Ovarian pain duringperimenopausecan be felt in the lower abdomen and pelvis.
Sometimes, the pain may even be felt in the lower back.
This article discusses some possible causes of pelvic and lower abdominal pain during perimenopause.
Verywell / Jessica Olah
Verywell / Jessica Olah
What Is Perimenopause?
Perimenopause means “around menopause” and is also known as the menopausal transition.
Perimenopause usually begins a few years before menopause, when a woman has her last menstrual cycle.
The hormone estrogen plays a key role in regulating the menstrual cycle.
About six months before menopause, estrogen drops significantly and periods become few and far between.
For most women, perimenopause starts around ages 40 to 44.
However, perimenopause can start as early as the 30s, or as late as the 50s.
Symptoms that accompany the pain may help narrow down the cause.
While this list is not exhaustive, the following are common causes.
Ovulation
Ovulationusually occurs once a month, when one of the ovaries releases an egg.
This shedding is what causes bleeding during a menstrual period.
Ovulation pain is also known asmittelschmerz,ormid-cycle pain.
You may experience headaches, stomach problems, ormalaise(general feeling of not being well) during ovulation.
Menstrual Pain
Menstrual cramping(dysmenorrhea) may occur or may worsen during perimenopause.
Worse cramping may be from changes in hormones or one of the other causes listed below.
Endometriosis
Endometrial tissue usually develops inside the uterus and is shed during a monthly period.
When this tissue grows outside of the uterus, it is calledendometriosis.
This endometrial tissue outside the uterus still reacts to hormonal changes, causing bleeding inside the pelvis.
This can cause severe cramping and heavy menstrual flow.
Ovarian Cysts
Ovarian cysts are fluid-filled masses that grow on one or both ovaries.
Some go undetected and are absorbed back into the body.
Larger ovarian cysts can cause pain on either or both sides.
This condition is called ovarian torsion.
Complications of ovarian cysts may cause symptoms similar toappendicitis.
Ruptured ovarian cysts require immediate medical help.
One cause of PID is sexually transmitted diseases (STDs), such as chlamydia and gonorrhea.
PID can result in infertility (trouble getting pregnant) or increase the risk of an ectopic pregnancy.
The adhesion causes the two surfaces to stick together.
Pelvic adhesions may develop as a result of:
Pelvic adhesions are often accompanied by long-term pelvic pain.
They can also grow larger and tighter over time, increasing the risk of complications.
Ectopic Pregnancy
Anectopicpregnancyhappens when a fertilized egg implants outside of the uterus.
Its often accompanied by nausea and vomiting and requires emergency surgery.
Ovarian Cancer
Ovarian pain fromovarian canceris rare.
It is more severe and persistent than pain from a menstrual cycle.
PCOS can cause ovarian cysts or prevent ovulation.
People with PCOS often experience irregular periods, weight gain, infertility, and excess body hair.
It can delay menopause and cause cyclic or constant pelvic pain.
Symptoms of ORS also include painful sex, urination, and bowel movements.
These tools can also be helpful for your healthcare provider if you are evaluated.
They may also perform apelvic exam,Pap smear, andsexually transmitted disease (STD) screening.
Providers begin with a history and physical that provides clues about what to do next.
They may order diagnostic tests such as urine and blood tests.
The following are conditions that can cause pain that mimics ovary pain.
This punch in of pain starts suddenly and comes in waves.
More complex conditions affecting the urinary tract may require advanced testing and treatment from aurologist.
Women are at higher risk of IBS, and the symptoms often get worse around a period.
Other symptoms include bloating, gas, alternating diarrhea and constipation, and mucus in the stool.
Appendicitis
Appendicitis, or inflammation of the appendix, can cause severe abdominal pain.
Symptoms usually come on suddenly, change, and get worse.
It often hurts worse when you cough, sneeze, or move.
It may also cause:
Appendicitis is usually diagnosed through blood work that tests for infection and imaging.
The pain usually gets worse when pressure is applied.
Treating Ovary Pain During Perimenopause
Treatment is based on the underlying cause of the pain.
It may include one or a combination of the following.
An ectopic pregnancy, ovarian torsion, or a ruptured appendix will require emergency surgery.
Ruptured Ovarian Cysts
Specific types of ruptured ovarian cysts require surgery, but they are rare.
Acupunctureis popular in treating many health concerns.
However, there is not enough science to support its use for menstrual pain.
There are preliminary findings that showacupressure, a self-treatment, may provide relief.
Always check with your healthcare provider before trying OTC medications or alternative treatments.
Some may be contraindicated with pregnancy, health conditions, or when taking certain medications.
Prevention
Many conditions, such as a ruptured ovarian cyst, are random.
It is not known why they occur or how to prevent them.
Maintaining a healthy diet and exercising can help you lose weight and regulate insulin more efficiently.
These healthy habits may decrease the risk of developing PCOS.
Endometriosis, ectopic pregnancy, and pelvic inflammatory disease are other possible causes of pain during perimenopause.
Not all causes are related to the reproductive system, though.
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