A woman’s ovaries are an important part of her reproductive system. The ovaries produce hormones, including estrogen, which triggers the menstrual cycle. There are many conditions that can be the causes of ovarian pain which is usually felt in the pelvis or lower abdomen, under the belly button. A woman can have either acute or chronic pelvic pain depending on the cause and in either case gynecological visits are necessary for proper diagnosis and treatment.
An ovarian cyst is a fluid-filled sac that forms on the ovaries. Signs of ovarian cysts include irregular periods, pain during intercourse or bowel movements, nausea or vomiting, bloating and the feeling of being full after eating a small amount. Although ovarian cysts can be painful, they are very common in women during their child-bearing years. A cyst can form during ovulation, can happen when the egg is not released, or when the follicle holding the egg does not dissolve after the egg is released.
Ovarian cysts can be diagnosed through a pelvic exam or by performing an ultrasound. During the pelvic exam a doctor will press firmly around the pelvic area feeling for any type of lumps. Usually, if a lump is found an ultrasound may be done for further evaluation.
Small cysts are usually just observed and not treated medically. However, the gynecologist will monitor the cyst for change in size and location. A large cyst that does not respond to conservative medical treatment may have to be evaluated through laparoscopy. During the procedure, small incisions are made and a tiny camera is inserted into the abdomen through a plastic tube. The doctor then can remove the cyst using a tool at the end of the plastic tube. If there is a larger cyst is present, a larger incision will be made in the abdomen with a procedure is called laparotomy.
During a normal menstrual cycle, the lining of the uterus prepares itself to nourish a fetus. When an egg is not fertilized, the lining is shed via menstruation. When the lining has no place to shed, it forms scar tissue that is very painful. This is endometriosis. Sometimes the ovaries may be involved in scar formation. Symptoms of endometriosis include painful periods, pain during intercourse, heavy menstrual cycles and infertility.
Endometriosis can be diagnosed by using ultrasound or laparoscopy. Mild to moderate cases of pelvic pain may be treated with pain medications and hormones. For severe cases of endometriosis a gonadotropin-releasing hormone agonist is given. This drug reduces the amount of estrogen produced in the body, which helps slow the growth of endometriosis. Laparoscopy and laparotomy to remove the scar tissues are used for treatment of extensive scarring. If severe a hysterectomy or surgical removal of the uterus is also done.
Pelvic Inflammatory Disease
Pelvic Inflammatory Disease or PID is an infection involving the ovaries, uterus and/or fallopian tubes. In most cases, this condition is caused by a sexually transmitted disease, and in others, a yeast infection. Symptoms of PID include pelvic pain, pain during intercourse, fever, vaginal discharge, irregular menstrual bleeding, diarrhea, vomiting and difficulty urinating.
PID can be diagnosed through a pelvic exam, ultrasound and laparoscopy. A blood or urine test can confirm and identify the type of infection. A culture can also be done on any discharge found during a pelvic exam.
The treatment of PID includes antibiotics which may be given by mouth or through injection. If a patient is being treated for PID, their sexual partner must be treated as well.
Ovarian tumors may be benign or malignant solid masses that can cause pelvic pains, a dull feeling or pressure in the lower abdomen, bloating, weight loss or gain, urgency to urinate, diarrhea, constipation or indigestion. Tumors in the ovaries may be felt during a pelvic exam and may be further evaluated using imaging techniques such as CT scan, MRI and PET scan. A biopsy will confirm if a tumor is malignant or benign.
Surgical removal of an ovarian tumor by laparotomy may be done, and if the cancer has spread to the uterus, fallopian tubes, omentum (fatty tissue covering the intestines), and nearby lymph nodes, these structures may be removed as well. Depending on the stage of a malignant tumor radiation therapy and chemotherapy may be added to the treatment of this type of ovarian pain.
Female reproductive health and diseases need special attention. Acute or chronic pelvic pain may reflect an abnormal condition of the ovaries for which early diagnosis and treatment may be given to prevent complications through regular gynecological visits.
Mayo Clinic: Causes of Ovarian Pain – www.mayoclinic.com/health/chronic-pelvic-pain/DS00571/DSECTION=causes
Medicine Net: Ovarian Cysts – www.medicinenet.com/ovarian_cysts/article.htm