If you menstruate, you're probably no stranger to discomfort: between menstrual cramps, bloating, back pain and PMS, it's not always a fun time! But one issue we don't often see discussed is pain during ovulation.
How can you tell the difference between abdominal aches and ovulation pain symptoms, and just how many people experience ovulation pain? We've taken the time to sort fact from fiction, researching what the experts and medically reviewed journals have to say about the matter.
So pop on the kettle, grab a cuppa (and if you're currently in pain, a hot water bottle) and take a look.
What is ovulation?
Let's start with the basics: ovulation is one part of the menstrual cycle whereby an egg is released from an ovary and makes its way along one of the fallopian tubes towards the uterus [1].
Usually, ovulation happens once a month, around 2 weeks before your next period, and can last from 16-32 hours.
It's possible to get pregnant in the 5 days leading up to ovulation, but the chances are higher in the 3 days leading up to and including ovulation. Once the ovary releases an egg and it makes its way down a fallopian tube, it will survive for up to 24 hours. If you're trying to conceive, you can use ovulation tests to find your most fertile days.
Some people find tracking their menstrual period cycles helpful to predict when ovulation and/or menstruation is likely to occur.
What is ovulation pain?
The answer is a bit more complex than just 'painful ovulation'.
Now, a lot of people are familiar with menstrual cramps — even if they don't get periods, it's a commonly known issue — but did you know around 40% of people who menstruate experience pain or discomfort during ovulation? That means that pain occurs for you roughly every two weeks if you also experience aches during your period.
Here's another factoid for you: women's health experts also sometimes refer to ovulation pain as mittelschmerz pain, a German word meaning 'middle pain' [2]. (They really do have a word for everything.) And while that may be a fun word to say, it's certainly not a fun experience.
Peer-reviewed studies sometimes describe ovulation pain as benign lower abdominal pain but just because it's benign, doesn't make it any less painful [3]. It does mean, though, that midcycle pain on its own is usually not a sign of anything serious.
What are ovulation pain symptoms?
The signs and symptoms of ovulation pain are usually different for each person and can vary from month to month. It can feel like a slight twinge of sudden discomfort or more sharp pain.
Generally speaking, other symptoms of ovulation pain can be:
- A feeling of uncomfortable pressure
- Twinges
- Sudden pain
- A dull ache in the lower abdomen
- Pain occurring on one side of the lower abdomen during one cycle, which may then switch to the other side (depending on which ovary releases the egg)
- Pain that occurs midway through the menstrual cycle [2].
Pain occurs every month for some people, and only once in a while for others.
Is pain during ovulation normal?
Generally speaking: yes, some pain is normal. Among both Australian and international reports, around 40% of people who menstruate will experience ovulation pain [3].
It's been found that ovulation pain is usually not experienced for the first few years after the first period (menarche), and varies in severity from a mild twinge to unbearable, severe pain.
Because women may feel pelvic pain during one ovulation cycle and not the next, it's been suggested that people may not recognise the abdominal pain as being related to their menstrual cycle at all.
Where do you feel ovulation pain?
Ovulation pain can feel like pelvic pain on one clear side of the lower abdomen, depending on which ovary releases an egg.
For some people, it feels more like general pelvic pain or cramping, but ovulation pain typically feels a bit more distinct and localised.
What causes ovulation pain?
Here's the funny (well, maybe not so funny) thing — despite how common it is, there is no single clear consensus on what causes ovulation pain [4]. Years and years of advances in human reproduction research and this issue remains one of life's unsolved mysteries! There are, of course, some theories around what exactly causes this pain.
One theory suggests that ovulation pain is caused by the egg breaking through the ovary wall, which can release a small amount of fluid. In some cases, this fluid can also contain small amounts of blood. The theory is that this fluid irritates nearby nerves, causing pain.
Some research has found that ovulation pain could be correlated with certain hormone levels. It's suggested that ovulation pain coincides with the peak in plasma luteinizing hormone (LH) levels, when the follicle is growing larger but not yet ruptured. This rise in LH levels can increase the ability of the ovarian muscles to contract, which is hypothesised to be causing pain [3].
Are you fertile during ovulation pain?
If you are experiencing pain during the time of ovulation, this does not mean you have any fertility problems [5].
By definition, ovulation is when the body is at its most fertile, so pain or no pain, you are more likely to conceive in the days leading up to and including ovulation. You may also experience ovulation bleeding during this time. That said, not many people will be feeling particularly frisky if they are experiencing severe ovulation pain.
But, if you are trying to conceive, the days leading up to ovulation and the day of ovulation are the best time to engage in timed intercourse.
To separate the issues of pain and fertility, you might consider tracking your cycles or taking a fertility test kit to ensure you're super informed about what's really going on for you and your body.
What does ovulation pain feel like?
As we mentioned earlier, ovulation pain symptoms can vary from person to person, and from cycle to cycle, but there are some frequently reported symptoms.
People describe ovulation pain as typically occurring on one side of the lower abdomen that feels like a distinct, often sharp pain, unlike period cramps or other stomach or abdominal pain [5].
In fact, the pain is in such a specific location that it often presents as appendicitis, which can lead to unnecessary tests and even unwarranted abdominal surgery [3]! This highlights a need for greater awareness of menstrual and ovulation pain to help people access the right treatment and support for their concerns.
How long does ovulation pain last?
Just like menstrual cramps, there is often no rhyme or reason for the length of time this discomfort can last. Ovulation pain can last from a few minutes to a few hours.
In most cases, the pain is gone within 24-48 hours [5].
If ovulation pain is common, when should I speak to my doctor?
You should consider speaking to your doctor immediately or presenting at an emergency room if you are experiencing severe pain — you know your body best.
Severe pelvic pain may be caused by:
- Appendicitis: As we mentioned earlier, ovulation pain and appendicitis can feel similar, but if you are feeling severe and sharp pains, it's best to get it assessed quickly
- Ectopic pregnancy: This is when pregnancy occurs in one of the fallopian tubes instead of the uterus. If you think you are pregnant, or if your last period was irregular, there's a chance the pain is caused by an ectopic pregnancy [2].
If you experience severe ovulation pain regularly during your menstrual cycles, this may be a sign of an underlying medical condition such as:
- endometriosis or pelvic inflammatory disease [6]
- an ovarian cyst or cysts [7].
When in doubt, always chat with your healthcare provider for personalised advice and support.
How long after ovulation pain is the egg released?
In general, you can expect to ovulate about 1-2 days after you feel pain [8]. Typically the pain is a preovulatory symptom and occurs in the lead-up to ovulation itself, but some women feel pain throughout the entire ovulation cycle.
The only way to be super certain about whether you are ovulating is through a proper testing kit or by speaking to a women's health specialist.
What's the best way to treat ovulation pain?
The good news is that most ovulation pain not caused by other health conditions can be treated with over-the-counter medications and treatments like a warm bath.
If you are experiencing heavy bleeding, concerning symptoms, or if the pain doesn't go away within a few days, seek medical attention.
Many women are used to dismissing or minimising their experience of pain but for optimal management of your health, it may be worth speaking to a doctor. Nobody should be living with severe pain every month (or every 2 weeks!) and you may in fact require treatment.
If you're one of the lucky ones, anti-inflammatory pain relief and a hot bath may be enough to address your pain and have you feeling tip-top in no time.
Photo credit: Getty Images
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