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Ovary Pain Early Pregnancy (Right or Left): Causes, Signs, Treatment

By: Author Dr Akatakpo Dunn, MBBS, PG Dip Ultrasound, Prof Dip O&G (RCPI) Medical Director & Lead Obstetrician/Ultrasonologist, Verah Clinic & Maternity

Posted on Last updated:

Question: What causes dull or sharp ovary pain early pregnancy on the right or left side of the abdomen?

During pregnancy, women experience changes to their pre-pregnancy body. Symptoms of pregnancy – food cravings, weight gain, fatigue, breast pain – are difficult to deal with and can make new moms feel stressed out emotionally and physically.

Having an additional sharp or dull pain on one side of your belly can be even more troubling.

Some women quickly think of miscarriage each time they experience a dull or sharp pain on the right, left, or lower part of their tummy.

The truth is women can experience belly pain during pregnancy that is often described as dull aching pain or tiny cramps that usually disappear on their own as the womb grows and ligaments stretch.

You may now find that walking, running, turning in bed, and sexual intercourse will sometimes cause pain in your abdomen and back.

Is it ovarian torsion or ovarian cyst?

If you are pregnant, your baby typically will grow within your womb. On each side of your uterus is a fallopian tube that connects your uterus to your ovaries.

Before conception, your body will release an egg each month during ovulation. The process is controlled by hormones FSH (follicle-stimulating hormone), LH (luteinizing hormone), progesterone, and estrogen.

During ovulation, a mature follicle will burst open and release an egg that may end up being fertilized by the man’s sperm.

Sometimes, the follicle that released the egg seals up and fills with fluid. This forms a small cyst called a corpus luteum cyst, which is common in early pregnancy and usually harmless. Most of these cysts disappear on their own by the second trimester.

However, in some women, the follicles get filled with more fluid, grow big, and form a larger ovarian cyst.

If the cyst is large, it can cause ovary pain during pregnancy. A large ovarian cyst can burst open and cause pain, or disrupt blood circulation to your ovaries by twisting on itself (ovarian torsion) with resultant sharp pain.

Though ovary pain in early pregnancy may indicate rupture of an ovarian cyst or ovarian torsion, there are other reasons you can feel pain in your abdomen.

An ectopic pregnancy, uterine fibroids, miscarriage, kidney stone, constipation, appendicitis, urinary tract infection, and gallbladder problems may also result in dull or sharp pain in your tummy during pregnancy.

This article explains the causes of ovary pain during early pregnancy, signs of an ovarian cyst during pregnancy, when you should worry and when to urgently see a doctor.

What causes ovary pain early pregnancy?

If you are experiencing pain on the right side or left side of your abdomen during pregnancy, here are possible reasons explained.

1. Ovarian cyst rupture or torsion during pregnancy

If you currently experience pain in your belly while pregnant, it could be due to an ovarian cyst.

Ovarian cysts are quite common in women of childbearing age, including pregnant women, and in many cases women do not get any symptoms. A small cyst that forms early in pregnancy will often disappear spontaneously, usually by the second trimester.

Usually, during routine abdomen or pelvic ultrasound to check the status of your baby, your doctor may accidentally find a cyst. In most cases, these cysts go unnoticed and do not cause harm.

On the other hand, some women may get complications from a large ovarian cyst that bursts open (rupture) or when it blocks blood supply to your ovaries (ovarian torsion).

Other symptoms of ovarian cyst complications (apart from a right or left side pain) are fever, nausea, vomiting, dizziness, feeling faint, and abdominal swelling.

If the pain becomes sudden and very severe, or you now feel persistent fever, vomiting, sharp abdominal pain, or you are unable to stand upright, you should see a doctor or go to the emergency room immediately.

2. You have an ectopic pregnancy

Normally, after the egg is fertilized in the fallopian tube, the embryo (your baby) is slowly moved back to the uterus where it implants and starts growing.

However, during an ectopic pregnancy, the embryo implants and grows outside the uterus – most commonly in the fallopian tube, but sometimes in the abdomen, ovary, cervix, or a previous caesarean scar.

If an embryo gets implanted in the fallopian tube, it means that as it grows, the tube will stretch until it may rupture, leading to internal bleeding and severe right or left side abdominal pain.

If you have back pain, vaginal bleeding, and a sharp right or left side belly pain in early pregnancy, it could be due to an ectopic pregnancy and should never be ignored.

Other warning symptoms are heavy vaginal bleeding, shoulder tip pain, dizziness, fainting, and extreme body weakness. These are emergency signs.

If you’ve been diagnosed with an ectopic pregnancy in the past, it’s possible that it may occur again. So don’t ignore a sharp one-sided pain in early pregnancy – talk to your doctor or go to the hospital ASAP.

(For more details, see ACOG patient information on ectopic pregnancy: https://www.acog.org/womens-health/faqs/ectopic-pregnancy)

3. You are having a miscarriage

The common fear of expecting mothers, especially women who have had a miscarriage before, is losing their baby very early in pregnancy.

First of all, miscarriage in the first trimester is sadly quite common. In many cases, it happens because the baby did not develop normally, often due to problems with the chromosomes, and is not caused by anything the mother did or did not do.

Secondly, you may get mild cramps from time to time when pregnant. In most cases, this is not something you should worry about.

Though more common in the 4th, 5th, 6th, and 7th weeks of pregnancy, if you’re already in your second trimester, the chances of a miscarriage decrease significantly.

Symptoms of miscarriage in early pregnancy are vaginal bleeding, waist pain, and belly cramps. Cramps may be very severe as your uterus contracts to expel the fetus.

Common causes of early miscarriage are chromosomal problems in the baby. Other possible factors are some infections, abnormalities of the uterus, uncontrolled medical conditions, and lifestyle factors like heavy smoking. Routine daily activities such as moderate exercise, sex, or working are not proven causes of miscarriage.

Though symptoms of a miscarriage will vary from woman to woman, heavy bleeding with blood clots or tissue coming out from the vagina is likely because of a miscarriage.

Talk to your doctor urgently if you notice these symptoms.

(For more information, see ACOG Early Pregnancy Loss: https://www.acog.org/womens-health/faqs/early-pregnancy-loss
and Cleveland Clinic’s overview of miscarriage: https://my.clevelandclinic.org/health/diseases/9688-miscarriage)

4. You probably have a pedunculated fibroid

Fibroids are benign (non-cancerous) growths that can occur within or outside the uterus. Sometimes, you may have fibroids located within the uterine muscle (intramural fibroid) or hanging on a stalk (pedunculated fibroid).

The truth is, if you have a fibroid, common symptoms are heavy or prolonged periods, spotting between periods, pelvic pressure, or a feeling of fullness in the lower abdomen. Some women also have belly or pelvic pain, especially if the fibroid is large or degenerating.

During pregnancy, some fibroids may grow due to pregnancy hormones and can sometimes affect your baby’s position or cause discomfort.

A pedunculated fibroid (attached to the uterus by a stalk) can twist on its stalk and cut off its own blood supply. This can cause sudden, sharp pain during pregnancy and may mimic “ovary pain”.

Treatment options your doctor may suggest include rest, hydration, and pregnancy-safe pain relief like acetaminophen (paracetamol). Always talk to your healthcare provider before taking any medication in pregnancy, and do not self-medicate with strong painkillers without advice.

(For more information on fibroids, see Mayo Clinic uterine fibroids overview:
https://www.mayoclinic.org/diseases-conditions/uterine-fibroids/symptoms-causes/syc-20354288)

Other causes of belly pain in early pregnancy are:

  1. Constipation

  2. Appendicitis

  3. Urinary tract infection

  4. Gallbladder stones or gallbladder inflammation

These conditions can also cause right- or left-sided abdominal pain and may happen with or without pregnancy.

When should you see a doctor urgently?

You should seek urgent medical help (nearest hospital or emergency room) if you are pregnant and have:

  • Sudden, severe pain on one side of your lower abdomen

  • Pain with heavy vaginal bleeding or passing clots/tissue

  • Pain with dizziness, fainting, or shoulder tip pain

  • High fever and chills with abdominal pain

  • Persistent vomiting with pain that is getting worse

  • Pain and burning when passing urine, with fever or flank pain

These can be signs of ectopic pregnancy, miscarriage, ovarian torsion, appendicitis, severe infection, or other emergencies that need quick treatment.

Future pregnancy and counselling

If you’ve had an ectopic pregnancy, miscarriage, ovarian cyst surgery, or fibroid surgery, you can still have a healthy pregnancy in the future. However, it is wise to:

  • See your doctor early in the next pregnancy for an early ultrasound to confirm the location and viability of the pregnancy.

  • Discuss any previous ectopic pregnancy, surgery on the tubes or ovaries, and known fibroids with your doctor before or early in pregnancy.

Your doctor can then monitor you more closely and advise you about risks in future pregnancies.

(For more information on causes of miscarriage, see NHS: https://www.nhs.uk/conditions/miscarriage/causes/)

FREQUENTLY ASKED QUESTIONS

What causes dull ovary pain early pregnancy?

Usually, dull pain in early pregnancy is not uncommon. A lot of women that are pregnant will have mild belly cramps as the uterus grows and ligaments stretch.

While it could be due to normal changes that take place in early pregnancy, if you have pain with spotting or bleeding, it’s advisable to let your doctor know.

Nonetheless, if you are in your 3rd or 4th week of pregnancy, a dull abdominal ache with very light spotting might be due to implantation in some women, but it can also look like an early period or early miscarriage. You can’t rely on this alone to know what is happening.

What causes sharp ovary pain early pregnancy?

If you are pregnant and get an intense, sharp pain in your abdomen, especially on one side, it’s more likely that something is wrong, particularly if you are spotting or feeling dizzy as well.

A severe urinary tract infection, ectopic pregnancy, ovarian cyst rupture or torsion, fibroid degeneration, and a miscarriage can cause this type of pain.

Any sharp, worsening pain in early pregnancy that does not settle quickly should be checked by a doctor.

Is left or right ovary pain early pregnancy sign?

A sharp pain in your abdomen days before your period is often due to your period coming or normal ovulation pain. When you are expecting your period, your body hormones can cause symptoms like back pain, abdominal pain, vomiting, and nausea.

On the other hand, a mild ache in your lower belly with other early pregnancy symptoms (breast tenderness, missed period, nausea) may occur in early pregnancy. Some women also report mild cramps around the time of implantation, but many pregnant women do not feel this at all.

If you are expecting a baby, it’s better you confirm after missing your period. A pregnancy test is the only reliable way to know if you’re pregnant or not, not pain alone.