Ovulation Pain

What is ovulation pain?

Ovulation pain is pelvic pain that some women and people assigned female at birth (AFAB) have during ovulation. Ovulation is the part of the menstrual cycle when your ovary releases an egg. Ovulation usually happens about halfway between your periods or around day 14 of a 28-day menstrual cycle. People who experience pain at ovulation often can tell based on the type of pain they feel and when it occurs.

Ovulation pain is also called “mittelschmerz.” The term comes from the German words for “middle” and “pain.” Mittelschmerz is typically harmless and doesn’t require medical attention. Over-the-counter (OTC) pain relievers are effective in treating painful ovulation. If the pain becomes severe, a healthcare provider may prescribe oral contraceptives to stop ovulation from occurring.

Where does ovulation pain occur?

You typically feel ovulation pain in your lower abdomen and pelvic region. Most people have two ovaries, one on the left and one on the right side of the uterus. Your ovaries usually take turns ovulating. So, each ovary releases an egg every other month.

Many people say they feel ovulation pain on just the side that’s releasing the egg. This means if the ovary on your right side is releasing the egg, you’ll feel pain on your right.

Some people find that the pain occurs every month, regardless of which ovary releases an egg. Others may find that ovulation only hurts on one side, so their pain likely occurs every other month.

How common is ovulation pain?

Mittelschmerz may affect up to 40% of women and people AFAB who ovulate during their reproductive years.

What are the symptoms of ovulation pain?

The pain may feel like a mild twinge, or you might have sudden, sharp pain. It usually hurts on just one side of your lower abdomen (the side that releases the egg). Some people feel pain for a few minutes, while others experience pain for the entire day. You may also experience:

• Light vaginal bleeding.
• Vaginal discharge that’s stretchy and clear (like egg whites).
• Nausea, if the pain is bad.
• Pain in your low back.

What causes ovulation pain?

To understand ovulation pain, it helps to understand what ovulation is.

Ovulation is the point in your menstrual cycle when one of your ovaries releases an egg. Eggs grow inside a follicle, which is a fluid-filled sac. This follicle eventually stretches and breaks open (ruptures) to release the egg. Both the follicle stretching and the egg bursting through the follicle may cause ovulation pain.

This is a normal part of the menstrual cycle and the ovulation process.

Is ovulation pain the same as period pain?

Ovulation pain may feel similar to period pain — like menstrual cramps (dysmenorrhea). But ovulation pain happens about two weeks before you get your period.

How long does ovulation pain last?

Ovulation pain typically lasts a few hours. However, the pain can last up to 48 hours.

How is ovulation pain diagnosed?

Your healthcare provider might diagnose mittelschmerz based on the timing of the pain. Ovulation usually happens about two weeks into your menstrual cycle. You may have ovulation pain if you feel pain at this point in your cycle. Your provider may ask you to keep a record of your menstrual cycles. Note whenever you have pain and where you feel the pain.

How to track your menstrual cycle

Your menstrual cycle length is the time from the first day of one period to the first day of the next period. For example, if you begin bleeding on March 1 and then again on March 30, your cycle length is 29 days. In this example, ovulation likely occurs around day 15. If your pain happens around day 15 of that cycle, it may be ovulation pain.

What tests will I need?

Your healthcare provider may perform an abdominal and pelvic exam. These tests can help rule out other causes of pain, such as endometriosis or an ovarian cyst. You may also need an abdominal or vaginal ultrasound. Your provider may also take swabs of fluid from your cervix to test for infection.

If your healthcare provider notices something suspicious during the exam or your pain is severe, you may need more tests to find the cause. Your healthcare provider will discuss the next steps with you.

How is ovulation pain treated?

Most people don’t need treatment for mittelschmerz. The pain typically goes away within a day. You can take medication available over the counter, such as nonsteroidal anti-inflammatory medications (ibuprofen or naproxen) or acetaminophen to help with the pain.

A heating pad or hot bath may also help provide pain relief.

For severe ovulation pain, talk to your healthcare provider about taking birth control pills. Hormonal birth control medications prevent ovulation. Without ovulating, you won’t have ovulation pain.

If you take birth control pills, you won’t be able to get pregnant. Talk to your healthcare provider if you wish to start or add to your family.

Can I prevent ovulation pain?

You can only prevent ovulation pain by preventing ovulation. Many hormonal contraceptives, including the pill, prevent ovulation.

What can I expect if I have mittelschmerz?

Ovulation pain is normal. It’s one of the side effects of your period. It’s not dangerous or a sign of a serious health condition. Ovulation pain doesn’t affect fertility, and it can help you be more aware of when you ovulate.

It’s always a good idea to talk to your healthcare provider about any pain you’re having. A healthcare provider can rule out a more serious condition that has similar symptoms.

What conditions can be mistaken for ovulation pain?

Ovulation pain itself is nothing to worry about. But talk to your healthcare provider if you have severe pain. It could be a sign of a different, more serious condition, including:

• Endometriosis, painful condition in which your uterine lining grows outside of your uterus.
• Scar tissue from a (C-section) or other abdominal surgery that caused abdominal adhesions.
• Sexually transmitted infections (STIs), such as chlamydia, which can cause inflammation that leads to painful ovulation.
• Pelvic inflammatory disease, an infection that affects your reproductive system.
• Ovarian cyst, a pouch of fluid that develops on your ovary.
• Ovarian torsion, when your ovary twists.
• Ectopic pregnancy, when a pregnancy develops outside of your uterus, often in your fallopian tube.
• Appendicitis, when the appendix is inflamed.
• Other abdominal problems, such as inflammatory bowel disease.

Can I use ovulation pain to plan a pregnancy?

Some people use ovulation pain to plan or avoid a pregnancy. Your chances of getting pregnant are higher if you have sex during ovulation. So, paying attention to any ovulation pain can help you know when you’re ovulating if you’re trying to get pregnant.

However, don’t rely on mittelschmerz as a way to avoid pregnancy. Use other, more reliable birth control methods.

How do I take care of myself?

If you have ovulation pain, try at-home treatments, such as a warm bath, heating pad and over-the-counter (OTC) pain relief. For severe ovulation pain, talk to your healthcare provider about other treatment options.

When should I contact my healthcare provider?

Call your healthcare provider if you missed your last menstrual period or have these symptoms during ovulation:

• Fever greater than 100.4 degrees Fahrenheit.
• Pain while urinating.
• Red or burning skin where the pain is located.
• Severe nausea or vomiting.
• Severe pain in the middle of your menstrual cycle that lasts longer than a day or occurs during most months.
• Over-the-counter pain medication isn’t providing relief from the pain.
• Heavy vaginal bleeding between periods.

What else should I ask my healthcare provider?

If you have pain during ovulation, ask your healthcare provider:

• What’s causing the pain?
• What can I do to relieve the pain?
• Is there a way to prevent ovulation pain?
• Will birth control pills help control the pain?

Does ovulation pain mean I’m more fertile?

No. Having pain during ovulation doesn’t mean you’re more fertile than someone who doesn’t have ovulation pain. It doesn’t affect your chances of getting pregnant that cycle in any way.

What are the signs of cysts on ovaries?

Symptoms of mittelschmerz can be mistaken for ovarian cysts. Some of the common symptoms of a cyst on your ovary are:

• Pelvic pain or a dull ache in your lower back.
• Feeling bloated or full.
• Pain during sex.
• Pain when you get your period.

If you’re unsure about your symptoms or what’s causing them, it’s always best to talk to a healthcare provider.

A note from Cleveland Clinic

Ovulation pain, also called mittelschmerz, happens when people experience ovulation cramps or other pain when they ovulate. Ovulation pain isn’t harmful. Most of the time, you can treat it with pain relievers from the drug store, heating pads and warm baths. But talk to your healthcare provider if you have severe ovulation pain. Your healthcare provider may recommend birth control pills to prevent ovulation.