Ovary Pain During Period (Right or Left): Causes, Treatment

Question: What causes left or right ovary pain during period?

One problem a lot of women encounter every month is stomach pain during menstrual period.

Menstruation pain may be discomforting especially when it’s sharp and affecting your daily activities – work, academic pursuits and social life.

When you are 9 or 10, you rarely will experience any change in your mood, abdomen or the way you look. But soon after, when you get your first menstrual period, a lot of changes will start happening.

The months after your “first ever” menstrual cycle may be difficult to understand, as you may get vague symptoms with irregular periods.

However, you may soon notice abdominal cramps that may start before your period and persist during period. These cramps on the right or left side of your abdomen will occur for many reasons.

The commonest is your uterus contracting to push out endometrial blood that comes out as your menstrual period. The hormone, prostaglandins, play a role here. It helps stimulate uterine contractions to force out your period. ACOG+1

Most times, during your period, this contraction causes pain in your lower abdomen; and can also radiate to your back, left or right side of your belly. Many women also feel nausea, loose stools or headache when period pain is bad. Mayo Clinic+1

For most ladies that experience severe cramps during menstruation, it’s mostly because of prostaglandins effect. However, there are other reasons; some would even require surgery to ease off pain completely.

Other causes of pain during periods are a large ovarian cyst that ruptures and bleeds, ovarian torsion, pelvic infections, endometriosis, uterine fibroids, and adenomyosis. (Pain from other organs in the tummy, like the appendix or kidneys, can also be felt around the time of your period and may be mistaken for “ovary pain”.)

This article explains the causes of ovary pain during periods, when to worry and how to ease severe symptoms. 

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What causes ovary pain during period?

If you are struggling with left or right ovary pain during your period, here are common causes.

1. Normal menstruation

During menstruation, it’s not surprising for women to feel pain in their abdomen. More than 50 percent of women will have mild, moderate or severe pain in their abdomen. It’s quite common, so don’t feel you are alone. MedlinePlus

During your monthly period, the endometrium that covers the lining of the uterus breaks down and is washed out as period. This is possible because of prostaglandins that cause contraction of the uterus.

During uterine contractions, blood supply to the endometrium is cut off, resulting in the death of endometrial cells that finally passes through your vagina as period. PubMed Central

Prostaglandins level varies from woman to woman. In women that experience severe painful periods, prostaglandin levels are very high. Cleveland Clinic+1

Also, another reason you may have an excruciating period pain is a narrow cervical canal. This may cause you to feel pain when clots and endometrial tissue pass through.

Other factors that could make you have painful periods are a lack of exercise and stress.

What to do if you experience a painful period?

If you are having period cramps in your abdomen, it’s not abnormal. In younger women, especially women who are yet to experience childbirth, pain may be severe.

Talking to your doctor is an easy way out, especially if the pain stops you from doing your normal activities or suddenly becomes worse than usual. However, you can try medications like ibuprofen, aspirin (for adults), and ketoprofen. These drugs help block the production of prostaglandins, thereby reducing pain. Cleveland Clinic+1

To work effectively, it’s encouraged that you start taking these medications at least 1–2 days before your period starts (if your cycle is regular) or as soon as the pain begins. Teenagers and young people are usually advised to avoid aspirin unless a doctor recommends it, because of the risk of side effects.

If over-the-counter pain medicine does not help, or your periods are getting heavier or more irregular, it’s safer to see your doctor or gynecologist for a proper check-up. Mayo Clinic Health System

2. Ruptured ovarian cyst

If you are experiencing pain in your abdomen, a problem with one of your ovaries can be the cause.

Your ovaries are whitish egg-like structures that can be found both sides of the lower abdomen (pelvis). They are involved with the production of hormones that help control your menstrual cycle. The ovaries secrete estrogen and progesterone.

The primary function of your ovaries is to release an egg during ovulation. This egg is developed within follicles that are located in your ovaries.

During ovulation, one of your ovaries randomly expels an egg due to rupture of the ovarian follicle.

However, in some women, this rupture fails to happen and forms cyst that can become very big. A large cyst may rupture and cause bleeding into your abdomen resulting in severe pain.

Many simple ovarian cysts do not cause any symptoms and are found only on ultrasound. However, if you do have symptoms, a severe sharp pain after stress, exercise or sexual intercourse could be due to an ovarian rupture or torsion.

What to do?

Inform your doctor right away. An ultrasound scan is usually needed to know the type and size of the cyst. If it’s a small functional cyst, in a few days’ time it may settle by itself with rest and pain relief. However, sudden very severe pain, dizziness, fainting or shoulder-tip pain can be a sign of significant internal bleeding and you should go to the emergency room urgently.

3. You have endometriosis

If you are having a sharp pain on the right or left side of your belly during menstruation, it may be due to endometriosis, especially if it keeps getting worse over time or is not relieved by usual pain medications. ACOG+1

Endometriosis occurs when tissue similar to your endometrial tissues (that are usually located within the uterus) is found outside the uterus where it does not belong.

Commonly, it can be found on the ovaries, fallopian tubes, the outer surface of the uterus and other areas in the pelvis. In rare cases, it may be seen in other parts of the body. One common theory is retrograde menstruation, where some menstrual blood flows backwards through the fallopian tubes into the pelvis instead of only coming out through the vagina. Mayo Clinic+1

Blood now flows through your fallopian tubes into your ovaries and abdomen. These implants can swell and bleed with each cycle and cause inflammation and pain.

Symptoms you will experience are

• A sharp lower, right or left tummy pain

• Heavy bleeding during your periods

• Pain after sexual intercourse

• Back pain

• Sometimes difficulty getting pregnant

For more detailed information, you can read:
WHO fact sheet on endometriosis: https://www.who.int/news-room/fact-sheets/detail/endometriosis
NHS endometriosis page: https://www.nhs.uk/conditions/endometriosis/ World Health Organization+1

4. Adenomyosis

Unlike endometriosis where endometrial cell are found in other parts of the body, women with adenomyosis will have endometrial tissues located within the uterine muscle.

If you’ve had a D & C, myomectomy (fibroid removal) or operation to deliver your baby in the past (caesarian section), severe pain during menstruation may be due to adenomyosis.

Common symptoms are

• Pain in the back and lower abdomen

• Heavy bleeding that won’t stop for weeks

• A feeling of a bulky or enlarged uterus on examination

What to do?

If you’ve completed having kids, there is an option to remove your uterus (hysterectomy). This is because, since endometrial cell are lodged in the muscle of the uterus, removal often gives permanent relief from adenomyosis. MSD Manuals

On the other hand, this option may not be available if you still wish to conceive. Pain medication, hormone therapy and sometimes a hormone-releasing intrauterine device (IUD) can help to reduce bleeding and pain in many women.

5. Pelvic inflammatory disease

Another reason for pain during menstruation is a pelvic inflammatory disease (PID), which occurs when lower genital tract infections located on the vagina start moving up through your cervix and affecting your womb, fallopian tube, and abdomen.

PID is often caused by sexually transmitted infections like chlamydia and gonorrhea, but other bacteria can also be responsible. CDC

PID is a common reason for infertility amongst young women, and that’s not all; Women with PID will experience pain during intercourse, and during their periods.

If diagnosed very early, it reduces the chance of infertility, ectopic pregnancy, and pelvic abscess; which are grave complications of the disease. Untreated PID can increase the risk of tubal infertility, chronic pelvic pain and ectopic pregnancy in the future. Mayo Clinic+1

If you have fever, smelly vaginal discharge, pain during sex, or severe lower tummy pain, especially after unprotected sex or a new partner, you should see a doctor urgently for examination and antibiotics.

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What Causes left ovary pain during period?

If you have left pain in your abdomen while having period, it could be due to

• Endometriosis

• Painful menstruation (normal dysmenorrhea)

• Ruptured ovarian cyst

• Adenomyosis

• Kidney stone or infection

• Ectopic pregnancy (pregnancy outside the womb – emergency)

• Pelvic inflammatory disease

• Urinary tract infection

Sudden, very severe one-sided pain with dizziness or fainting can be a sign of ectopic pregnancy or internal bleeding, especially if you have missed your period or think you could be pregnant. This needs emergency care.

What causes right ovary pain during period?

• Painful menstruation

• Appendicitis

• Pelvic infections

• Ectopic pregnancy

• Large ovarian cyst

• Ovarian torsion (twisting of the ovary – emergency)

• Adenomyosis

• Endometriosis

Right-sided pain with fever, vomiting and loss of appetite can suggest appendicitis. Sudden severe pain with vomiting on either side may be ovarian torsion. Both conditions require urgent hospital review and possible surgery.

Still worried about pain during your menstrual period? Ask Us!!!

For more background on painful periods (dysmenorrhea), you can also read the ACOG patient FAQ here:
https://www.acog.org/womens-health/faqs/dysmenorrhea-painful-periods
and the MedlinePlus page on period pain:
https://medlineplus.gov/periodpain.html ACOG+1