This is an overview of 10 common ovarian problems. But, let’s start with a definition.
What are the Ovaries?
The ovaries are a pair of small, oval-shaped organs located in the lower abdomen (pelvis) on either side of the uterus.
Part of the female reproductive system, their two primary functions are to store and release eggs (ovulation) and to produce vital reproductive hormones, including estrogen and progesterone.
What it is: Sacs filled with fluid or semi-solid material that form on or inside an ovary during a normal menstrual cycle, typically when a follicle fails to rupture or release its egg.
Common signs: Most cause no symptoms and disappear on their own, but they can cause a dull ache or a feeling of fullness on one side of the lower abdomen.
When to Worry:
Sudden, sharp, or severe pelvic pain (which may indicate a ruptured cyst)
Pain accompanied by fever, dizziness, faintness, or vomiting
When to See a Doctor:
Routinely for minor, persistent discomfort to monitor the cyst; immediately if severe pain develops.
What it is: A medical emergency where an ovary (and often part of the fallopian tube) becomes twisted around its supportive tissues, cutting off its blood supply. It is frequently associated with an existing cyst.
Common signs: Sudden, intense, and sharp pain on one side of the lower abdomen, which frequently spreads to the back or groin.
When to Worry:
Sudden onset of severe, unremitting pelvic pain
Severe pain accompanied by nausea, vomiting, or a low-grade fever
When to See a Doctor:
Immediately. Go to the nearest A&E (or Emergency Room, ER). Emergency surgery is required within a critical window to restore blood flow and save the ovary.
What it is: A common hormonal disorder causing the ovaries to enlarge and develop numerous small, harmless fluid-filled sacs (immature follicles) that do not release eggs regularly.
Common signs: Irregular or completely absent menstrual periods, unexplained weight gain, acne, excess facial or body hair (hirsutism), and difficulty conceiving.
When to Worry:
Highly irregular or long gaps between periods (which can affect the lining of the womb long-term)
Trouble getting pregnant after 12 months of regular unprotected intercourse
When to See a Doctor:
Routinely. To establish a formal diagnosis via blood tests or an ultrasound, and to discuss tailored lifestyle and medical management.
What it is: A type of ovarian cyst caused by endometriosis, where tissue similar to the lining of the womb grows outside the uterus and attaches to the ovary, forming a sac filled with dark, old blood.
Common signs: Chronic pelvic pain, deep pain during or after sexual intercourse, and exceptionally heavy, painful menstrual periods.
When to Worry:
Menstrual pain that is severe enough to cause you to miss work, school, or daily activities
Persistent pain that continues to worsen over several cycles
When to See a Doctor:
Soon. A specialist referral to a Consultant in Obstetrics and Gynaecology (O&G) is recommended to manage the underlying endometriosis and protect long-term fertility.
What it is: An exaggerated medical response to excess hormones, most commonly occurring as a complication for women undergoing fertility treatments like In Vitro Fertilisation (IVF).
Common signs: Mild to moderate abdominal bloating, a feeling of abdominal tightness, nausea, and mild discomfort.
When to Worry:
Rapid weight gain (more than 1kg in 24 hours) or a significantly increased abdominal girth
Severe abdominal pain, persistent vomiting, or shortness of breath
A noticeable decrease in urination frequency
When to See a Doctor:
Urgently. Contact your fertility clinic or emergency services immediately if you show signs of moderate to severe OHSS, as it requires close monitoring and fluid management.
What it is: A condition, sometimes referred to as premature menopause, where the ovaries stop functioning normally and egg depletion occurs before the age of 40.
Common signs: Irregular or stopped periods, hot flushes, night sweats, vaginal dryness, irritability, and difficulties with concentration.
When to Worry:
Missing periods for three or more months in a row before the age of 40
Experiencing bothersome menopausal-like symptoms at a young age
When to See a Doctor:
Soon. Early diagnosis via blood hormone levels is crucial to start Hormone Replacement Therapy (HRT) to protect bone, cardiovascular, and metabolic health.
What it is: A benign (non-cancerous) germ cell tumor on the ovary that can contain a mix of different tissue types, such as hair, skin, teeth, or fat, because it develops from embryonic cells.
Common signs: Often entirely asymptomatic, but if they grow large, they can cause a dull, heavy ache in the pelvis or visible abdominal swelling.
When to Worry:
A persistent, localised feeling of pressure or a heavy ache on one side of the lower abdomen
Sudden, severe pain, as larger dermoid cysts carry a higher risk of causing ovarian torsion
When to See a Doctor:
Soon. While typically benign, large dermoid cysts are usually surgically removed to prevent rupture or twisting.
What it is: An infection of the female reproductive organs, often originating from an untreated STI, that can progress to form a pocket of pus (an abscess) involving the ovary and fallopian tube.
Common signs: Persistent lower abdominal pain, abnormal or foul-smelling vaginal discharge, pain during sex, and erratic bleeding between periods.
When to Worry:
Deep pelvic pain accompanied by a high fever, chills, or shaking
Feeling generally unwell, nauseous, or experiencing severe pain that makes it difficult to stand straight
When to See a Doctor:
Promptly. Intravenous or oral antibiotics are required immediately; a confirmed tubo-ovarian abscess may necessitate hospital admission and drainage.
What it is: Non-cancerous epithelial growths that develop from the cells on the outer surface of the ovary. They can be filled with a watery fluid or a thick, mucous material and can grow very large.
Common signs: Abdominal bloating, pelvic pressure, a frequent urge to urinate (due to pressure on the bladder), or feeling full quickly when eating.
When to Worry:
Increasing, unexplained abdominal distension or a visible increase in belly size
Ongoing, unexplained changes in bowel or bladder habits
When to See a Doctor:
Soon. An ultrasound or MRI scan is needed to evaluate the growth and differentiate it from malignant conditions.
What it is: A malignant growth of abnormal cells that originates within the ovaries, fallopian tubes, or the surrounding peritoneal tissue, primarily affecting postmenopausal women but possible at any age.
Common signs: Often subtle in the early stages, presenting as persistent abdominal bloating, feeling full quickly, pelvic or abdominal pain, and an urgent or frequent need to urinate.
When to Worry:
The key symptoms (bloating, pain, early satiety, urinary changes) are new, frequent (e.g., happening more than 12 times a month), and do not go away
Unexplained weight loss, extreme fatigue, or a persistent change in bowel habits
When to See a Doctor:
Soon. Any persistent, progressive abdominal symptoms should be evaluated promptly. A simple blood test (CA125) and a pelvic ultrasound are standard first-line investigations to rule out malignancy.
Subtle, persistent abdominal symptoms like bloating, early fullness, or pelvic pain should never be ignored if they are new and continuous.
Sudden, severe lower abdominal pain is a medical emergency that warrants immediate emergency assessment.
The vast majority of ovarian cysts and masses are entirely benign, but early investigation protects your health and options.
Ovarian issues can present with vague abdominal symptoms—never hesitate to see a doctor to investigate persistent changes.
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