Ovary Pain During Pregnancy: Causes, Treatment And Management

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Ovary pain during pregnancy can be due to several underlying conditions and often manifest as pelvic or abdominal pain. It is common during the early stages of pregnancy, especially in the first trimester (1). Irrespective of the symptoms and the trimester, consult your healthcare provider if you experience severe abdominal pain, specifically in the pelvic region, to rule out underlying morbidities.

This post will guide you through the causes, symptoms, diagnosis, and treatment of ovary pains during pregnancy.

Is Ovary Pain A Sign Of Implantation?

Ovarian pain can be a sign of implantation if it arises from ovarian cysts, which are common during pregnancy and help sustain it (2). However, ovarian pain can also indicate an ectopic pregnancy, where the egg implants outside the uterus, such as in the fallopian tubes or ovary (3) . Hence, any abdominal pain during pregnancy should be made known to the healthcare provider.

What Are The Causes Of Ovarian Pain?

Although ovarian pain is common in pregnancy, its causes can vary and, sometimes, lead to other health conditions. The causes of ovarian pain include

  1. Stretching of round ligament: During the second trimester of pregnancy, as the uterus begins to grow, the round ligaments around it stretch, causing cramping in the lower abdomen. The intensity of round ligament pain may range from acute to mild pain (4).
  1. Accommodation changes: As the pregnancy progresses, you may experience pain in the pelvic region or ovaries as your body stretches or loosens the pelvic bones to accommodate the growing uterus and prepare for childbirth (5).
  1. Ectopic pregnancy: In this type of pregnancy, implantation occurs outside the uterus, mostly in the fallopian tube. Since the fallopian tubes are not meant to hold an egg, complications arise, such as pain on either side of the uterus.

You may experience symptoms such as bleeding as the pregnancy progresses and should consult your healthcare provider (6).

  1. Miscarriage: Miscarriage or spontaneous abortion is the loss of pregnancy due to abnormalities of the chromosomes, thyroid disorder, high sugar levels, etc., and can cause pelvic or ovarian pain.

Eight out of ten miscarriages occur in the first three months of pregnancy and are present with bleeding, lower back pain, lower abdominal pain, and cramps (6).

  1. Ovarian rupture and torsion: This is among the most common causes of ovarian pain. Growing functional ovarian cysts can sometimes rupture, causing pain and bleeding in the ovaries. The weight of the ovarian cysts can also cause the ovaries to twist on the tissues surrounding it or the fallopian tubes, causing severe pelvic pain (6).
  1. Appendicitis: Appendicitis during pregnancy may cause the implanted uterus to displace the infected appendix into the abdomen. It requires prompt treatment and surgery if suggested (7).
  1. Gallbladder problems: Gallbladder problems during pregnancy are common because of the increased hormone levels that may slow down or stop bile flow from the gallbladder, causing the bile to harden and resulting in gallbladder stones. Clinical manifestations may include itchiness, vomiting, jaundice, and severe pain in the abdomen (8).
  1. Urinary tract infection (UTI): Pregnancy makes women more prone to UTIs since the increasing size and weight of the uterus, which is directly above the bladder, can block the flow of urine from the bladder.

Common symptoms include a burning sensation while peeing, pain in the bladder or lower abdomen, and blood in the urine (9).

  1. Fibroids: These are benign tumors found in the uterine cavity or the organs surrounding the uterus. They cause severe lower abdominal pain, which could indicate enlargement of the fibroids and cause complications such as miscarriage, premature birth, and problems in implantation (10).
  1. Kidney stones: The tendency to urinate frequently in pregnancy could make you drink less water. However, the lack of fluids in the body may cause kidney stones. Common symptoms include blood in the urine, vomiting, and dizziness (11).
  1. Placental abruption: This refers to the detachment of the placenta from the uterus before delivery. Placental abruption can be fatal and causes acute stomach pain and hardening of the stomach for long durations (4).
  1. Preeclampsia: It is a pregnancy condition characterized by high blood pressure and protein in the urine, causing vomiting, nausea, and abdominal pressure (4).

How Is Ovarian Pain Diagnosed?

The diagnosis for ovarian pain largely depends on the symptoms and causes and is made using the following diagnostic tools (12) (13):

  1. Lab and blood tests: Vaginal swabs for bacterial culture and blood tests for white blood cell count may be carried out to detect any signs of the infection causing ovarian pain.
  1. Imaging: The most common imaging modalities are MRI and CT scans, which help visualize the cross-sectional area of the abdominal and pelvic region. Your healthcare provider may also suggest an ultrasound, depending on the symptoms.
  1. Pelvic laparoscopy: It may be performed for better visualization. A small cut is made in the abdomen and a tube fitted with a camera is inserted for either tissue extraction or surgery, depending on the type and cause of pain.
  1. Differential diagnosis: For most of the above-mentioned causes of ovarian pain, an MRI and a CT scan are the first diagnostic tools utilized. However, there are some exceptions.
  • For UTI and kidney stone-related pain, urine analysis is carried out to test for UTI-causing bacteria.
  • For pain caused by an ectopic pregnancy, ovarian cyst rupture, or torsion, a pelvic examination, such as transvaginal ultrasound, often accompanies the MRI and CT scan.

When Should You Seek Help?

Ovarian pain can be a complication if accompanied by severe or persistent symptoms. Hence, contact your healthcare provider if any of the following symptoms arise (4):

  • Vomiting or nausea
  • Vaginal discharge, bleeding, or spotting
  • Fever with chills
  • Persistent pains for long durations
  • Dizziness
  • Pain accompanied by breathing difficulty

Can Ovarian Pain Be Managed At Home?

You could try these home remedies for ovary pain if your healthcare provider rules out any complications (6):

  • Simple stretching exercises
  • Prenatal yoga and meditation
  • Sufficient water intake
  • Ample rest to regain strength and ease fatigue
  • Sitting with your knees close to the chest to minimize pressure
  • Shifting positions often

What Are The Treatments For Ovarian Pain?

The treatments for ovarian pain may depend on the cause and symptoms of the pain.

  • Medication: The medication prescribed would primarily depend on the cause and severity of the pain. Your doctor may prescribe certain pain relief medications for conditions, such as kidney stone, gallbladder stone, and appendicitis (7) (8) (11). In the case of ovarian cysts, birth control pills are commonly suggested. For ectopic pregnancy, methotrexate is injected into the body (3).
    Note: You can take medications only after consultation with your healthcare provider.
  • Surgery: Ovarian pain due to ectopic pregnancy requires immediate surgery. In case of ovarian torsion, laparoscopic surgery or laparotomy may be performed. Uteroscopy may be carried out for kidney stones that do not dissolve naturally or with medication (6) (11).

Ovarian pain during early pregnancy is your body’s way of adjusting to the pregnancy changes. While it is a common occurrence, it may also indicate severe underlying health conditions. Therefore, you should be aware of the symptoms and causes to seek the right treatment at the right time.

Key Pointers

  • Ovarian pain can indicate implantation if it arises from ovarian cysts that are common during early pregnancy.
  • However, ovarian pain can also occur due to ectopic pregnancy, stretching of the round ligament, UTIs, gallbladder problems, or placental abruption.
  • Medical intervention is necessary if ovarian pain is accompanied by additional symptoms, such as fever with chills, spotting/bleeding, and vomiting/nausea.
  • Cultures, blood tests, pelvic laparoscopy, MRI, and CT scans are some diagnostic tools the doctor may use to determine ovarian pain’s cause.
  • If the doctor rules out any complications, prenatal yoga, optimal water intake, ample rest, and frequent position change could help manage pain at home.

References:

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
  1. Pregnancy Cramps.
    https://americanpregnancy.org/healthy-pregnancy/pregnancy-concerns/cramping-during-pregnancy/
  2. Ovarian cysts.
    https://www.womenshealth.gov/a-z-topics/ovarian-cysts
  3. Ectopic Pregnancy.
    https://my.clevelandclinic.org/health/diseases/9687-ectopic-pregnancy
  4. Stomach Pain in Pregnancy.
    https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/abdominal-pain-during-pregnancy/
  5. Pregnancy: Pelvic and Hip Pain.
    https://www.lancastergeneralhealth.org/healthwise-library/healthwise-article?documentId=tn9115
  6. Uterus Pain: Learn About The Causes and Treatment In Early Pregnancy.
    https://www.medanta.org/patient-education-blog/what-causes-uterus-pain-in-early-pregnancy/
  7. Gad Aptilon Duque and Stephen Mohney; (2021); Appendicitis in Pregnancy.
    https://www.ncbi.nlm.nih.gov/books/NBK551642/
  8. Abdominal Pain in Pregnancy Gallstones.
    https://www.mountnittany.org/wellness-article/abdominal-pain-in-pregnancy-gallstones
  9. Urinary Tract Infection During Pregnancy.
    https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/urinary-tract-infections-during-pregnancy/
  10. Fibroids and Fertility.
    https://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/fibroids-and-fertility/
  11. Pregnancy and Kidney Stones.
    https://www.urologyhealth.org/healthy-living/urologyhealth-extra/magazine-archives/summer-2019/did-you-know-pregnancy-and-kidney-stones
  12. Sarah L. Cartwright and Mark P. Knudson; (2008); Evaluation of Acute Abdominal Pain in Adults.
    https://www.aafp.org/afp/2008/0401/p971.html
  13. Pelvic Pain.
    https://my.clevelandclinic.org/health/symptoms/12106-pelvic-pain
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Aneesha Amonz

Aneesha holds a Bachelor's degree in Biotechnology from USTM, Meghalaya and Master’s degree in Applied Microbiology from VIT, Vellore. She has worked on different research projects in the field of Food Sciences. In addition, she has an internship experience in Oil India Limited as an R&D project trainee. As a writer at MomJunction, Aneesha ensures her content is engaging and... more