Most ovarian cancer symptoms are called “silent” or “vague” because they’re similar to symptoms of many other health conditions. Ovarian cancer also shares symptoms with other gynecologic cancers, which can make diagnosis difficult. Because these symptoms can be easy to confuse with something else, only about 20 percent of ovarian cancer cases are diagnosed in the early stages (stages 1 or 2). However, when ovarian cancer is found and treated early, the five-year survival rate is 93 percent.

Ovarian cancer happens when cells in the ovaries begin to grow and divide in an uncontrolled way. There are three main types of ovarian cancer: epithelial ovarian cancer, germ cell ovarian cancer, and stromal ovarian cancer.

In this article, we explain the symptoms that may be signs of ovarian cancer.

Common Ovarian Cancer Symptoms

Some ovarian cancer symptoms can also be caused by other conditions. In ovarian cancer, these symptoms often become more persistent and noticeable over time. For example, they may happen more frequently or feel more intense.

Keep in mind that everyone experiences symptoms differently. Pay attention to changes in your body and talk to your doctor if you have concerns. It’s especially important to reach out if you notice symptoms often. Symptoms that don’t improve with changes in diet, exercise, or medication may point to a more serious problem. At your appointment, your doctor may perform a pelvic exam and may order additional tests.

Epithelial and germ cell ovarian cancer symptoms are often similar, while stromal cell ovarian cancer tends to cause other types of symptoms. Epithelial ovarian cancer involves the cells covering the outside of the ovaries, while ovarian germ cell cancer begins in the egg cells. Surface epithelial tumors are the most common and can be more dangerous because symptoms are often not visible until the cancer has spread to other organs. This can make early diagnosis more difficult.

1. Pelvic Symptoms

Pelvic symptoms of ovarian cancer usually affect the lower abdominal area. These symptoms can sometimes be mistaken for another condition or disease. Common pelvic symptoms include:

• A mass located in the pelvic area
• Swelling in the pelvic area
• Abnormal vaginal discharge
• Painful sex
• Pelvic pressure
• Pelvic pain
• Frequent urination or urinary urgency (feeling like you always need to pee)
• Abnormal vaginal bleeding
• Changes to menstrual cycle bleeding, such as bleeding that is heavier or more irregular than usual
• Back pain

2. Gastrointestinal Symptoms

Ovarian cancers may also cause gastrointestinal (GI) symptoms. One review found that about 22 percent of women were first diagnosed with a GI condition before their cancer diagnosis. Of those women, about 61 percent received their ovarian cancer diagnosis within 6 months of their GI diagnosis.

Common GI symptoms of ovarian cancer include:

• Abdominal bloating
• Changes in bowel habits, such as constipation or diarrhea
• Nausea or upset stomach
• Abdominal pain
• Indigestion
• Early satiety (feeling full sooner than normal when eating)

3. General Symptoms

Women with advanced ovarian cancer may also experience vague symptoms, which can make it harder to receive a diagnosis. General symptoms of ovarian cancer may include:

• Fatigue
• Loss of appetite
• Difficulty eating
• Unexplained weight loss or weight gain

Stromal Cell Ovarian Cancer Symptoms

Stromal cell ovarian tumors are rare. They account for only 1.2 percent of malignant (cancerous) ovarian tumors. Unlike other types of ovarian cancer, early detection is common with stromal cell ovarian cancer. Because of this, stromal cell ovarian cancer has a 5-year survival rate of 91 percent.

Unlike other types of ovarian tumors, stromal cell tumors often involve hormone production. This can cause symptoms like early puberty or changes in menstrual cycles. Symptoms typically appear in teenagers and young adults.

Symptoms of stromal cell ovarian tumors may include:

• Abdominal bloating
• Sudden, intense abdominal pain, which can happen if the tumor starts bleeding or if an ovary twists around the ligaments holding it in place
• Irregular vaginal bleeding, if the tumor is producing estrogen
• A sudden stop in menstruation, along with excess growth of facial or body hair, if the tumor is producing testosterone
• Menstrual periods and breast development starting earlier than expected in young girls
• Noncancerous thickening of the uterine lining (called endometrial hyperplasia)

Some ovarian cancer risk factors are genetic, meaning they can be passed down in families. For example, if you’ve been diagnosed with Peutz-Jeghers syndrome, you have a higher risk of ovarian cancer due to stromal cell tumors.

Late-Stage Ovarian Cancer Symptoms

In many cases, ovarian cancer does not cause symptoms until it begins to spread. Early-stage ovarian cancer may cause no symptoms, or it may cause abdominal pain or pressure. As the disease progresses, new symptoms may appear, such as urinary changes or pain during sex.

As the cancer spreads to other areas of the body, symptoms may become more noticeable and more severe. Advanced ovarian cancer symptoms may include:

• Intense pain
• Nausea with or without vomiting
• Reduced appetite
• Constipation
• Severe swelling in the abdomen
• Lack of energy
• Difficulty catching your breath

Are Ovarian Cysts a Cancer Symptom?

Doctors use the term ovarian cysts to describe fluid-filled sacs that form inside an ovary. Functional cysts develop as part of the normal ovulation process (egg release) and often go away on their own. Some people may feel discomfort or pain from ovarian cysts, which can require treatment. While this pain may feel similar to ovarian cancer, cysts are usually benign (not cancerous). If you have ovarian cysts but no symptoms, your doctor may simply monitor them to see if they shrink over time.

Sometimes, ovarian cysts can be a cause for concern. For example, cysts that develop before puberty or after menopause may need further testing. Larger cysts that don’t go away on their own after a few months can also be a cause for concern and should be checked by a doctor.

Ovarian Cancer Symptoms vs. Treatment Side Effects

It can be hard to tell the difference between the symptoms of ovarian cancer and the side effects of treatment. Common treatments for ovarian cancer include chemotherapy, hormone therapy, and targeted therapy. These ovarian cancer treatments can cause side effects such as:

• Nausea or upset stomach
• Constipation
• Diarrhea
• Fatigue
• Weight loss

Symptoms of ovarian cancer and side effects from treatment can vary from person to person. Let your doctor know if you notice any new symptoms or side effects so your cancer care team can help you manage them.

Talk to Your Doctor

Ovarian cancer symptoms can be hard to recognize because they often look like symptoms of less serious health conditions. But if you have persistent or worsening pelvic pain — or symptoms such as bloating, pelvic pain, or changes in appetite — don’t ignore them. Paying close attention to your body and talking with your doctor about any unusual symptoms or symptoms that don’t go away is key to getting diagnosed and treated as soon as possible.

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