10 Warning Signs and Symptoms of Ovarian Cancer You Should Never Ignore

Ovarian cancer is often called the “silent killer” because its symptoms can be subtle and easily mistaken for other common conditions. However, recognizing the early warning signs can be crucial for timely diagnosis and better outcomes. This comprehensive guide explores the most important symptoms of ovarian cancer that every woman should be aware of.

Ovarian cancer occurs when abnormal cells in the ovaries begin to multiply uncontrollably, forming a tumor. While it can affect women of any age, it’s most commonly diagnosed in women over 50. Understanding the symptoms can help you seek medical attention promptly if you experience any concerning changes in your body.

1. Abdominal Bloating and Swelling

One of the most common and persistent symptoms of ovarian cancer is abdominal bloating that doesn’t go away. Unlike normal bloating that comes and goes with your menstrual cycle or after certain meals, ovarian cancer-related bloating tends to be constant and progressive.

Women often describe feeling unusually full or swollen in the abdomen, even when they haven’t eaten much. The abdomen may appear visibly distended or larger than usual. This occurs because the tumor can cause fluid accumulation in the abdominal cavity, a condition called ascites, or because the tumor itself is growing and taking up space.

Key characteristics:

• Persistent bloating lasting more than three weeks
• Bloating that occurs almost daily
• Abdominal swelling that progressively worsens
• Feeling of fullness or tightness in the belly

2. Pelvic or Abdominal Pain

Persistent pain or discomfort in the pelvic area or lower abdomen is another significant warning sign of ovarian cancer. This pain may feel different from typical menstrual cramps and doesn’t follow your normal cycle pattern.

The pain can range from a dull, constant ache to sharp, intermittent discomfort. It may be localized to one side of the pelvis or spread across the entire lower abdomen. Some women describe it as a feeling of pressure or heaviness in the pelvic region. The pain occurs because the growing tumor puts pressure on surrounding organs and tissues, or because the tumor itself is irritating the tissues.

Warning signs to watch for:

• Pain that persists for more than two weeks
• Discomfort that’s not related to your menstrual cycle
• Pain that interferes with daily activities
• Aching that doesn’t improve with over-the-counter pain relievers

3. Difficulty Eating or Feeling Full Quickly

Many women with ovarian cancer experience significant changes in their eating habits and appetite. They may feel full after eating only a small amount of food, a symptom known as early satiety, or they may have difficulty eating normal portion sizes.

This symptom develops because the growing tumor or accumulated fluid in the abdomen reduces the space available for the stomach to expand. Additionally, the cancer can affect the digestive system’s normal functioning, leading to reduced appetite and feelings of fullness. Some women may unintentionally lose weight as a result of eating less, while others may actually gain weight due to fluid accumulation despite eating less food.

Related eating changes include:

• Feeling satisfied after eating just a few bites
• Loss of appetite
• Nausea after eating small amounts
• Unintentional weight loss or gain

4. Frequent or Urgent Need to Urinate

Changes in urinary habits are common in women with ovarian cancer. You may notice that you need to urinate more frequently than usual, or you may experience a sudden, urgent need to use the bathroom that’s difficult to control.

These urinary symptoms occur when an ovarian tumor grows large enough to press against the bladder, reducing its capacity and creating a sensation of fullness even when the bladder contains only a small amount of urine. The pressure can also irritate the bladder, causing urgency and frequency. It’s important to note that while urinary tract infections can cause similar symptoms, those with ovarian cancer typically don’t have the burning sensation associated with infections.

Urinary symptoms to monitor:

• Needing to urinate more often than usual
• Sudden, strong urges to urinate
• Feeling like you can’t empty your bladder completely
• Symptoms that persist despite treatment for urinary tract infections

5. Persistent Fatigue

Extreme tiredness that doesn’t improve with rest is another important symptom of ovarian cancer. This isn’t the normal fatigue you might feel after a busy day or poor night’s sleep—it’s a profound exhaustion that affects your ability to perform daily activities.

Cancer-related fatigue occurs for several reasons. The cancer cells consume a significant amount of the body’s energy and nutrients. Additionally, the body’s immune system works overtime trying to fight the cancer, which is exhausting. Anemia, which can result from internal bleeding or the cancer’s effects on blood cell production, also contributes to fatigue. Some women describe this fatigue as feeling completely drained or depleted, regardless of how much they sleep or rest.

6. Back Pain

Lower back pain that develops without an obvious cause, such as injury or strain, can be a symptom of ovarian cancer, particularly in more advanced stages. This pain is typically felt in the lower back region and may be constant or intermittent.

The back pain associated with ovarian cancer occurs when the tumor grows large enough to press on nerves and structures in the pelvis and lower back, or when the cancer spreads to the abdominal cavity and affects surrounding tissues. Unlike typical back pain from muscle strain, this pain usually doesn’t improve with rest or typical back pain treatments, and it may be accompanied by other symptoms on this list.

7. Digestive Changes

Women with ovarian cancer often experience various digestive problems that can significantly impact their quality of life. These may include persistent indigestion, gas, nausea, constipation, or diarrhea that doesn’t respond to typical treatments.

The digestive system can be affected because ovarian tumors can press against the intestines or stomach, disrupting normal digestive processes. Additionally, fluid accumulation in the abdomen can interfere with how the digestive organs function. Some women notice alternating patterns of constipation and diarrhea, while others experience constant upset stomach or heartburn-like symptoms that don’t improve with antacids or dietary changes.

Common digestive symptoms include:

• Persistent indigestion or heartburn
• Excessive gas or flatulence
• Changes in bowel habits lasting more than a few weeks
• Nausea that occurs frequently
• Constipation that doesn’t respond to typical treatments

8. Abnormal Vaginal Bleeding

While not as common as other symptoms, unusual vaginal bleeding can occur with ovarian cancer. This is particularly significant in postmenopausal women who are no longer having regular periods.

Abnormal bleeding may include spotting between periods, heavier than normal menstrual bleeding, bleeding after menopause, or irregular bleeding patterns. This symptom is more commonly associated with certain types of ovarian tumors. Any unexplained vaginal bleeding, especially in postmenopausal women, should be evaluated by a healthcare provider promptly, as it can indicate various gynecological conditions including ovarian cancer.

9. Changes in Menstrual Cycle

Some women with ovarian cancer notice significant changes in their menstrual patterns. These changes might include periods becoming irregular when they were previously regular, unusually heavy or light bleeding, or more painful periods than normal.

While menstrual changes are common and can be caused by many factors including stress, hormonal changes, and other conditions, persistent or unexplained changes should be discussed with a doctor, especially when accompanied by other symptoms on this list. The hormonal imbalances created by some ovarian tumors can disrupt the normal menstrual cycle.

10. Painful Intercourse

Discomfort or pain during sexual intercourse, medically known as dyspareunia, can be a symptom of ovarian cancer. Women may experience this as deep pelvic pain during or after intercourse.

This symptom occurs because an ovarian tumor can cause the ovaries to become enlarged and tender, and the pressure during intercourse can cause pain. Additionally, if the cancer has spread to surrounding tissues in the pelvis, this can create areas of inflammation and sensitivity that are aggravated during sexual activity. Any new or persistent pain during intercourse should be evaluated by a healthcare provider.

What Causes Ovarian Cancer

While the exact cause of ovarian cancer isn’t fully understood, researchers have identified several factors that may increase a woman’s risk of developing this disease:

Genetic Factors:

• Inherited gene mutations: Mutations in the BRCA1 and BRCA2 genes significantly increase ovarian cancer risk. Women with these mutations have up to a 40% lifetime risk of developing ovarian cancer.
• Family history: Having close relatives (mother, sister, daughter) with ovarian or breast cancer increases your risk.
• Lynch syndrome: This inherited condition, also known as hereditary nonpolyposis colorectal cancer (HNPCC), increases the risk of several cancers including ovarian cancer.

Age and Reproductive History:

• Age: The risk increases significantly after age 50, with most cases diagnosed in women between 55 and 64.
• Never having been pregnant: Women who have never carried a pregnancy to term have a higher risk.
• Early menstruation or late menopause: Starting periods before age 12 or going through menopause after age 52 slightly increases risk.
• Fertility treatments: Some studies suggest a possible link between fertility drugs and ovarian cancer, though the evidence is not conclusive.

Lifestyle and Environmental Factors:

• Obesity: Being significantly overweight increases the risk of developing and dying from ovarian cancer.
• Hormone therapy: Long-term use of hormone replacement therapy after menopause may slightly increase risk.
• Endometriosis: Women with this condition have a higher risk of certain types of ovarian cancer.

Other Medical Conditions:

• Previous history of breast, colon, or uterine cancer
• Polycystic ovary syndrome (PCOS)
• Certain non-cancerous ovarian conditions

It’s important to note that having one or more risk factors doesn’t mean you will definitely develop ovarian cancer, and some women with no known risk factors still develop the disease.

Prevention Strategies

While there’s no guaranteed way to prevent ovarian cancer, certain strategies may help reduce your risk:

Medical Interventions:

• Birth control pills: Using oral contraceptives for several years has been shown to reduce ovarian cancer risk by up to 50%. However, birth control pills have their own risks and benefits that should be discussed with your healthcare provider.
• Surgical options: For women at very high risk due to genetic mutations, preventive surgery to remove the ovaries and fallopian tubes (risk-reducing salpingo-oophorectomy) can significantly lower risk. This is a major decision that should be carefully discussed with specialists.
• Tubal ligation: Having your tubes tied may reduce ovarian cancer risk, though this shouldn’t be done solely for cancer prevention.

Pregnancy and Breastfeeding:

• Having children, especially before age 35, is associated with lower ovarian cancer risk
• Breastfeeding for a year or more may provide additional protection

Genetic Testing and Counseling:

• If you have a strong family history of ovarian or breast cancer, consider genetic counseling to assess your risk
• Testing for BRCA mutations can help you make informed decisions about preventive measures
• Regular screening may be recommended for high-risk women

Healthy Lifestyle Choices:

• Maintain a healthy weight: Obesity is linked to increased ovarian cancer risk and poorer outcomes
• Regular exercise: Physical activity may help reduce risk
• Healthy diet: While no specific diet prevents ovarian cancer, a balanced diet rich in fruits, vegetables, and whole grains supports overall health
• Avoid smoking: Smoking is associated with increased risk of certain types of ovarian cancer

Regular Medical Check-ups:

• Attend regular gynecological exams
• Report any persistent or unusual symptoms to your doctor promptly
• Know your family medical history and share it with your healthcare provider

Frequently Asked Questions

How early can ovarian cancer be detected?

Unfortunately, ovarian cancer is often diagnosed at advanced stages because early symptoms are vague and easily attributed to other conditions. There is currently no reliable screening test for ovarian cancer in women at average risk. However, being aware of symptoms and reporting persistent changes to your doctor can lead to earlier detection. Women at high risk due to genetic factors may benefit from specialized surveillance programs.

Are ovarian cancer symptoms constant or do they come and go?

Ovarian cancer symptoms tend to be persistent and progressive, meaning they occur frequently (often daily or almost daily) and gradually worsen over time. Unlike symptoms from less serious conditions that might come and go or be triggered by specific foods or activities, ovarian cancer symptoms are typically constant and don’t resolve on their own. If you experience symptoms more than 12 times per month for more than a few weeks, consult your doctor.

Can ovarian cancer occur in young women?

Yes, although ovarian cancer is most common in women over 50, it can occur in younger women, including teenagers and women in their 20s and 30s. Certain types of ovarian cancer, such as germ cell tumors, are more likely to occur in younger women. Young women with a strong family history of ovarian or breast cancer, or those with known genetic mutations, are at higher risk and should discuss surveillance options with their healthcare provider.

What’s the difference between ovarian cysts and ovarian cancer?

Ovarian cysts are fluid-filled sacs that form on or in the ovaries and are very common, especially in women of reproductive age. Most ovarian cysts are benign (non-cancerous), cause no symptoms, and disappear on their own. Ovarian cancer, on the other hand, involves malignant tumor growth. While most cysts are harmless, some characteristics such as large size, solid components, or irregular shape may require further evaluation. Your doctor can use imaging tests and blood work to help distinguish between cysts and potential cancer.

Does a normal Pap smear rule out ovarian cancer?

No, a Pap smear does not detect ovarian cancer. Pap smears are designed to screen for cervical cancer by collecting cells from the cervix. Ovarian cancer develops in the ovaries, which are not sampled during a Pap test. This is why it’s crucial to pay attention to symptoms and report any persistent changes to your doctor, even if your Pap smears are normal. A pelvic exam, imaging tests, and blood tests (such as CA-125) are used to evaluate ovarian concerns.

Should I see a doctor if I have just one symptom?

If you have one symptom that is persistent, unusual for you, and doesn’t resolve within a few weeks, it’s reasonable to see your doctor. However, ovarian cancer typically causes a combination of symptoms. If you experience two or more symptoms on this list that occur almost daily for more than two to three weeks, you should definitely consult your healthcare provider. Remember that these symptoms can be caused by many other conditions, but it’s important to get them checked to rule out serious causes.

What tests are used to diagnose ovarian cancer?

If your doctor suspects ovarian cancer based on your symptoms and physical exam, several tests may be ordered. These typically include imaging tests such as transvaginal ultrasound, CT scan, or MRI to visualize the ovaries; blood tests including CA-125 (a tumor marker that may be elevated in ovarian cancer); and possibly a biopsy or surgical procedure to obtain tissue for examination. Your doctor may also refer you to a gynecologic oncologist, a specialist in treating cancers of the female reproductive system.

Is bloating always a sign of ovarian cancer?

No, bloating is a very common symptom that’s usually caused by other conditions such as digestive issues, food intolerances, irritable bowel syndrome, or hormonal changes related to the menstrual cycle. However, bloating associated with ovarian cancer tends to have specific characteristics: it’s persistent (occurring almost daily), progressive (gradually worsening), and often accompanied by other symptoms such as pelvic pain, difficulty eating, or urinary changes. If your bloating has these characteristics and lasts more than a few weeks, it should be evaluated by a doctor.

References:

• American Cancer Society – Ovarian Cancer Signs and Symptoms
• National Cancer Institute – Ovarian Cancer
• Mayo Clinic – Ovarian Cancer
• Centers for Disease Control and Prevention – Ovarian Cancer Symptoms
• NHS – Ovarian Cancer