Left-Side Ovary Pain After Menopause: What It Could Mean and When to Seek Care
If you’ve gone through menopause and start experiencing pain or pressure on the left side of your lower abdomen or pelvis, you may immediately wonder: Could this be my ovary?
It’s a reasonable question. Although the ovaries are much less active after menopause, they don’t disappear. And while pelvic pain can have many causes, new or persistent pain after menopause deserves attention.
The good news is that pelvic pain is not automatically a sign of something serious. Muscles, nerves, the bladder, bowel, and reproductive organs can all contribute to pain in the pelvis. Understanding the possible causes can help you know when it’s time to check in with your healthcare provider.
What Do the Ovaries Do After Menopause?
Menopause marks the end of ovulation and menstrual periods, but the ovaries remain in the body.
After menopause, the ovaries dramatically decrease their production of estrogen and progesterone. They also become smaller over time. However, they can still be involved in conditions that cause pelvic discomfort, including ovarian cysts and other ovarian or pelvic masses.
It’s also important to remember that pain you feel near your ovary doesn’t necessarily mean the ovary is the source of the pain.
The pelvis contains many structures in a very small space. The bladder, bowel, uterus, pelvic floor muscles, hip muscles, connective tissue, and nerves can all create pain that feels like it is coming from the ovary.
Common Causes of Left-Side Pelvic Pain
Ovarian cysts
Ovarian cysts are fluid-filled sacs that develop on or within an ovary. While many cysts are benign, the approach to an ovarian cyst after menopause is different than it may be before menopause.
Some cysts cause no symptoms at all, while others can cause pelvic pressure, aching, or sharper pain on one side.
If your healthcare provider suspects an ovarian cause, they may recommend imaging to evaluate the ovary and determine whether a cyst is present.
Pelvic floor muscle tension
One of the most overlooked causes of pelvic pain after menopause is the pelvic floor.
Your pelvic floor is a group of muscles that supports the bladder, bowel, and reproductive organs. These muscles can become overactive or develop areas of tension and tenderness.
Pelvic floor muscle tension can cause pain that feels deep in the pelvis and may be felt more strongly on one side. You may also notice pain with intercourse, sitting, bowel movements, urination, or certain movements and activities.
Importantly, pelvic floor dysfunction can occur even when there is no obvious pelvic floor injury.
Genitourinary syndrome of menopause (GSM)
The decrease in estrogen after menopause can affect the tissues of the vagina, vulva, bladder, and urethra. This is known as genitourinary syndrome of menopause, or GSM.
GSM can contribute to vaginal dryness, burning, urinary symptoms, painful intercourse, and pelvic discomfort.
While GSM doesn't specifically cause "left ovary pain," discomfort from the pelvic tissues can sometimes be perceived as deeper pelvic or abdominal pain.
Gastrointestinal causes
The bowel sits directly next to the reproductive organs, which means gastrointestinal issues can sometimes feel surprisingly similar to ovarian pain.
Constipation, gas, diverticular disease, irritable bowel syndrome, and other gastrointestinal conditions can cause pain in the lower left abdomen or pelvis.
If your pain changes with bowel movements or is accompanied by bloating, constipation, diarrhea, or changes in your stool, your digestive system may be contributing.
Bladder and urinary causes
Urinary tract infections, bladder irritation, and other urinary conditions can cause pelvic pressure or pain.
Some people also experience bladder pain or urinary urgency as part of pelvic floor dysfunction or GSM.
Musculoskeletal pain
Your pelvis is connected to your hips, low back, abdomen, and pelvic floor. Pain from the hip or low back can sometimes be felt in the groin or lower abdomen and may be mistaken for pain from an internal pelvic organ.
This is one reason a comprehensive evaluation is important. Not all pelvic pain is coming from a pelvic organ.
Endometriosis
Although endometriosis is often associated with the reproductive years, symptoms don't necessarily disappear immediately with menopause. In some people, endometriosis-related pain can persist after menopause.
If you have a history of endometriosis and develop new or persistent pelvic pain after menopause, discuss it with your healthcare provider.
When Is Pain Normal vs. When Should You Worry?
There isn't one specific type of pelvic pain that can tell you whether the cause is harmless or serious.
However, new pelvic or abdominal pain after menopause should not simply be ignored, particularly if it persists, worsens, or is accompanied by other symptoms.
Contact your healthcare provider if you experience:
New or persistent pelvic or abdominal pain
Pain that is progressively worsening
Persistent bloating or abdominal swelling
Feeling full quickly when eating
Unexplained weight loss
Changes in bowel or bladder habits
A pelvic or abdominal mass or fullness
Vaginal bleeding after menopause
Seek urgent medical attention for sudden, severe pelvic or abdominal pain, particularly if it is accompanied by vomiting, fever, dizziness, fainting, or significant weakness.
The goal isn't to assume the worst. It's to make sure that persistent or unexplained symptoms are properly evaluated.
Tests and Exams Your Doctor May Order
If you're experiencing new left-sided pelvic pain after menopause, your healthcare provider will likely start with a detailed history and physical or pelvic examination.
Depending on your symptoms, they may recommend:
Pelvic ultrasound:
An ultrasound can evaluate the uterus and ovaries and look for cysts, masses, or other structural changes. A transvaginal ultrasound is commonly used when a closer look at the pelvic organs is needed.
Blood tests:
Depending on the situation, your provider may order bloodwork to look for signs of infection, inflammation, or other concerns. Certain tumor-marker tests may also be considered in the evaluation of an ovarian mass, although these tests cannot diagnose ovarian cancer by themselves.
Additional imaging:
A CT scan or MRI may be recommended if your provider needs more information about the pelvis, abdomen, bowel, or other structures.
Pelvic floor evaluation:
If your symptoms suggest a musculoskeletal or pelvic floor component, a pelvic floor physical therapist can evaluate the muscles, connective tissues, movement patterns, and other factors that may be contributing to your pain.
Treatment Options Based on the Cause
Treatment depends entirely on what's causing the pain.
An ovarian cyst or other ovarian finding may require monitoring, medication, or additional treatment depending on its size, appearance, symptoms, and other factors.
If GSM is contributing to your symptoms, treatment may include vaginal moisturizers, lubricants, pelvic floor therapy, or locally applied vaginal estrogen or other therapies when appropriate.
If pelvic floor muscle tension is contributing, pelvic floor physical therapy can be an important part of treatment.Treatment may include hands-on techniques, breathing and relaxation strategies, mobility work, nervous system regulation, and education about how the pelvic floor interacts with the rest of the body.
If the pain is related to the bowel, bladder, hip, or low back, treatment will be directed toward that specific source.
And sometimes, there isn't just one cause.
For example, someone may have GSM-related tissue changes and pelvic floor muscle tension. Addressing both can be much more effective than focusing on only one piece of the puzzle.
Don't Assume Your Ovary Is the Problem
One of the most important things to remember about pelvic pain is that where you feel pain isn't always where the pain is coming from.
Pain on the left side of your pelvis may be related to the ovary—but it could also be coming from your pelvic floor, bladder, bowel, hip, low back, or surrounding connective tissues.
That's why persistent or new pelvic pain deserves a thorough evaluation rather than trying to diagnose the source based on location alone.
Where to Find Menopause-Specific Pelvic Floor Therapy for Ovary Pain in Thousand Oaks
If your healthcare provider has ruled out concerning gynecologic or abdominal causes and you're still experiencing pelvic pain, a pelvic floor physical therapist can help determine whether the muscles and surrounding tissues are contributing to your symptoms.
At Cappuccino Physical Therapy, we take a whole-body approach to pelvic health. We evaluate not only the pelvic floor, but also how the hips, abdomen, low back, breathing, movement, and nervous system may be contributing to your symptoms.
You don't have to live with pelvic pain simply because you've gone through menopause.
If you're experiencing persistent pelvic pain, pressure, or discomfort, schedule an evaluation with your healthcare provider. And if a pelvic floor component is suspected, we'd love to help you understand what's happening and create a plan to get you feeling better.
You deserve care that takes your symptoms seriously. And relief is more possible than you might think. At Cappuccino Physical Therapy, we work with women in perimenopause/menopause all the time and can help you get rid of your pain and back to your daily life.
Give us a call today.
