Ovarian Cancer: The Symptoms That Get Dismissed

TL;DR: The main symptoms of ovarian cancer are bloating or a swollen tummy, feeling full quickly or losing your appetite, pain in your tummy or pelvis, and needing to pee more urgently or more often. They are usually caused by something else, but if they happen most days, roughly 12 or more times a month, see a doctor and ask about a CA125 blood test and an ultrasound. There is no screening programme, so knowing the signs and your family history is your best protection.

You have probably been told it is your diet. Or stress. Or "just your period". A swollen tummy that will not settle, feeling stuffed after a few spoons of jollof, needing the toilet every hour on the bus home. These are some of the most ordinary feelings in the world, and that is exactly the problem. The symptoms of ovarian cancer look like everyday digestive and bladder niggles, so they are easy for you to dismiss, and easy for others to dismiss too. This post is about learning the pattern that matters, so you know when to push for a test.

What are the main symptoms of ovarian cancer?

The NHS lists four main symptoms: a swollen tummy or feeling bloated, pain or tenderness in your tummy or the area between your hips, no appetite or feeling full quickly after eating, and an urgent need to pee or needing to pee more often. The key detail is frequency. The NHS says these are symptoms that happen roughly 12 or more times a month.

There are other possible signs too. The NHS also mentions indigestion, constipation or diarrhoea, back pain, tiredness, losing weight without trying, and unusual vaginal bleeding. On their own, any one of these is far more likely to be something common. What should make you pay attention is when they are new for you, persistent, and do not go away.

Why these symptoms get dismissed

Bloating is something almost every woman knows. It comes before periods, after a heavy meal, with constipation, with stress, with IBS. Our post on gut health, your cycle and IBS explains why your gut and hormones are so tied together. So when bloating becomes constant, it is natural to file it under "normal for me".

Clinical guidance in the UK tries to guard against exactly this. The NICE guideline on suspected cancer tells GPs to carry out tests if a woman reports persistent abdominal bloating, feeling full or loss of appetite, pelvic or abdominal pain, or increased urinary urgency or frequency, particularly more than 12 times per month, especially if she is 50 or over. It also says that if you are 50 or over and develop symptoms that suggest IBS for the first time, you should be tested for ovarian cancer, because IBS rarely presents for the first time at this age.

That second point matters. If you are in your fifties and someone tells you your new bloating is "just IBS", it is fair to ask whether ovarian cancer has been ruled out first.

How often is "often enough" to see a doctor?

If bloating, fullness, pelvic pain or urinary changes are happening on most days, or about 12 or more times a month, book an appointment. Keep a simple note of which days you notice them for two or three weeks. That record turns "I feel bloated a lot" into something a clinician can act on.

The NHS also says to go back to your GP if you have been before and your symptoms have not gone away, are worse or more frequent. Being reassured once does not mean you cannot return.

What tests will a doctor do?

You will usually have a blood test and a scan if a GP thinks you may have ovarian cancer. The blood test measures CA125, a protein that can be raised in ovarian cancer. The scan is an ultrasound, either over your tummy or using a small probe inside the vagina, which the NHS describes as a transvaginal scan.

The NICE guidance on how this works was updated in 2026, and age now shapes the pathway:

• Aged 40 or over: your GP should measure CA125, and arrange an urgent ultrasound of the abdomen and pelvis if the result is at or above an age-based threshold. For women aged 40 to 49, that threshold is 35 IU/ml, and it is lower for some older age groups.
• Aged 39 or under: NICE says CA125 should not be used on its own to make decisions, because it is not an accurate indicator of ovarian cancer risk in this age group. Instead, it advises considering an urgent direct ultrasound scan.
• If a doctor feels a mass or fluid in your tummy: NICE recommends a suspected cancer referral straight away.

CA125 is not a perfect test. Cancer Research UK notes that some women with ovarian cancer have a normal level, and conditions such as endometriosis, fibroids, pelvic inflammatory disease and pregnancy can raise it, which is why it is paired with a scan rather than used alone. If the tests suggest cancer, the NHS says the GP should refer you to a gynaecological cancer specialist, and specialists may then arrange a CT scan or a biopsy.

If you are outside the UK, in Lagos, Nairobi or Accra, these same two tests are the ones to ask about. Naming your symptoms and how often they happen helps a clinician decide which tests you need and how quickly.

Is this the same as an ovarian cyst?

Not usually. Ovarian cysts are very common, and the RCOG says almost all cysts found before the menopause are benign. Many cysts cause no symptoms at all and go away by themselves. After menopause, a cyst is watched more closely, and the RCOG guideline recommends a CA125 test alongside the scan. Our guide to ovarian cysts walks through the types and when they need treatment.

Who is at higher risk?

Risk rises with age. The NHS says most cases in the UK are in women over 50. It also lists inherited faulty genes, such as BRCA genes or those linked to Lynch syndrome, along with endometriosis, diabetes, HRT and smoking as things that can raise your risk.

Family history deserves its own moment. The US National Cancer Institute estimates that about 1.1% of women in the general population will develop ovarian cancer, compared with about 39% to 58% of women who inherit a harmful BRCA1 change and 13% to 29% with a harmful BRCA2 change. The same fact sheet notes that specific inherited BRCA changes have been found in a number of populations, including West African and African American people.

In many families, cancer is not discussed openly, or a relative's illness was simply called "a stomach problem". If you can, ask your mother, aunties and grandmothers what they know. If ovarian or breast cancer runs in your family, the NHS advises you to talk to a GP, who may refer you for genetic testing.

Is there a screening test for ovarian cancer?

No. In the UK there is no national screening programme, because, as Cancer Research UK explains, there isn't a test that reliably picks up ovarian cancer at an early stage. A large UK trial called UKCTOCS tested CA125 and ultrasound as screening tools, and Cancer Research UK reports that this did not lead to saving lives. Cervical screening checks the health of the cervix, so it is not a test for ovarian cancer.

For women at high genetic risk, such as BRCA carriers, the conversation is different. Cancer Research UK says specialists usually discuss risk-reducing surgery to remove the ovaries and fallopian tubes, with regular CA125 tests as an option for some women who cannot or do not want surgery. This is a big decision that belongs with a genetics team.

Why catching it early matters

Stage at diagnosis makes a large difference. Cancer Research UK reports that in England, around 95% of women diagnosed at stage 1 survive for 5 years or more, compared with around 15% at stage 4. That gap is why getting persistent symptoms checked, rather than waiting, is so worthwhile.

When to get help

See a doctor if you have bloating, fullness, pelvic or tummy pain, or urinary changes on most days, or if you are over 50 and have new IBS-type symptoms. If you have severe tummy pain or feel very unwell, contact your nearest hospital emergency department. Any bleeding after the menopause also needs checking promptly, as we explain in womb (endometrial) cancer: signs and risk factors.

Logging helps you see a pattern that is otherwise easy to miss. With Asele, you can use symptom logging to note bloating, pain and bladder changes alongside your cycle, and talk them through with Amara in Yoruba, Hausa, Igbo, Swahili, French or English. The Health Brief turns those logs into a short summary to take to your appointment, so "it happens most days" comes with dates. You can find us at Asele. For a wider look at checks worth knowing, see our women's health screening checklist.

This post is education, not medical advice. If something feels wrong in your body, you deserve to be examined and listened to.

References

1. NHS. Symptoms of ovarian cancer. nhs.uk
2. NHS. Tests and next steps for ovarian cancer. nhs.uk
3. NHS. Causes of ovarian cancer. nhs.uk
4. NICE. Suspected cancer: recognition and referral (NG12), recommendations organised by site of cancer. nice.org.uk
5. National Cancer Institute. BRCA gene changes: cancer risk and genetic testing. cancer.gov
6. Cancer Research UK. Screening for ovarian cancer. cancerresearchuk.org
7. Cancer Research UK. Tests to diagnose ovarian cancer. cancerresearchuk.org
8. Cancer Research UK. Survival for ovarian cancer. cancerresearchuk.org
9. Royal College of Obstetricians and Gynaecologists. Ovarian cysts before the menopause. rcog.org.uk
10. Royal College of Obstetricians and Gynaecologists. Ovarian cysts in postmenopausal women (Green-top Guideline No. 34). rcog.org.uk