Various conditions or diseases of the Ovary can cause new abdominal pain. The worst is Ovarian Torsion, when the ovary twists on itself. Pain usually begins suddenly, and can be very severe. There’s often nausea and/or vomiting. It’s sometimes possible to feel the ovary on pelvic examination, usually not, but in the case of Torsion it may be way too painful. Ultrasound can sometimes see the twisting, but sometimes not. A pregnancy test can rule out diseases of pregnancy, but pregnant women can also have ovarian torsion.
Rapid surgery is necessary in order to save the ovary. But nobody wants to do it unnecessarily if the diagnosis is really something else. Surgeons need to put all the information together, consider other possibilities like ectopic pregnancy or appendicitis (which need their own operations), and especial simple cysts and conditions which would never require surgery.
A Ruptured Ovarian Cyst can cause pain, sometimes as severe as torsion. Once again, a pregnancy test is necessary to rule out ectopic pregnancy. Cysts can almost always be seen on ultrasound. Most do not require surgery, but if pain is severe, surgeons are the experts who make the diagnosis.
Ovarian cancer almost never causes pain until it’s far advanced. The pain would be milder than the conditions just mentioned, and more inconsistent. Other symptoms of early ovarian cancer are likewise vague, such as bloating or changes in urinary habits (peeing more often in small amounts, without pain to suggest a UTI). Sadly, most ovarian cancer gets discovered when complications arise.