The information on this page was reviewed and approved by
Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on September 21, 2021.

Ovarian cancer symptoms

Many people mistakenly believe that a Pap smear test can detect ovarian cancer. In fact, there’s no reliable routine screening test for ovarian cancer, so women with a family history of the disease or other risk factors should ask their doctor about genetic testing and other steps to monitor or reduce their risk. Routine gynecologic care and annual pelvic exams are recommended to follow up on symptoms of ovarian cancer.

Early warning signs of ovarian cancer

In most cases, ovarian cancer isn’t diagnosed until it’s progressed to an advanced stage. In fact, according to the American Cancer Society, only about 20 percent of cases are diagnosed at an early stage. Typically, this is because ovarian cancer symptoms either aren’t noticeable in the early stages of the disease or they mimic common stomach and digestive issues that are often mistaken for minor ailments.

Women are more likely to experience symptoms once the disease has spread beyond the ovaries, typically to the lymph nodes outside the abdomen, the skin, the liver, the spleen, the fluid around the lungs, the intestines or the brain.

The most common signs and symptoms of ovarian cancer are:

  • Bloating
  • Pelvic or abdominal pain
  • Early satiety (feeling full quickly) or difficulty eating
  • A need to urinate frequently or urgently

Less common ovarian cancer symptoms include:

  • Back pain
  • Extreme tiredness
  • Weight loss
  • Pain during sex
  • Acid reflux
  • Constipation or upset stomach
  • Unusual belly swelling
  • Menstrual changes

Women who have persistent symptoms for more than a few weeks or notice a change in their ovarian health should consult a doctor for follow-up. In advanced stages of ovarian cancer, patients may experience gastrointestinal and other digestive disorders, with symptoms such as nausea, vomiting and diarrhea.

Ovarian cysts, masses or tumors

A pelvic mass may represent either benign (not cancerous) or malignant (cancerous) conditions. Symptoms of ovarian cysts, masses or tumors may include:

  • Pelvic pain
  • Nausea or vomiting
  • Pain shortly before or after the start of menstruation
  • Pressure, swelling or pain in the abdomen
  • A dull ache in the lower back and thighs
  • Difficulty emptying the bladder
  • Pain during sex
  • Abnormal bleeding

Women who suspect a pelvic mass should see a doctor for an evaluation. During a physical exam, the doctor may be able to feel the mass. An ultrasound may follow, to determine the size, shape, location and composition of the lump. This information helps doctors make recommendations about next steps, which may include surveillance or surgery.

Risk factors and screening

Knowing the risk factors for ovarian cancer can be helpful in knowing if you’re more prone to ovarian cancer, so you can look out for warning signs or try to mitigate the risk. Risk factors may not play a role in all types of ovarian cancers, but they often do in the most commonly diagnosed type: epithelial ovarian cancer.

Some of the risk factors for ovarian cancer include:

  • Age
  • Personal and family history
  • Genetic mutations, such as BRCA1 or BRCA2 
  • Endometriosis
  • Difficulty trying to conceive or having never given birth
  • Hormone replacement therapy after menopause

Prevention is crucial in the fight against ovarian cancer. But it’s hard to detect the disease without the presence of symptoms. While ovarian cancer screenings and tests exist, they aren’t usually recommended unless a woman is considered to be high-risk or has symptoms.

It’s important to schedule regular women’s health exams. Even though not all tumors may be found during a regular pelvic exam, the doctor may order additional testing to determine whether ovarian cancer is a possibility.

Ovarian cancer overview

ovarian cancer infographic

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