Ovarian cancer is a type of cancer that occurs when cells in the ovaries grow and divide abnormally. It can begin in various ovarian cells or in other surrounding areas, such as the fallopian tubes. Vaginal bleeding can be a sign of ovarian cancer, but it is also a symptom of other common conditions.

People may mistake the symptoms of early onset ovarian cancer for other common conditions, such as constipation. Women have a 1 in 78 chance of developing ovarian cancer in their lifetime.

Detecting signs of ovarian cancer early can help people receive sooner treatment and a better outlook. When discovered early, 93% of individuals live for more than 5 years after their diagnosis.

This article examines the connection between bleeding and ovarian cancer. It also discusses other symptoms, risk factors, protective factors, diagnosis, and when to contact a doctor about suspected ovarian cancer.

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Abnormal bleeding from the vagina can be a sign of ovarian cancer. This may include any kind of unusual vaginal bleeding, such as:

  • bleeding between periods
  • bleeding after intercourse
  • frequent discharge that ranges in color from clear, white, or tinged with blood
  • bleeding after menopause

Changes in a person’s menstrual cycle, including missed periods, irregular periods, or heavier bleeding than usual, can also be signs of ovarian cancer.

But it is important to note that bleeding is not the most common symptom, nor always a sign, of ovarian cancer. Common causes may include:

  • ovulation
  • uterine fibroids or polyps
  • implantation bleeding
  • uterine or endometrial cancer
  • cervical cancer
  • vaginal cancer

The symptoms of ovarian cancer often mimic common issues of less threatening ailments. Understanding the symptoms provides a better chance for early detection.

Here are some other common symptoms of ovarian cancer:

Other less common symptoms can include:

These symptoms can also occur in people who do not have ovarian cancer. Some symptoms may occur due to benign illnesses or other types of cancer. Symptoms of ovarian cancer usually persist and are often more severe.

While many people can still get ovarian cancer without being at high risk for the disease, several factors may increase a person’s chance of having the disease.

Age

The risk of developing ovarian cancer increases as a person ages. It is more common in women over 65 years old and less common in women under 40 years old.

Data from the National Cancer Institute (NCI) reports that women of all races receive a diagnosis of ovarian cancer most frequently between the ages of 55–64 years old. The median age of diagnosis is 63 years old. The NCI data also states that 12% of the new cases are in people under 45 years old.

Obesity and body mass index

According to the International Agency for Research on Cancer, having obesity is a risk factor associated with 13 types of cancer, including ovarian cancer.

A 2015 investigation that looked at 12,390 women with ovarian carcinoma also found that a higher body mass index (BMI) is also associated with poorer outlooks.

Smoking

Smoking is not a strong risk factor of ovarian cancer overall. But a large 2019 review of 37 studies found that smoking has a strong dose–risk relationship with a subtype of ovarian cancer, mucinous ovarian cancer, while being slightly protective for other rare subtypes of ovarian cancer.

Another 2019 review reported that smoking can increase a person’s risk for dying from ovarian cancer. Smoking can also be a subsequent risk factor of delayed surgical wound healing and post-operation or cancer treatment-related complications.

Pregnancy not reaching term

Women who have never carried a child to full term (40 weeks) are at an increased risk for the disease. A 2018 study found that preterm delivery (delivery before 40 weeks) was associated with an increased risk of ovarian cancer. The study suggests that the risk increases as the length of pregnancy decreases.

Using fertility drugs

Results from studies on the relationship between fertility drugs and ovarian cancer remain varied. Some studies have reported an increased risk or incidence, while others have reported no increase. Underlying infertility is a suspected contributing factor.

Recent studies have concluded that women who received fertility treatments but did not conceive were at a higher risk for developing ovarian cancer than women who used fertility drugs and delivered full term.

Family history

Having a mother, sibling, or child with ovarian cancer increases a person’s risk for having the disease, especially non-mucinous tumors. Similarly, a family history of breast cancer, colorectal cancer, and Lynch syndrome also increases the risk of ovarian cancer.

Inherited breast and ovarian cancer syndromes account for 65–75% of ovarian cancers, while Lynch syndrome makes up about 10–15%. Having certain genetic mutations, such as BRCA1 and BRCA2, which are commonly affected genes in hereditary breast and ovarian cancers, also increases a person’s risk.

People with Eastern European or Ashkenazi Jewish ancestry are also at risk for developing hereditary ovarian cancer.

Using hormone therapy

Existing research is undecided about whether hormone therapy is a risk factor of ovarian cancer.

A 2016 study found that using postmenopausal hormone therapies (PHTs) regardless of dose, formulation, route, and progestin type increases a woman’s risk for ovarian cancer. But another study done in 2019 found that combined estrogen-progesterone types do not have the same risk as estrogen-only PHTs.

It is important to note that screening for ovarian cancer is largely dependent upon a person’s categorized risk. Currently, there are no screening recommendations for people who do not have symptoms and are not genetically predisposed for ovarian cancer.

Several tests can screen for and help detect ovarian cancers early in those of higher risk. These include:

  • Pelvic tests. These include a visual and physical examination of the reproductive organs.
  • Transvaginal ultrasound. This involves inserting an ultrasound wand inside the vagina.
  • CA-125 blood test. This checks for a protein that is usually high in people with ovarian cancer.

Once a doctor suspects that a person may have ovarian cancer, they may request imaging tests to look for tumors in the ovaries. For example, ultrasounds are often the first tests that doctors request to examine the ovaries and determine if tumors or cysts are a cause for concern.

A PET scan may also help in looking for tumors in the ovaries and determining whether they are cancerous.

Aside from imaging tests, a doctor may do a biopsy by taking a portion of the tumor and examining it in a lab. Aside from CA-125, other blood tests can help determine the presence of certain cancers, including:

Genetic counseling and testing may benefit people with a moderate to strong family history of ovarian cancer, a known inherited mutation in the family, or a personal history of other gynecological cancers.

Conditions that stop ovulation could help decrease a person’s risk for developing ovarian cancer.

Breastfeeding

A 2019 study found that breastfeeding reduces a woman’s risk for ovarian cancer, with protection persisting for more than 30 years. Other breastfeeding-related factors that increased the protective benefit included the following:

  • longer duration of breastfeeding (3 months and up)
  • more breastfed children
  • earlier age of first breastfeeding

Using contraceptives

Many studies mention that using combined oral contraceptives reduces a person’s risk for having the ovarian cancer. A 2021 study found that extended use can reduce the risk of the disease and offer long-term protection for BRCA1 carriers.

Giving birth

A recent pregnancy may reduce the risk of ovarian cancer by eliminating precancerous cells with the help of pregnancy hormones. A 2018 study found that having five or more pregnancies (high parity) and full-term pregnancies decreases a woman’s risk for ovarian cancer.

In its early stages, ovarian cancer rarely presents with symptoms. The symptoms can often be vague and may be due to other conditions.

If symptoms are unusual for individuals or persist for longer than 2 weeks, a person should consult their doctor.

Ovarian cancer is a common reproductive cancer, with a lifetime mortality risk of 1 in 108. This is largely because it often shows no symptoms or very subtle symptoms, making it harder to detect. This is why diagnosis is more common at later stages.

One common sign of ovarian cancer is unusual vaginal bleeding, among other common, persisting, and nonspecific symptoms. People with recurring symptoms or who are at high risk for developing ovarian cancer should speak with their doctors promptly. Early detection can significantly improve outlook.