If you have ovulation pain, also called mittelschmerz, you may experience twinging or cramps during ovulation. Other ovulation pain symptoms include light vaginal bleeding and discharge. Most of the time, rest and over-the-counter medications help. For severe ovulation pain, talk to your provider about options such as birth control pills.
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.
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.
Mittelschmerz may affect up to 40% of women and people AFAB who ovulate during their reproductive years.
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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:
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.
Ovulation pain may feel similar to period pain — like menstrual cramps (dysmenorrhea). But ovulation pain happens about two weeks before you get your period.
Ovulation pain typically lasts a few hours. However, the pain can last up to 48 hours.
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.
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.
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.
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.
You can only prevent ovulation pain by preventing ovulation. Many hormonal contraceptives, including the pill, prevent ovulation.
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.
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:
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.
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.
Call your healthcare provider if you missed your last menstrual period or have these symptoms during ovulation:
If you have pain during ovulation, ask your healthcare provider:
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.
Symptoms of mittelschmerz can be mistaken for ovarian cysts. Some of the common symptoms of a cyst on your ovary are:
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.
Last reviewed by a Cleveland Clinic medical professional on 02/09/2023.
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