Enlarged Ovaries: Everything You Need to Know

An enlarged ovary can be a common occurrence during the menstrual cycle, and it is often harmless. However, in some cases, it may be a sign of an underlying medical condition. You may have an enlarged ovary if a cyst develops on it. You may not have any other symptoms, and the cyst can go away naturally without any treatment.

If you experience symptoms that affect your menstrual cycle, or if you experience abdominal pain or cramping, your doctor may arrange for an imaging test. If they detect an enlarged ovary, they will arrange for further tests to determine any medical causes.

Read on to learn more about the causes of enlarged ovaries. This guide also includes information about treatments and diagnoses.

The ovaries are part of the female reproductive system. They can appear enlarged when a functional ovarian cyst develops as a natural part of menstruation. This is not usually a cause for concern.

However, enlarged ovaries may occasionally occur as a result of an underlying medical condition. If this is the case, you may experience other symptoms affecting menstruation and your abdomen.

Although functional ovarian cysts are a typical part of the menstrual cycle, you may also experience a pathological ovarian cyst. This occurs due to abnormal cell growth.

Pathological cysts can develop before and after menopause. They are typically noncancerous, or benign. A small number of pathological ovarian cysts are cancerous and may require surgical removal.

Learn more about ovarian cysts here:

• Can Ovarian Cysts Become Cancer?
• Guide to Ovarian Cysts
• How Ovarian Cysts Affect Pregnancy and Fertility
• What to Know About Ovarian Cysts

Polycystic ovary syndrome (PCOS) is a condition wherein the ovaries become enlarged and contain many cysts. It can occur at any age following puberty, though there is no known specific cause.

PCOS affects around 1 in 10 females of childbearing age in the United States.

Learn more about PCOS here:

• 7 Things to Know About PCOS
• 10 Signs You Might Have PCOS
• Guide to PCOS
• Tips for Coping with PCOS

Ovarian torsion is a rare disorder wherein the ovary can become twisted at the point where it attaches to the uterus or pelvis. This prevents blood from being able to flow from the ovary, resulting in a swollen and enlarged ovary. If blood cannot reach the ovary, it may cause ovarian tissue to die.

Females ages 9–14 years are most likely to develop ovarian torsion, as the tissue is at its most flexible around this time.

Endometriosis occurs when the lining of the womb begins to grow in other places. This can include the ovaries, causing them to look enlarged. The womb lining can also grow in the fallopian tubes.

Endometriosis affects around 10% of females who are of reproductive age worldwide. However, this is likely to be an underestimation, as there is currently no screening test specifically for endometriosis.

Learn more about endometriosis here:

• 8 Signs You Could Have Endometriosis
• Don’t Ignore These Symptoms of Endometriosis
• Endometriosis Hub
• Guide to Endometriosis

Ovarian cancer typically begins in the ovaries. In some cases, it may begin in the fallopian tubes. The cells that grow in the ovaries can result in enlarged ovaries.

A female has a roughly 1 in 78 chance of developing ovarian cancer in their lifetime. It typically develops later in life.

Learn more about ovarian cancer here:

• Guide to Ovarian Cancer
• Stages of Ovarian Cancer and What They Mean
• Talking with Your Doctor About Ovarian Cancer
• Where Ovarian Cancer Can Spread

Although you may require imaging tests to properly detect an enlarged ovary, you may experience some symptoms as a result of an underlying medical condition.

Symptoms that can occur alongside an enlarged ovary will depend on the underlying cause.

Symptoms of ovarian cysts can include the following:

• pain in the pelvis
• pain during sex
• frequently needing to urinate
• difficulty emptying the bowels
• heavy, irregular, or light periods
• bloating

Symptoms of PCOS can include:

• an irregular menstrual cycle, such as missed, longer, or shorter periods
• oily skin
• acne
• excess hair growth in areas where you do not usually have hair
• thinning of the hair on the scalp
• unexplained weight gain

Symptoms of ovarian torsion include the following:

• sudden and severe pelvic pain
• nausea
• vomiting
• persistent cramps

Symptoms of endometriosis can include:

• painful periods
• chronic pelvic pain
• pain during or after sex
• pain when urinating
• painful bowel movements
• fatigue
• abdominal bloating
• nausea

Symptoms of ovarian cancer are more likely to occur once the condition has spread. However, you may notice symptoms earlier on.

Symptoms of ovarian cancer can include:

• bloating
• pelvic pain
• abdominal pain
• feeling full quickly
• frequent urination

A lot of symptoms associated with enlarged ovaries can occur for a number of different reasons. Tests or scans will be able to rule out or confirm the cause of ovary growth.

Treatments for an enlarged ovary will depend on the underlying cause. A doctor may prescribe medications for some conditions, while surgery is preferential for others.

An ovarian cyst can sometimes go away on its own. If the cyst is larger — causing you to experience severe symptoms — or may be cancerous, your doctor may recommend that it is surgically removed.

Although there is currently no cure for PCOS, some treatments can help you manage the symptoms. These include:

• losing 5% of your body weight if you are overweight
• taking a birth control pill to regulate or control periods
• taking metformin to regulate periods and help with fertility
• taking a medication to control excessive hair growth and hair loss
• undergoing laparoscopic ovarian drilling surgery if fertility problems do not reduce with medication

Surgery is required to treat ovarian torsion. This can include laparoscopy or laparotomy.

During laparoscopy, the surgeon will make small incisions in your abdomen to insert a laparoscope, which is a thin tube with a camera and light on the end of it. The surgeon will untwist the ovary and remove any cysts. You can undergo this treatment as an outpatient under anesthesia.

During laparotomy, the surgeon will make a larger incision in the abdomen to examine the affected organs. They will untwist the ovary and remove any cysts before sewing up the incision. You will need to stay at the hospital overnight while you recover.

There is currently no cure for endometriosis. However, it may be possible to treat the symptoms of endometriosis.

Treatments for pain caused by endometriosis can include:

• hormone therapy, which can include:
  • GnRH medications
  • oral birth control
  • progesterone and progestin
  • danazol
• over-the-counter pain medications, such as nonsteroidal anti-inflammatory drugs
• laparoscopy or laparotomy surgery to remove endometriosis patches for short-term relief

Learn more about endometriosis surgery here.

Depending on the stage of the cancer, your doctor may recommend local treatments or systemic treatments.

With local treatments, your doctor or surgeon can treat the tumor without affecting the rest of the body. Systemic treatments, on the other hand, reach cells virtually anywhere in the body.

Types of ovarian cancer treatments include:

• surgical removal
• radiation therapy
• chemotherapy
• hormone therapy
• targeted therapy

Your doctor will discuss each option with you and make sure you fully understand each type of treatment before proceeding.

In order to diagnose the cause of an enlarged ovary, your doctor may conduct a number of tests. If you have other symptoms, conducting imaging tests and scans can help determine the condition or rule out differential diagnoses.

An ultrasound scan can help detect ovarian cysts. During an ultrasound scan, a medical professional such as a gynecologist will place a probe into the vagina to look for the cyst. If they find a cyst, they may arrange for you to have another scan after a few weeks.

If the gynecologist suspects that the cyst may be cancerous, they will arrange for blood tests to check for high levels of chemicals that might indicate ovarian cancer. They may also plan for you to have surgery to remove the cyst.

Learn more about how doctors diagnose ovarian cysts here.

In order to reach a PCOS diagnosis, your doctor will first need to rule out other possible causes of your symptoms.

You will then need to meet two of the three following criteria:

• Your periods are irregular or infrequent.
• Your blood tests show high levels of testosterone or signs of excess male hormones.
• Scans show that you have polycystic ovaries.

Learn more about how doctors diagnose PCOS here.

You will require laparoscopy if a doctor suspects that you have ovarian torsion and they have ruled out other possible causes.

During this procedure, a surgeon will make small incisions in your abdomen, and they will insert a thin tube with a camera and a light on the end of it so that they can see the ovaries.

If the surgeon is able to see the twist in the ovary, they will untwist it and remove any cysts that are present.

Surgery is the only way to diagnose endometriosis, with laparoscopy being one of the most common approaches.

During the laparoscopy procedure, the surgeon will examine the ovaries using a laparoscope, which is a small camera on the end of a thin tube that they insert into your abdomen.

If endometriosis is present, the surgeon may take a sample to send to the laboratory for testing.

Find out more about talking with your doctor about endometriosis.

There are a number of tests that can help with diagnosing ovarian cancer.

Imaging tests take pictures of your ovaries and other parts of your body so that the doctor can see any unusual growths. These tests include:

• ultrasound scans, or ultrasonography
• CT scans
• barium enema X-rays
• MRI scans
• PET scans
• chest X-rays, which can help the doctor see if ovarian cancer has spread to the lungs

Other tests and procedures for ovarian cancer can include:

• laparoscopy
• colonoscopy
• biopsy
• blood tests

Certain factors can increase your risk of developing an enlarged ovary or a condition of which it might be a symptom.

Risk factors for ovarian cysts include:

• receiving fertility treatments
• using tamoxifen
• being in the second trimester of pregnancy
• having hypothyroidism
• smoking

Risk factors for PCOS include:

• having obesity
• having diabetes
• having a family history of PCOS

Having an ovarian cyst is the biggest risk factor for ovarian torsion. This is because a cyst adds weight to the ovary, causing it to become weighted and twist.

Risk factors for endometriosis can include:

• starting menstruating before the age of 11 years
• having a close female relative with endometriosis
• having short menstrual cycles of less than 27 days
• having heavy menstrual periods
• having infertility

Risk factors for ovarian cancer include:

• being postmenopausal or over the age of 40 years
• being overweight or having obesity
• having children later in life
• taking hormone therapy after menopause
• having a family history of ovarian cancer
• receiving fertility treatments
• having had a previous breast cancer diagnosis
• having a family history of a familial cancer syndrome
• smoking, which can increase the risk of mucinous ovarian cancer

Depending on the cause, an enlarged ovary may return to its regular size on its own, particularly if it occurs due to a functional ovarian cyst. However, in some cases, there may be complications if the enlarged ovary or underlying condition is not treated.

Having an ovarian cyst may affect fertility, as it can make it harder for you to conceive.

Undergoing surgery to remove an ovarian cyst may result in infertility. Your surgeon will take care to remove just the cyst, but, in some cases, they may need to remove one or both of the ovaries. If they have to remove both ovaries, you will no longer produce any eggs.

Your surgeon will discuss the procedure with you in detail before you agree to the operation.

Learn more about what to expect after ovary removal surgery here.

If you have PCOS, you may experience complications such as:

• infertility
• miscarriage
• premature birth
• high cholesterol
• high blood pressure
• heart disease
• liver inflammation
• diabetes
• endometrial cancer

Complications of ovarian torsion can be serious. If treatment is not received quickly enough, it may result in:

• the loss of ovarian function
• tissues in the organ dying
• problems with fertility

Ovarian torsion can also cause an infection in the abdominal cavity.

Complications of endometriosis can include:

• fertility problems
• ovarian cysts
• adhesions, which are sticky areas of endometriosis that can join organs together
• bowel problems
• bladder problems
• surgery complications, such as:
  • infected wounds
  • minor bleeding
  • bruising around the wound
  • organ damage
  • severe internal bleeding
  • deep vein thrombosis, which is a blood clot in the leg
  • pulmonary embolism, which is a blood clot in the lungs

You may experience complications following ovarian cancer treatment. Complications can depend on the type of treatment you receive, but they can include:

• infections
• swollen legs
• vaginal bleeding
• abdominal bleeding
• pelvic bleeding
• blood clots

An enlarged ovary can occur as a natural part of the menstrual cycle and is often not a cause for concern. However, in some cases, it may be a symptom of an underlying condition. Conditions that may cause an enlarged ovary include PCOS, ovarian torsion, and ovarian cancer.

A doctor can arrange for imaging tests and scans to examine the ovaries. Performing these procedures, as well as gathering information about other symptoms you are experiencing, can help them reach an accurate diagnosis.

In most cases, the underlying cause of the enlarged ovary is the main focus of the treatment. You will need surgery if the ovary has become twisted.

Contact your doctor if you have any of the symptoms mentioned above or if you notice changes in your menstrual cycle that you cannot explain.