Written by: Dr. Amy Beckley, PhD, Founder and Inventor of the Proov test — the first and only FDA-cleared test to confirm successful ovulation at home.
Updated on 11/14/22
While period cramps are common, some women may experience pain in the middle of their cycle, around ovulation.
Many women are familiar — and probably loathe — the pain that comes with their period. While period cramps are common, some women may experience pain in the middle of their cycle, around ovulation. This is known as ovulation pain. Keep reading to learn more about ovulation pain and when you should consult your doctor.
What is ovulation pain?
Ovulation pain is also called mittelschmerz, which is German for “middle pain” since it occurs about midway through your cycle and it’s one of the symptoms of ovulation. About 1 in 5 women experience ovulation pain or ovulation cramps around the time when an egg is released from the ovary. If the pain occurs about 12 to 14 days before your next suspected period, it’s likely ovulation pain.
Additionally, if it appears your abdominal pain switches sides each cycle, this is a sign of ovulation pain. This is because typically ovulation occurs from one ovary – the right or left – each cycle.
Cramping during ovulation is sometimes accompanied by some spotting or vaginal bleeding. Typically ovulation spotting is much lighter than the bleeding you would experience during your period.
You may experience ovulation spotting randomly or after intercourse. It can be light pink or beige, suggesting a few drops of blood mixed with cervical fluid. Ovulation spotting typically only lasts a day or two.
What does ovulation pain feel like?
Most women usually don’t feel anything during ovulation and can’t tell exactly when they are ovulating. However, others may feel a dull ache, cramping, or a sharp stab in their lower stomach when ovulation occurs. As we mentioned above, it’s often a sided pain.
You may notice ovulation pain more when you walk or exercise. You might even have the sensation that you can “feel” your ovary when you take a seat. Other women report might experience pressure in their lower stomach during their luteinizing hormone (LH) surge.
A very small amount of women end up in the emergency room due to pain. They may be scared they might have an ovarian cyst or an inflammation of the appendix.
Some women may experience the pain every cycle or it may be more sporadic. Ovulation pain may be short lived or it can last from several hours up to a few days, depending on the woman.
It’s usually nothing to be concerned about and most women do not need to take anything for the pain. However if it bothers you, you may want to consider Tylenol or other pain medications. If you are trying to conceive, you may want to avoid anti-inflammatory medications since studies show they can impact ovulation.
If your mittelschmerz is strong, occurs regularly, and impacts your quality of life, we recommend consulting your doctor. Sometimes, they will recommend birth control to manage the pain.
Some women may feel a dull ache, cramping, or a sharp stab in the lower part of the abdomen, usually on the side of the ovary containing the ovulating follicle.
What causes ovulation pain?
The exact cause of mittelschmerz is unknown. However, there are several theories:
- As the follicle grows and prepares to release the egg, it stretches the ovary which can cause pain and pressure.
- The fallopian tube cramps to help the egg along on its journey to the uterus.
- When the ovary releases an egg, the blood and fluid inside the follicle may irritate the lining of your abdomen, causing pain.
More recent studies suggest mittelschmerz coincides with an LH surge, most likely due to the ovary contracting before the follicle bursts and releases the egg.
Is ovulation pain normal?
Pain caused by ovulation and occurring mid-cycle is normal, rather common, and usually not a reason for concern. Tracking your cycles and identifying your LH surge will help you know when to expect it and get prepared.
Unless you’re in a lot of pain, you can probably manage ovulation pain with over-the-counter painkillers, heating pads, or a warm bath. Relaxing and taking a bath may also help relieve the discomfort.
If you are experiencing unbearable pain around ovulation each cycle, you may want to talk to your doctor. They might be able to run tests to rule out other potential issues. For example, pain in the lower right abdomen may be a sign of acute appendicitis. Because of this, you may want to make sure there are not any other underlying conditions you might have overlooked.
Of course, if you are concerned about any pain you may be experiencing it’s always a good idea to consult your doctor.
If you are experiencing unbearable pain around ovulation each cycle, you may want to talk to your doctor.
What are other causes of pain during my cycle?
Pelvic pain is any pain felt in your lower abdomen. It may occur anytime during the cycle and can be caused by many different things. Here are a few causes of pelvic pain:
Menstrual cramps: Menstrual cramps occur at the beginning of the cycle right before or during your period. They are hormonal and will go away once your period is over. Typically you can keep them under control with OTC painkillers or anti-inflammatory medicines. However, if they are debilitating or cause other symptoms like nausea, dizziness, or vomiting, we recommend consulting your doctor.
Ovarian cysts: Ovarian cysts are fluid filled sacs on your ovaries and usually go away without treatment. They may cause pain if they twist or rupture. If you are concerned about an ovarian cyst, we recommend consulting your doctor.
Sexually transmitted infections (STIs): Infections caused by chlamydia or gonorrhea can cause inflammation of fallopian tubes and ovaries, causing pain. They need treatment with antibiotics and may cause infertility when left untreated. If you think you have an STI, we recommend consulting your doctor.
Endometriosis: Endometriosis is a condition where the tissue from your uterine lining grows outside your uterus. This tissue will grow and shed as your uterine lining does each cycle, which can cause pain in your abdominal cavity. Endometriosis can be very painful and impact your quality of life. There is no cure for it, but treatments range from painkillers to excision surgery.
Ectopic pregnancy: Ectopic pregnancy occurs when a fertilized egg attaches outside the uterus, usually in one of the fallopian tubes. It is potentially life-threatening and needs immediate medical attention.
Appendicitis: Appendicitis is the inflammation of the appendix. Symptoms include pain, nausea and a fever. In most cases surgery is needed to fix it.
Urinary tract infections (UTIs): UTIs are very common in women. A UTI may cause pelvic pain, a burning sensation during urination, and may sometimes be accompanied by fever. Treatment typically involves antibiotics from a doctor.
It’s important to listen to your body to identify pain. Luckily, ovulation pain is totally normal and likely not something to worry about!
