Ovarian Cancer Symptoms: Early Signs, Stages and When to Get Checked
Medically reviewed by Mr Amer Raza MBBS MRCOG, GMC 5205372 | Last reviewed: 17 August 2026
The main symptoms of ovarian cancer are persistent bloating, pain in your tummy or the area between your hips, feeling full quickly or losing your appetite, and needing to pass urine more often or more urgently. What matters is not the symptom itself but the pattern. The NHS advises that these symptoms are worth investigating when they happen 12 or more times a month, do not settle, and are new for you. Most women with these symptoms do not have ovarian cancer. They are far more often caused by irritable bowel syndrome, ovarian cysts, fibroids or hormonal change. The reason to get them checked is that ovarian cancer is easiest to treat when it is found early.
Key Facts: Ovarian cancer symptoms are persistent rather than dramatic. Bloating, tummy pain, feeling full quickly and needing to pass urine often are the four to know. Frequency is the signal: 12 or more times a month, and new for you. Around 7,700 women are diagnosed in the UK each year.
“The women I see in clinic almost never describe a dramatic symptom. They describe trousers that stopped fitting over about six weeks, or feeling full after half a meal when they used to finish it. That is the pattern I take seriously. A pelvic ultrasound and a CA125 blood test together can usually give a clear answer within days, and in most cases that answer is reassuring.”
Mr Amer Raza, Consultant Gynaecologist and Robotic Surgeon, Ovara Health
What Are the Main Symptoms of Ovarian Cancer?
The NHS lists four main symptoms of ovarian cancer. They are worth knowing precisely, because they are easy to explain away individually.
A swollen tummy or persistent bloating. This is the symptom women notice most often. It is not the bloating that comes and goes with your cycle or after a large meal. It is bloating that is there most days and does not settle overnight. Many women first notice it because clothes that fitted a month ago now feel tight around the waist.
Pain or tenderness in your tummy or the area between your hips. This is usually a dull ache rather than a sharp pain. It can sit low in the abdomen or feel more like pelvic pressure. Women frequently describe it as a heaviness rather than pain.
Losing your appetite or feeling full quickly. Doctors call this early satiety. You sit down hungry, eat a third of your usual portion and cannot manage any more. Over weeks this can lead to weight loss without dieting.
Needing to pass urine more often or more urgently. An ovarian mass sits close to the bladder and can press on it. If you are suddenly planning journeys around toilets and you have no signs of a urine infection, that is worth mentioning.
The NHS also lists indigestion, constipation or diarrhoea, back pain, fatigue, unexplained weight loss and vaginal bleeding that is unusual for you.
What Are the Early Warning Signs of Ovarian Cancer?
There is no single early warning sign. The early signs are the same four symptoms above, and what makes them significant is how they behave rather than how severe they are. Three questions separate symptoms worth investigating from everyday digestive upset.
Are they persistent? Ovarian cancer symptoms tend to be there most days rather than flaring and settling. The NHS uses 12 or more times a month as the threshold worth acting on.
Are they new? If you have had irritable bowel syndrome since your twenties, bloating is your normal. If bloating started three months ago and you are 55, that is a change, and change is what matters.
Are they progressing? Symptoms that are slowly getting worse over weeks carry more weight than symptoms that have stayed the same for years.
A useful habit is to keep a simple symptom diary for three or four weeks. Note the date and what you felt. Bringing that to an appointment turns a vague account into evidence, and it makes the decision to scan much easier.
Bloating or pelvic pain that will not settle? You do not need a GP referral to be seen at Ovara Health. Call us on 0207 751 4488 or request a callback for a prompt private assessment in Chelsea, usually with a scan and blood test at the same visit.
Why Is Ovarian Cancer So Often Diagnosed Late?
Ovarian cancer has a reputation as a silent disease. That is not quite accurate. It does produce symptoms, and it produces them earlier than most people assume. The difficulty is that the symptoms are ordinary.
Bloating, indigestion and needing the toilet more often are among the most common complaints in general practice, and the overwhelming majority are caused by something benign. Both patients and clinicians can reasonably attribute them to diet, stress, perimenopause or irritable bowel syndrome. Weeks pass, then months.
The ovaries also sit deep in the pelvis with room around them, so a tumour can grow to a reasonable size before it presses on anything enough to cause obvious pain. There is no national screening programme for ovarian cancer in the UK, unlike cervical and breast cancer, so there is no routine test that would pick it up incidentally.
This is why symptom awareness does real work. The combination of a pelvic ultrasound and a CA125 blood test is quick, widely available and good at telling you whether further investigation is needed.
What Are the Symptoms of Stage 1 Ovarian Cancer?
At stage 1 the cancer is contained within one or both ovaries and has not spread beyond them. Symptoms at this stage are mild, intermittent and easy to dismiss. Some women have none at all, and the cancer is found incidentally on a scan arranged for another reason.
When symptoms are present they are usually mild bloating, occasional pelvic discomfort on one side, or a subtle change in how quickly you feel full. Periods may become irregular. Because there is often nothing alarming to report, stage 1 is the stage most likely to be missed, and it is also the stage at which treatment is most straightforward.
What Are the Symptoms of Stage 2 Ovarian Cancer?
At stage 2 the cancer has spread from the ovary into nearby pelvic structures such as the fallopian tubes, uterus, bladder or bowel. Symptoms become more consistent and harder to explain away.
Pelvic pain is more regular. Bloating is present most days rather than some days. Bowel habit often changes, with constipation or looser stools than usual. Urinary urgency becomes more noticeable as the mass presses on the bladder. Some women notice pain or discomfort during sex, and some have vaginal bleeding that is not part of their normal pattern.
What Are the Symptoms of Stage 3 Ovarian Cancer?
Stage 3 means the cancer has spread beyond the pelvis into the abdomen, or to the lymph nodes at the back of the abdomen. This is the stage at which ovarian cancer is most commonly diagnosed, because this is usually when symptoms become impossible to ignore.
Abdominal swelling is often marked, and is frequently caused by ascites, which is fluid collecting in the abdomen. Women describe looking several months pregnant. Feeling full after very little food becomes pronounced, and unintentional weight loss can happen alongside a swollen abdomen, which is a combination worth taking seriously. Fatigue is common, nausea may appear, and bowel symptoms can become more marked.
What Are the Symptoms of Stage 4 Ovarian Cancer?
Stage 4 means the cancer has spread to distant organs such as the liver, the lungs or beyond the abdomen. All of the earlier symptoms may be present and more severe.
Breathlessness can develop if fluid collects around the lungs, which is called a pleural effusion. Significant unintentional weight loss and muscle loss are common. Pain may be more constant and may need regular medication. Persistent nausea and vomiting can occur if the bowel becomes obstructed.
It is important to say that stage 4 is still treatable. Treatment at this stage focuses on controlling the disease, relieving symptoms and maintaining quality of life, and many women live well for a considerable time with the right treatment plan.
Ovarian cancer stages at a glance
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Can Ovarian Cancer Cause Back Pain?
Yes, although back pain on its own is very unlikely to be ovarian cancer. Back pain is one of the most common complaints there is, and musculoskeletal causes account for the overwhelming majority.
Ovarian cancer can cause back pain in two ways. An enlarging ovarian mass can press on nerves or structures at the back of the pelvis, producing a persistent low back ache. Fluid building up in the abdomen can also change posture and load the lower back.
The pattern that matters is back pain that appears alongside bloating, appetite change or urinary symptoms, rather than back pain in isolation. Ovarian back pain also tends not to behave like mechanical back pain. It does not usually improve with rest or worsen with a specific movement, and it often does not respond well to standard painkillers.
Can Ovarian Cancer Cause Hot Flushes?
Hot flushes are not a typical symptom of ovarian cancer, and on their own they point far more strongly towards perimenopause or menopause. There are two indirect connections worth understanding.
Some less common ovarian tumours are hormone producing, and these can disrupt the normal hormonal pattern and cause symptoms including flushing, irregular bleeding or bleeding after menopause. Separately, treatment for ovarian cancer that involves removing both ovaries causes immediate surgical menopause, and hot flushes after that surgery are expected rather than a sign of the cancer itself.
If you are having hot flushes with bloating, pelvic pain or bleeding that is unusual for you, that combination deserves assessment. If you are having hot flushes, night sweats and irregular periods in your forties or fifties, perimenopause is much the more likely explanation. You can read more on our menopause service page.
At What Age Is Ovarian Cancer Most Common?
Ovarian cancer becomes more common with age. Cancer Research UK reports that incidence rates in the UK are highest in women aged 80 to 84, with around 9% of all new cases diagnosed in that age group. Most diagnoses occur after the menopause.
That said, ovarian cancer does occur in younger women, and certain types are more common before 40, including germ cell tumours. Age is a risk factor, not a rule. Persistent symptoms in a woman of 35 deserve the same investigation as persistent symptoms in a woman of 65.
Cancer Research UK also reports that survival varies considerably with age at diagnosis, with 82.9% of women diagnosed aged 15 to 44 surviving ten years or more, compared with 14.8% of those diagnosed aged 75 to 99.
What Increases Your Risk of Ovarian Cancer?
Most women who develop ovarian cancer have no identifiable risk factor beyond age. Having a risk factor does not mean you will develop it, and having none does not mean you cannot.
- Age. Risk rises after the menopause.
- Family history. A close relative with ovarian or breast cancer raises risk, particularly where there is a known BRCA1 or BRCA2 gene change, or Lynch syndrome.
- Never having been pregnant. Pregnancy and breastfeeding both appear to lower risk.
- Endometriosis. Associated with a modestly increased risk of certain ovarian cancer types.
- Hormone replacement therapy. Long term use is associated with a small increase in risk, which needs weighing against the benefits with your doctor.
- Being overweight. Associated with a small increase in risk.
Factors associated with lower risk include having used the combined contraceptive pill, having had children, and breastfeeding.
How Is Ovarian Cancer Diagnosed?
Assessment usually involves three things, and they are often done together.
Examination. An abdominal and internal pelvic examination to check for a mass, tenderness or fluid.
Pelvic ultrasound. Usually transvaginal, which gives a much clearer view of the ovaries than an abdominal scan alone. It shows the size of the ovaries, whether there is a cyst or a solid mass, the character of that mass and whether there is free fluid. Our pelvic ultrasound service covers what to expect.
CA125 blood test. CA125 is a protein that can be raised in ovarian cancer. It is useful but it is not a cancer test in isolation. It can be raised by endometriosis, fibroids, pelvic infection, pregnancy and even menstruation, and it can be normal in some women who do have ovarian cancer. It is interpreted alongside the scan, not on its own.
If those results raise concern, the next steps are usually a CT scan to assess spread, referral to a specialist gynaecological oncology team, and in some cases a biopsy or surgery to confirm the diagnosis and stage it accurately.
How Is Ovarian Cancer Treated?
Treatment depends on the type of cancer, the stage and your general health, and it is planned by a specialist multidisciplinary team.
Surgery. Usually the main treatment. This can range from removing the affected ovary in early disease where fertility matters, through to removing both ovaries, the fallopian tubes, the uterus and the omentum. The aim is to remove all visible disease.
Chemotherapy. Often given after surgery to treat any remaining cells, and sometimes before surgery to shrink the cancer first, which is called neoadjuvant chemotherapy. Platinum based drugs are the usual foundation of treatment.
Targeted treatments. Drugs such as PARP inhibitors are used in some women, particularly those with BRCA gene changes, to reduce the chance of the cancer coming back.
When Should You See a Doctor?
See a doctor if the four main symptoms are persistent, new for you and happening 12 or more times a month. You do not need to wait until you are certain something is wrong. Investigating and finding nothing is a good outcome, not a wasted appointment.
You should also seek assessment for any bleeding after the menopause, any new bleeding between periods or after sex, and any abdominal swelling that is getting worse.
Seek urgent medical help by calling 999 or going to A&E if you have severe abdominal pain that comes on suddenly, are vomiting and unable to keep fluids down, have a swollen abdomen with a high temperature, or become breathless at rest. These need same day assessment.
How Quickly Can You Be Seen at Ovara Health?
You do not need a GP referral to be seen at Ovara Health. Our Chelsea clinic offers consultant led assessment, and in most cases a pelvic ultrasound and CA125 blood test can be arranged at the same visit, so you leave with answers rather than another appointment to wait for.
You are seen by a consultant gynaecologist, not a nurse or a trainee. If the results are reassuring, we will explain what is causing your symptoms and what to do about them. If they are not, we will arrange onward specialist care quickly.
Frequently Asked Questions About Ovarian Cancer Symptoms
What are the first signs of ovarian cancer?
The first signs are usually persistent bloating, pain in the tummy or pelvis, feeling full quickly when eating, and needing to pass urine more often or more urgently. They are typically mild at first and are often mistaken for irritable bowel syndrome or normal digestive upset. What makes them significant is that they are persistent, new for you and happening 12 or more times a month.
How long can you have ovarian cancer without knowing?
Ovarian cancer can be present for months before it is diagnosed, because early symptoms are mild and easy to attribute to something else. Many women look back and recognise symptoms that were present for three to six months before diagnosis. This is why persistent symptoms should be investigated rather than monitored indefinitely at home.
Can a blood test detect ovarian cancer?
The CA125 blood test can support a diagnosis but it cannot confirm or rule out ovarian cancer on its own. CA125 can be raised by endometriosis, fibroids, pelvic infection, pregnancy and menstruation, and it can be normal in some women who do have ovarian cancer. It is always interpreted alongside a pelvic ultrasound and a clinical examination.
Does ovarian cancer show on an ultrasound?
A pelvic ultrasound, particularly a transvaginal scan, is very good at showing the ovaries and identifying cysts, solid masses and free fluid in the pelvis. It can show features that suggest a mass is suspicious, such as solid areas or increased blood flow. It cannot confirm cancer by itself, but it is the single most useful first test.
Is bloating always a sign of ovarian cancer?
No. Bloating is extremely common and is far more often caused by irritable bowel syndrome, diet, constipation, ovarian cysts, fibroids or hormonal change. Bloating linked to ovarian cancer tends to be persistent rather than fluctuating, does not settle overnight, and is often accompanied by feeling full quickly or urinary changes.
Can you have ovarian cancer with normal periods?
Yes. Many women with ovarian cancer have entirely normal periods, and many are past the menopause so have no periods at all. Menstrual changes are not a reliable indicator either way, which is why the four main symptoms matter more than what your cycle is doing.
What does ovarian cancer pain feel like?
It is usually described as a dull ache, pressure or heaviness low in the abdomen or pelvis rather than a sharp pain. It tends to be persistent rather than coming in waves, and it often does not respond well to ordinary painkillers or change with movement or rest.
Is ovarian cancer hereditary?
Most cases are not inherited, but around one in five is linked to an inherited gene change, most commonly BRCA1 or BRCA2. Lynch syndrome also raises risk. If you have a close relative with ovarian or breast cancer, particularly diagnosed young, genetic counselling and testing may be appropriate.
Can young women get ovarian cancer?
Yes, although it is much less common. Certain types, including germ cell tumours, are more common in women under 40. Cancer Research UK reports that 82.9% of women diagnosed between 15 and 44 survive ten years or more. Persistent symptoms in a younger woman should be investigated in the same way.
Is there a screening test for ovarian cancer in the UK?
There is no national screening programme for ovarian cancer in the UK, unlike cervical and breast cancer. Large trials have not shown that routine screening of women at average risk reduces deaths. Women at high risk because of a known gene change may be offered surveillance through a specialist genetics service.
How many women are diagnosed with ovarian cancer in the UK each year?
Cancer Research UK reports around 7,700 new ovarian cancer cases in the UK every year, which is about 21 a day. It is the sixth most common cancer in females in the UK and accounts for around 4% of all new female cancer cases.
Can ovarian cysts turn into ovarian cancer?
The vast majority of ovarian cysts are benign and never become cancerous, particularly simple fluid filled cysts in women before the menopause. A small number of complex cysts, especially after the menopause, need closer monitoring or removal. This is why the character of a cyst on ultrasound matters as much as its size. You can read more about ovarian cysts and how they are managed.
Does ovarian cancer cause weight gain or weight loss?
It can cause both, sometimes at once. Fluid collecting in the abdomen can make the abdomen swell and the scales go up, while at the same time reduced appetite and early fullness cause loss of muscle and fat. A swollen abdomen combined with unintentional weight loss elsewhere is a combination worth reporting promptly.
How quickly does ovarian cancer progress?
It varies considerably by type. Some high grade tumours can progress over months, while some low grade tumours grow very slowly over years. Because the rate cannot be predicted from symptoms alone, persistent symptoms should be assessed within weeks rather than watched over many months.
Sources
- NHS. Ovarian cancer symptoms. nhs.uk
- Cancer Research UK. Ovarian cancer statistics. cancerresearchuk.org
- NICE. Suspected cancer: recognition and referral, NG12. nice.org.uk
- Royal College of Obstetricians and Gynaecologists. Ovarian cysts and ovarian cancer patient information. rcog.org.uk
This article is for general information and does not replace individual medical advice. Symptoms described here have many possible causes, most of them not cancer. If you are concerned about your symptoms, please speak to a doctor. If you need urgent help, contact your GP, call 111, or call 999 in an emergency.
Speak to a Consultant Gynaecologist in Chelsea
If you have persistent bloating, pelvic pain or a change in appetite that is not settling, a same visit scan and blood test can usually give you a clear answer quickly. No GP referral is needed.