Why do ovaries hurt

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Last updated: April 8, 2026

Quick Answer: Ovarian pain can result from various conditions, including ovarian cysts (which affect about 8% of premenopausal women), ovulation pain or mittelschmerz (occurring in roughly 20% of women), and endometriosis (affecting approximately 10% of reproductive-aged women). Other causes include pelvic inflammatory disease (PID), ovarian torsion (a medical emergency), and ectopic pregnancy. The pain may be sharp, dull, or crampy and often requires medical evaluation to determine the underlying cause.

Key Facts

Ovarian cysts affect about 8% of premenopausal women, with most being benign functional cysts.
Mittelschmerz (ovulation pain) occurs in approximately 20% of women during their reproductive years.
Endometriosis impacts roughly 10% of women of reproductive age, often causing ovarian pain.
Pelvic inflammatory disease (PID) is a common cause of ovarian pain, with over 1 million cases diagnosed annually in the U.S.
Ovarian torsion accounts for about 3% of gynecologic emergencies and requires prompt surgical intervention.

Overview

Ovarian pain, or pain in the ovaries, is a common gynecological concern that can arise from various physiological and pathological conditions. Historically, ovarian pain has been documented since ancient times, with Hippocrates (c. 460–370 BCE) describing pelvic pain in women, though modern understanding began to develop in the 19th century with advances in gynecology. In the early 20th century, the identification of conditions like ovarian cysts and endometriosis improved diagnosis. Today, ovarian pain affects millions of women globally, with studies indicating that up to 20% of women experience ovulation-related pain (mittelschmerz) at some point. The ovaries, located on either side of the uterus, are key reproductive organs that produce eggs and hormones like estrogen and progesterone. Pain can be acute or chronic, ranging from mild discomfort to severe, debilitating symptoms, often prompting medical evaluation to rule out serious conditions such as ovarian cancer, which accounts for about 1.3% of all new cancer cases in the U.S. annually.

How It Works

Ovarian pain mechanisms involve various physiological and pathological processes. During ovulation, the release of an egg from an ovarian follicle can cause mittelschmerz, characterized by mild to moderate pain due to follicular rupture and fluid or blood irritation of the peritoneal lining. Ovarian cysts, fluid-filled sacs that develop on the ovaries, can cause pain if they rupture, bleed, or become large, with functional cysts (like corpus luteum cysts) being common during the menstrual cycle. Endometriosis, where endometrial-like tissue grows outside the uterus, can lead to ovarian endometriomas (chocolate cysts), causing inflammation and pain, often exacerbated during menstruation. Pelvic inflammatory disease (PID), typically caused by sexually transmitted infections like chlamydia or gonorrhea, can spread to the ovaries, resulting in pain and potential scarring. Ovarian torsion, a twisting of the ovary on its ligament, cuts off blood supply, leading to severe pain and tissue necrosis if not treated within hours. Hormonal fluctuations, such as those in polycystic ovary syndrome (PCOS), can also contribute to ovarian discomfort through cyst formation and inflammation.

Why It Matters

Understanding ovarian pain is crucial for women's health, as it can signal benign conditions or serious medical issues requiring prompt intervention. Accurate diagnosis and treatment help prevent complications like infertility, chronic pain, or life-threatening emergencies such as ovarian torsion or ectopic pregnancy. For instance, untreated PID can lead to tubal scarring and increase infertility risks, affecting reproductive outcomes. Early detection of conditions like endometriosis or ovarian cysts can improve quality of life through pain management and fertility preservation. In the U.S., gynecological pain accounts for significant healthcare visits, with ovarian pain being a common reason for emergency department admissions. Raising awareness promotes timely medical care, reducing long-term health burdens and supporting overall well-being for millions of women worldwide.