Many women seem to start gaining abdominal weight within a few years of completing menopause and some will wonder if it could be ovarian cancer.

As awareness campaigns for ovarian cancer gain steam, more and more postmenopausal women are wondering if the weight gain in their bellies – which wasn’t there prior to menopause – could actually be ovarian cancer.

They are on the ball, because unexplained weight gain only in the belly, or disproportionately in the belly, should raise red flags – as this could mean fluid retention in the abdominal cavity.

Fluid retention in the abdomen is never a trivial situation, though it’s not always cancer, either.

Ascites (Uh-sight-eez)

“Ovarian cancer causes bloating and fluid to accumulate in the abdomen,” says Dr. Kate Killoran, OBGYN and medical advisor at Your Doctors Online, an online doctor chat site.

“It’s usually described more as increasing abdominal girth as opposed to weight gain.”

Belly Bigger, Pants Tighter: Fat or Ovarian Cancer?

Dr. Killoran explains, “Midlife weight gain may occur more around the abdomen and thus increase waist circumference, but you should be able to tell if it is fluid in your abdomen or fat around your middle.”

Ascites vs. Fat

“Fluid in your abdomen feels tense,” says Dr. Killoran. “Your abdomen can feel distended or full. You may feel increased pressure.

“You may even notice it is difficult to take a deep breath due to the increased abdominal pressure.

“If you try to ‘pinch an inch’ you will find that it’s difficult or even impossible because of the tension against your skin.

Though the example is a man, this is what a more advanced ascites would look like on a woman. Shutterstock/donikz

“Unlike when you have just gained weight or fat around your middle where it’s easy to pinch that soft tissue.”

Balloon vs. Pillow

Try to “pinch an inch” on a balloon filled with air. You can’t. But with a same-size, same-shape pillow, you can.

The squishy and doughy appearance strongly suggests pure body fat. Shutterstock/A.J.Photos

If your bigger belly reminds you more of a balloon than a pillow, you’ll want to make an appointment with your OBGYN.

But just because you have thin arms and legs but an expanding belly doesn’t mean you probably have ovarian cancer, either.

When I was a personal trainer one of my clients had a plump belly but thin arms and legs.

After a few months of an intense training program (but no dieting, as she was not overeating), she had lost eight inches in abdominal circumference while her limbs remained the same.

Ascites from untreated ovarian cancer will not go away with any kind of exercise or diet, and in fact, over time the abdomen will just get bigger and bigger (with increasing tension).

Screening for Ovarian Cancer

Unfortunately, science has not caught up to this disease. A Pap smear cannot detect it.

The CA-125 blood test may be useful in some cases, but that, too, is not a reliable screening tool – as it can be high in the absence of ovarian cancer and low in the presence of.

“Detecting ovarian cancer at an earlier stage is one of the many challenges of this disease,” says Dr. Killoran.

“Symptoms in the early stages are vague, if present at all. For ovarian cancer to cause any symptoms it has already spread to the pelvis and abdomen. Some early signs can be constipation, early satiety and crampy pain.”

Because of the early satiety – feeling uncharacteristically full after small meals – a woman may lose weight due to eating less – all “while their waist circumference increases,” says Dr. Killoran.

Tests Are Negative for Ovarian Cancer

If your doctor has declared that you do not have ovarian cancer, but your belly has gotten bigger since menopause – there’s several weapons you can wield at this fat gain.

Excess abdominal fat is not good for the body. It’s a risk factor for a number of medical conditions including heart disease and hiatal hernia.

To reverse this fat gain (never settle for it as a natural consequence of aging or menopause), you must employ the following (along with a healthful diet):

• Compound strength training
• Progressive resistance
• High intensity interval training

Compound Strength Training

Focus on “big” moves to reduce belly fat: deadlift, squat, leg press, flat or incline bench press, any-grip lat pull-down.

Big moves burn more fat. Think of an 18-wheeler truck vs. a small car. Which burns more fuel?


Progressive Resistance

Strive to increase your weight loads over time using proper form.

More lean muscle mass means a faster metabolism = shrunk midsection.

High Intensity Interval Training

Example: Instead of jogging at 5 mph for 30 minutes, you run at 12 mph for 30 seconds, then walk for two minutes, back and forth, over a 30-minute period.

Belly weight gain does NOT have to be a normal fallout from menopause or getting older.

But remember, if you can’t explain your expanding abdomen, don’t put off seeing your OBGYN, especially if you have other symptoms of ovarian cancer – which also include unexplained back pain, leg pain or an odd heaviness on one side of the pelvic area.

Dr. Killoran has a private practice and is also a health coach at Your Doctors Online offers a free 7 day trial: Ask a doctor questions and get answers in minutes from anywhere 24/7. Learn more here.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  


Top image: Shutterstock/Inspiration GP