, but also the bladder or intestines. This dislocated endometrium is subject to the normal cycle, builds up and grows and is also rejected again.
During a normal pregnancy, abdominal pain may occasionally occur, which is usually explained by the baby’s pressure on the organs. Rarely, a pregnancy in the fallopian tube is also possible, which is a so-called ectopic pregnancy in the fallopian tube instead of in the uterus. In addition, a so-called extrauterine pregnancy (pregnancy outside the uterus) can occur in the ovary itself.
In this case, fertilisation and implantation of the egg in a different place than in the uterus has occurred. This can be detected in ultrasound and by determining pregnancy hormones as in a pregnancy test. An extrauterine pregnancy is not sustainable and can be very dangerous, as major bleeding is possible.
Cysts in the ovary are relatively common.They can also cause pain, but often burst by themselves and usually do not require treatment. Ovarian inflammation (pelvic inflammatory disease) can be caused by the ascension of pathogens, mostly bacteria. In this process, often due to improper hygiene, bacteria from the intestine pass through the vagina into the uterus and from there can reach the fallopian tubes and ovaries, but also the abdominal cavity in general, since there is an open connection from the fallopian tube to the abdominal cavity.
An infection of the reproductive organs can manifest itself through a burning sensation and a (purulent) discharge. Pain can also occur during sexual intercourse and also during bladder and bowel emptying. Fever and vomiting may occur and in the worst case, the structures may become sticky.
This can result in infertility, as the fallopian tubes can no longer transport the cracked egg once a bond has formed. Ovarian inflammation is usually treated with antibiotics. If a board-hard abdomen and severe pain occur, immediate admission to a clinic is necessary.
A board-hard abdomen can indicate the rupture of an inflamed structure (ovary/fallopian tube/appendicitis) and makes peritoneal involvement likely. Immediate clarification should also be given in cases of severe pain that suddenly becomes completely painless, as this description is typical of the bursting of the inflamed structure (perforation). An absolutely acute onset of unilateral pain can be caused by a stem rotation of the ovary.
Typically, this occurs during sports/exercise. The ovary rotates around its suspension and squeezes the supplying vessels. This is an emergency, which should quickly lead to an operation, since without blood supply there is a risk of the organ dying and losing its function.
An important differential diagnosis for right-sided lower abdominal pain is appendicitis (correct appendicitis). Ovarian cancer (ovarian carcinoma) almost never manifests itself through pain in the lower abdomen, and is usually conspicuous by other symptoms. Possible pain due to a tumor only develops at a very late stage through displacement symptoms.
A pulling or pushing of the ovaries is quite unspecific. It is therefore not possible to say exactly what the cause of the abdominal pain is. However, there are various possibilities, which will be explained in more detail below.
First of all, pulling the ovaries may indicate a tumor. However, inflammation of the ovaries can just as easily cause severe pain in the abdomen. There is also the theory of so-called Mittelschmerz.
Some women experience a pulling or pricking of the ovaries close to the time of ovulation, which occurs monthly. However, it has not been proven whether this pulling is actually a sign of the activity of the ovaries or whether there are other causes for this so-called “Mittelschmerz”. Mittelschmerz can vary from month to month and, according to the patients’ statements, also changes sides.
The mature follicle is believed to cause this stabbing pain when it bursts open during ovulation. However, no more precise statements can be made. The middle pain is therefore not a sure indication of ovulation and should therefore not be used as a tool for family planning.
It cannot be treated. Affected women can, however, alleviate their symptoms with a relieving posture or a hot water bottle. However, if the pain is very severe and long-lasting, a doctor should always be consulted in order to rule out other pathological causes for the pain.