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by Symptom Advice on May 5, 2011

(CBS) think detecting ovarian cancer symptoms is easy? think again. Even doctors have a hard time making the call. in part, that's because many of the symptoms, like weight gain and abdomen pain, could be a host of things, or nothing at all.

It's no small problem. Each year around 20,000 American women get ovarian cancer in the United States and yet many are not fully aware of the warning signs.

The symptoms, according to Medline are:

- Heavy feeling in pelvis- Pain in lower abdomen- Bleeding from the vagina (especially after menopause)- Weight gain or loss- Abnormal periods- Unexplained back pain that gets worse- Gas, nausea, vomiting, or loss of appetite

Sounds like a lot of things right? and sometimes there are no symptoms at all, which makes things tough on doctors. more than 25 percent of women with apparent  signs of early stage ovarian cancer are not receiving biopsies to test for it, according to new research from the University of California Davis Cancer Center.That's a big deal, because the longer you wait, the more deadly the disease becomes.

To make matters worse, there is no simple screening test for the disease. your doctor can perform several tests to help narrow it down including a rectovaginal pelvic exam, a transvaginal ultrasound, and a CA-125 blood test.

The disease overwhelming strikes older women – 90 percent are over 40 and most of those are over 60, according to the Centers for Disease Control (CDC).

There are several things that can lower your chance of getting the disease and some risk factors too. Here's the short list, according to the CDC.

LOWER YOUR RISK

- having used birth control pills for more than five years.- having had a tubal ligation (getting your tubes tied), both ovaries removed, or hysterectomy (an operation in which the uterus, and sometimes the cervix, is removed).- having given birth.

RISK FACTORS

- being middle-aged or older.- having close family members(such as your mother, sister, aunt, or grandmother) on either your mother's or your father's side who have had ovarian cancer.- having had breast, uterine, or colorectal cancer.- having an Eastern European (Ashkenazi) Jewish background.- having never given birth or having had trouble getting pregnant.- having endometriosis (a condition where tissue from the lining of the uterus grows elsewhere in the body).

For more information check out Medline, the Mayo Clinic and the CDC.

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