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Ovarian Pain: Possible Causes, Diagnosis, and Treatments

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Ovarian Tumors

Tumors can form in the ovaries, just as they form in other parts of the body. They can be either noncancerous (benign) or cancerous (malignant).

Other symptoms of ovarian tumors

  • Bloating or pressure in the abdomen
  • Urgent need to urinate
  • Indigestion
  • Diarrhea or constipation
  • Loss of appetite
  • Unintentional weight loss or gain

How ovarian tumors are diagnosed

  • Computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET). These are detailed imaging scans that the doctor can use to find ovarian tumors. They allow the doctor to determine whether and how far the ovarian tumors have spread.
  • CA-125. This is a blood test to look for a protein that tends to be higher in some (but not all) women with ovarian cancer. CA-125 isn't effective as a screening test for ovarian cancer. But it can be checked in women with symptoms that might be caused by ovarian cancer.

Treatment of ovarian tumors

  • Laparotomy. This is surgery performed through an incision into the abdomen. The surgeon will remove as much of the tumor as possible. The removal of tumor tissue is called debulking. If the tumor is cancerous and has spread, the surgeon may also remove the ovaries, uterus, fallopian tubes, omentum (fatty tissue covering the intestines), and nearby lymph nodes.
  • Chemotherapy. Chemotherapy involves drugs given through a vein (IV), by mouth, or directly into the abdomen. The drugs kill cancer cells. Because they kill normal cells as well, chemotherapy medications can have side effects. These can include nausea and vomiting, hair loss, kidney damage, and increased risk of infection. These side effects should go away after the treatment is stopped.
  • Radiation. This treatment uses high-energy X-rays to kill or shrink cancer cells. Radiation is either delivered from outside the body, or placed inside the body near the site of the tumor. This treatment also can cause side effects. These can include inflamed skin, nausea, diarrhea, and fatigue. Radiation is not often used to treat ovarian cancer.

Ovarian Pain Caused by Endometriosis

Every month, the lining of the uterus builds up in preparation to nourish a growing fetus. When an egg is not fertilized, that lining sheds and is released from the body via menstruation. In some women, tissue like the lining of the uterus develops elsewhere in the body. This tissue swells and bleeds each month. It has nowhere to shed, though, and so it forms scar tissue and can be very painful.

Other symptoms of endometriosis

  • Painful periods
  • Pain during intercourse
  • Heavy menstrual periods
  • Infertility

How endometriosis is diagnosed

  • Ultrasound and MRI. These scans create images of the ovaries to help the doctor spot endometriosis.
  • Laparoscopy. This procedure uses a thin lighted scope inserted into a tiny hole in the abdomen to allow the doctor to visualize the ovaries. The doctor may possibly remove a small sample of tissue for biopsy.

Treatment of endometriosis

  • Pain medications. Drugs such as ibuprofen (Advil, Motrin) can help relieve some of the discomfort of endometriosis.
  • Birth control pills. The pill prevents the monthly buildup of uterine tissue on the ovaries. This makes periods lighter and reduces the symptoms of endometriosis.
  • Gonadotropin-releasing hormone agonists (GnRH agonists). These drugs reduce the amount of the hormone estrogen in the body. By slowing the growth of endometriosis, they limit its symptoms.
  • Laparoscopy and laparotomy. These are surgical procedures that let the doctor remove endometriosis on the ovaries and other places. If the endometriosis is extensive, the doctor may recommend a hysterectomy. This procedure removes the uterus and sometimes also the ovaries and fallopian tubes.
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