Why Do My Ovaries Hurt?

Dear Doctor,

I’m 32 and for the past few months, I’ve been getting these sharp pains near my lower abdomen, mostly on the right side. It usually flares up around the middle of my menstrual cycle, but sometimes right before my period, too. At first, I thought it was just cramps, but it feels deeper, almost like it’s coming from my ovaries. I’m worried it might be something serious. Why do my ovaries hurt? Should I be concerned?

— Feeling the Pinch in Philly

Hello, Feeling the Pinch in Philly,

I’m sorry to hear about the pain you’re experiencing. However, you may be surprised to find that ovary pain is a common complaint, but it can have very different causes depending on when and how it shows up. Let’s break it down.

Firstly, since you notice it mid-cycle, it could be mittelschmerz, a German term meaning “middle pain.” That’s when the ovary releases an egg during ovulation, which can cause a brief, sharp twinge on one side. It’s harmless, but some women feel it every month, while others never notice at all.

But if the pain is intense or chronic (AKA, ongoing), there may be a few other possibilities. It could be a symptom of an ovarian cyst, a fluid-filled sac that forms on an ovary. These growths can cause discomfort as they grow or rupture. Most cysts are benign and go away on their own, but some, like endometriomas (cysts caused by endometriosis), can cause chronic pain and even impact fertility.

Then there’s the possibility of pelvic inflammatory disease (PID), often linked to infections like chlamydia or gonorrhea. PID can cause dull, aching pain in the ovaries and, if left untreated, can lead to scarring and fertility issues.

If you’re feeling intense or recurrent right ovary pain, that could be a sign of a rare condition called ovarian torsion. In this condition, the ovary twists around its own blood supply, causing severe pain, nausea and vomiting. If left untreated, it can permanently damage ovarian tissue, so we always recommend emergency surgery.

Less common underlying reasons could include appendicitis, kidney stones, or even constipation, which can mimic ovarian pain. That’s why pinpointing the exact cause usually requires a pelvic exam, ultrasound, or blood work.

One last thing to mention is pelvic floor health. Tension or dysfunction in the pelvic floor muscles can cause sensations that feel like ovarian pain but aren’t directly tied to the reproductive organs. This is especially common in women who sit a lot, have had children, or have experienced pelvic surgeries.

Here’s what I’d recommend:

• Start tracking when the pain occurs; is it mid-cycle, during sex, or around your period?
• Note any other symptoms like bloating, irregular periods, or changes in bathroom habits.
• And definitely schedule a visit with your Genesis provider.

Ovary pain can be benign, but if it’s persistent, intense, or affecting your daily life, it deserves attention. Better to check now than wonder later.

Warmly,

Dr. Anna Nelson-Moseke

OB/GYN, Genesis Women’s Health

Best,
Anna Nelson-Moseke, MD, FACOG, is a board-certified OB/GYN practicing at Pueblo in Tucson, AZ.