Kissing Ovaries

Endometriosis is a disorder that causes the inner lining of the uterus to grow on spots on the outside of the uterus. This can be very painful, particularly during menstrual periods or intercourse. People with endometriosis can also have problems with fertility, though many do not.1,2

Endometriosis is most common around the ovaries. It is also often found around the uterus, fallopian tubes, and other structures in that area of the pelvis. When endometrial tissue grows in this area, it can attach to these structures. In some cases, the endometrial tissue will tug them out of place or penetrate deep into them.1-3

There is a wide range of symptoms with endometriosis. The severity of the disease also varies widely. Depending on the severity of endometriosis, people can develop cysts (called "endometriomas") on their ovaries. If cysts and tissue grow enough, they can sometimes develop into a symptom doctors call "kissing ovaries."2,3

What are kissing ovaries?

Kissing ovaries happen when the tissue that grows outside the uterus tugs on both your ovaries. Sometimes, when this happens, the ovaries move closer to each other. They can get close enough to "kiss."2,3

Your ovaries are anchored in your body by 3 main structures. Sometimes in more severe endometriosis, enough tissue grows to grab onto these structures and shift them around. Not everyone who has severe endometriosis will develop kissing ovaries. But if the tissue grows in just the right way, the chances of this symptom get higher.2,3

How are kissing ovaries diagnosed?

Generally, endometriosis can be confirmed by a pelvic exam, ultrasound, blood test, or other ways. You can also undergo a laparoscopy. This is a surgery where doctors make just a small incision in the abdomen. It is minimally invasive. Laparoscopic surgery is the most accurate way to diagnose endometriosis.1,2

If you or your doctor suspect you may have kissing ovaries, your doctor can do a transvaginal ultrasound or magnetic resonance imaging (MRI) scan to confirm. Your doctor can also recommend you have laparoscopic surgery. These methods let doctors see your pelvic tissue and organs more clearly. From the ultrasound or MRI images, they can see if you have kissing ovaries. They can also see if there are other issues they can help you with.1-3

What does this mean for my endometriosis?

Kissing ovaries usually occur in more severe stages of endometriosis. There are 4 recognized stages of endometriosis, named in order of severity. Stages I and II are less severe and would not include kissing ovaries. Kissing ovaries are only present in Stage III and IV endometriosis.2,4

Researchers have found that kissing ovaries are linked to the severity of the disease, infertility, and how deep the endometriosis has gotten into the other structures of the pelvis. The odds of having Stage IV endometriosis are 8 times higher when ovaries are either kissing or have moved out of their usual places.3,4

There are a variety of treatments available for endometriosis. Sometimes hormone therapies or just pain medicines can help. In other cases, surgery to remove the extra tissue may be needed. It all depends on your endometriosis and how you and your care team want to approach it.1

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