A Guide to Ovarian Inflammation: How to Diagnose and Treat This Sneaky Disease

What happens when one or both ovaries become inflamed? What is the best way to diagnose and treat ovarian inflammation? Our in-depth blog post describes the symptoms and consequences of this uncommon, but dangerous condition, and explains what to do if you notice them in yourself.

The ovaries are considered the primary reproductive organs for women, like the testes for men. These two, small, almond-shaped glands are located to the upper right and upper left of the uterus, suspended by ligaments just below the fallopian tubes. The ovaries have two main functions: they produce, store, and release oocytes, or human egg cells, and they produce the sex hormones oestrogen, progesterone, and small amounts of androgens.

More about ovaries and what they do

At birth, a baby girl’s ovaries contain around two million oocytes—all the eggs she will ever produce. Once she reaches puberty, usually between 10 and 15 years of age, that number will have dwindled to around 400 000 immature egg cells. At puberty, the ovaries begin producing differing amounts of hormones over the course of each month creating a menstrual cycle.

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At the mid-point of that cycle—ovulation—one or the other ovary releases an egg (sometimes several eggs) that has been maturing in response to follicle stimulating hormone, or FSH. It goes through the opening of the corresponding fallopian tube where it can travel to the uterus and potentially be fertilized if male sperm are present.

A woman’s reproductive life lasts from puberty to menopause, or an average of 35 to 37 years. Each month, several follicles begin the maturation process but usually only one dominant follicle fully matures to release an egg. The non-dominant follicles shrink and disappear in a process called follicular atresia. Of all the oocytes present at puberty, fewer than 450 have the chance to be fertilized.

Menopause marks the end of a woman’s reproductive life. When you have gone at least 12 months without having a menstrual period, you have officially reached menopause. The transition to this state, or perimenopause, begins anywhere from 4 to 10 years earlier, usually between the ages of 45 and 55. This is the time of hot flashes, sleep problems, irregular periods, and moodiness—all normal symptoms of the body adapting to changes in hormone production.

At menopause there are typically around 1000 eggs remaining in the ovaries. Unlike immature oocytes that are reabsorbed into the body or unfertilized eggs that are expelled with menstrual blood, the eggs that remain after menopause simply shrink and die inside the ovaries as they cease their reproductive functions.

What is ovarian inflammation?

Ovarian inflammation, or oophoritis, is the condition when one or both ovaries become inflamed. This is a rare condition that most often occurs as the result of an infection that has entered the body through some surgical intervention in the pelvic area. If left untreated, ovarian inflammation can spread to other organs and cause serious complications, so it must be treated urgently.

What are the symptoms of inflamed ovaries?

It can be tricky to recognize the symptoms of oophoritis because they are similar to those of many other conditions.

The symptoms of ovarian inflammation include:

• dull pain on one or both sides of the abdomen
  
• lower abdominal discomfort
  
• fever
  
• vaginal discharge
  

Because the condition is so rare, your doctor may suspect the symptoms are being caused by another condition such as pelvic inflammatory disease (PID), a sexually transmitted infection (STI), miscarriage, dysmenorrhea (painful periods), or some other related disorder.

If you experience the symptoms listed above not in relation to your menstrual cycle, it’s important to react quickly and seek medical attention ASAP. An untreated STI or missed miscarriage can lead to ovarian inflammation, and untreated inflammation in the ovaries can potentially spread to other organs and poison the blood.

Causes of ovarian inflammation

Ovarian inflammation rarely happens without some prior infection, injury, or an autoimmune response. Below are the most common reasons for the condition.

Infection

Bacterial or viral infections are the most common cause for oophoritis. If left untreated, STIs such as chlamydia and gonorrhoea can spread to the ovaries and other reproductive organs.

Take care of yourself and your partner by practicing safe sex and getting screened for STIs regularly. Between 45% and 77% of all chlamydia and gonorrhoea cases are asymptomatic—you have been infected but don’t feel any symptoms. Not experiencing symptoms doesn’t mean you aren’t being affected by the disease. An untreated infection can cause complications, and you can be spreading the infection without knowing it.

Autoimmune response

Sometimes the body’s immune system mistakenly attacks healthy cells that, for some reason, it perceives as a threat. If the immune cells target the ovaries, this can lead to oophoritis.

What to expect if you have the symptoms of ovarian inflammation?

If you suspect you are experiencing inflammation in your ovaries, your doctor can perform various tests to confirm the diagnosis so they can prescribe the proper treatment for you. The most likely procedures in this situation include:

• Medical history: Your doctor or gynaecologist will generally begin by asking you about your symptoms, including the nature of the pain or discomfort you’ve been experiencing, where you feel it, and when it started. They will also want to know about your menstrual cycle, sexual activity, any recent illnesses or infections, and other potential risk factors for ovarian inflammation.
  
• Physical examination: A physical examination may involve palpating the abdomen to assess for tenderness or swelling. The doctor may also perform an internal pelvic exam to evaluate the ovaries, uterus, and fallopian tubes.
  
• Pelvic ultrasound: The ultrasound scan is a safe, non-invasive tool that provides diagnostic images of soft tissues in real time. An ultrasound of the ovaries and other reproductive organs can help your doctor identify inflammation and other potential issues such as cysts or abscesses.
  
• Swab test: If you suspect you have an STI, your doctor can perform swab tests to check for specific pathogens such as chlamydia or gonorrhoea bacteria.
  
• Blood tests: A blood test can verify signs of infection and identify the specific virus or bacterium causing the problem. Blood tests are also used to screen for diseases such as HIV, syphilis, hepatitis B and C, and other more common STIs.
  

How is ovarian inflammation treated?

The treatment for ovarian inflammation depends on the root cause of the infection.

Some of the medications your doctor might prescribe include:

• Antibiotics: If the inflammation is caused by a bacterial infection such as chlamydia or gonorrhoea, the main treatment is usually a course of antibiotics. The specific medication will depend on the type of bacteria. Commonly prescribed antibiotics include Zithromax (azithromycin), Vibramycin (doxycycline), and Rocephin (ceftriaxone).
  
• Antiviral medications: If the inflammation is caused by a viral infection, your doctor will prescribe an antiviral drug that combats the particular virus causing the problem.
  
• Immunosuppressive medications: If the inflammation is caused by autoimmune oophoritis, the treatment might include medications that suppress the immune system to help manage the body’s immune response and reduce inflammation.
  

The length of the treatment will depend both on the root cause and on the severity of the inflammation. It may take several weeks to completely clear a bacterial infection, while a viral infection can be eradicated within a few days. The treatment of autoimmune conditions is more complicated because we still don’t know what causes them. While there is no true cure for autoimmune disorders, symptoms can usually be managed successfully with medications and small lifestyle adjustments.

Stay hydrated and get plenty of rest while you are healing. Applying a warm compress or hot water bottle to the abdomen can help you manage the discomfort. Your doctor may also recommend supportive care or over-the-counter pain relievers to help you through.

Related questions

Is ovarian inflammation the same as PID?

Pelvic inflammatory disease is an inflammation of one or more of the organs in the pelvic region. PID can affect the uterus, the ovaries, the cervix, and the fallopian tubes. While ovarian inflammation can be an aspect of pelvic inflammatory disease, on its own it is known as oophoritis.

Can ovaries die from ovarian inflammation?

While lack of oxygen to the cells is not the first thing we tend to associate with inflammation, the two are connected. Inflamed tissues have been shown to have lower than normal oxygen levels, and hypoxia can cause inflammation. All organs need oxygen to function. How long an organ can survive without oxygen depends on the organ. Even so, a person suffering from oophoritis can recover fully if treated in a timely manner.

What is ovarian torsion?

Ovarian torsion, however, is a different matter. Ovarian torsion happens when the ligament suspending the ovary twists around on itself—often due to an imbalance caused by an ovarian cyst. The twisted ligament squeezes off the blood vessels providing blood and oxygen to the ovary. When this happens, it is considered a surgical emergency. The problem must be corrected immediately, and if the ovary is damaged beyond repair, an oophorectomy will be performed to remove it.

Ovarian torsion is a very rare condition that cannot be confused with inflammation. The pain comes on suddenly and quickly becomes unbearable.

Final words

Ovarian inflammation is a serious condition that won’t resolve on its own and can cause serious complications if left untreated. If you experience a dull pain in your abdomen—unrelated to your menstrual cycle—that persists for more than a day or two along with discomfort and/or fever, seek medical attention.

Even if it turns out not to be ovarian inflammation, it might be a symptom of an STI, which can lead to inflammation in your pelvic organs. Err on the side of caution and keep yourself safe.

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