Signs and Symptoms of Ovarian Cancer

Ovarian cancer is characterized as the growth of malignant (cancerous) cells that form in or around the ovaries (the glands where the eggs—or ovas—form in the body and the hormones estrogen and progesterone are made) in people assigned female at birth. Common symptoms of ovarian cancer include abdominal discomfort, bloating, feeling full quickly, constipation, and frequent urination. 

In the past, ovarian cancer was called a “silent killer” because it was believed that symptoms only develop once the disease has reached an advanced stage. But research shows that nearly 90% of people with ovarian cancer experience symptoms, even in the early stages. 

Early signs and symptoms of ovarian cancer are vague and often mistakenly attributed to other causes. As a result, many people are diagnosed with the disease after it has metastasized (spread) to other areas of the body. Being aware of ovarian cancer symptoms can help improve your chances of getting an early diagnosis when the disease is easier to treat.

Common Symptoms

Ovarian cancer symptoms are often subtle and many people brush them off as symptoms of more common conditions, like digestive issues or premenstrual syndrome (PMS). Symptoms of ovarian cancer range in severity, though they tend to be mild in earlier stages and worsen as the disease progresses.

Common symptoms of ovarian cancer include: 

• Abdominal discomfort
• Abnormal vaginal discharge
• Bloating
• Constipation
• Feeling full quickly when eating and/or reduced appetite
• Frequent urination
• Post-menopausal vaginal bleeding
• Pressure or pain in the pelvis

Stage 1 Ovarian Cancer Symptoms 

Stage 1 ovarian cancer is confined to the ovaries or fallopian tubes (the tube that allows the egg to move from the ovaries to the uterus) and has not spread. Although some people with early-stage ovarian cancer do not notice symptoms, almost 88% of people diagnosed with stage 1 ovarian cancer report experiencing mild symptoms.

The most common symptoms of stage 1 ovarian cancer include: 

• Abdominal discomfort 
• Bloating 
• Frequent urination 
• Loss of appetite or feeling full quickly 
• Pelvic pressure or pain

Stage 2 Ovarian Cancer Symptoms

Stage 2 ovarian cancer means cancer has spread from the ovaries or fallopian tubes into other areas in the pelvis, such as the uterus or bladder. Symptoms of stage 2 ovarian cancer are similar to stage 1:

• Abdominal pain or discomfort
• Bloating
• Changes in urinary frequency and urgency
• Loss of appetite or feeling full quickly
• Pelvic pressure or pain

Stage 3 Ovarian Cancer Symptoms

Stage 3 ovarian cancer means cancer has spread from the ovaries and fallopian tubes into other areas of the abdomen and pelvis, like abdominal lymph nodes. Along with symptoms common in earlier stages, symptoms of stage 3 ovarian cancer also include:

• Back pain
• Changes to vaginal discharge or abnormal bleeding
• Constipation
• Fatigue
• Fluid in the abdomen (ascites)
• Pain during sex
• Unexplained weight loss
• Post-menopausal vaginal bleeding

Stage 4 Ovarian Cancer Symptoms

Stage 4 ovarian cancer is when cancer has spread outside of the abdomen and pelvis to more distant parts of the body, like the liver or lungs.

People with advanced-stage ovarian cancer experience many disease- and treatment-related symptoms, including:

• Abdominal and/or back pain
• Anemia
• Difficulty urinating or passing bowel movements
• Fatigue
• Fluid in abdomen (ascites)
• Heavy or irregular periods or abnormal vaginal bleeding
• Nausea
• Shortness of breath
• Significant loss of appetite
• Vomiting
• Weight loss

Symptoms by Tumor Type

There are many types of ovarian cancer, which are classified based on which type of cell the cancer starts from. The three most common ovarian cancer types include:

• Epithelial tumors develop from cells on the surface of the ovary.
• Germ cell tumors develop from the reproductive cells that form eggs (ova).
• Stromal cell tumors develop from the cells that make up ovarian structural connective tissues.

Though symptoms are similar across all ovarian cancer types, germ cell and stromal cell tumors release hormones that can cause additional symptoms, such as:

• Early puberty (in young people)
• Excessive growth of body hair on the face, chest, and back
• Enlarged breasts
• Hyperthyroidism (overactive thyroid)

When to See a Healthcare Professional

Many early symptoms of ovarian cancer can be caused by less serious medical conditions, so it can be difficult to know when to see your healthcare provider about what you are experiencing. A good rule of thumb to follow is to see your healthcare provider if your symptoms are:

• New to you and different from your “normal”
• Persistent
• Frequent (you feel them more than 12 times a month)

The earlier ovarian cancer is detected, the easier it is to treat. You know your body best, so if something feels “off,” it’s better to get evaluated by your healthcare provider than to wait and wonder.