How to Deal with Painful Ovulation

When you ovulate, your ovary releases an egg, along with follicular fluid and blood. For many women, normal ovulation produces no symptoms at all, but some women regularly experience pain and discomfort when they ovulate. These symptoms are sometimes called “mittelschmerz,” from the German words for “middle” (because ovulation occurs at the midpoint of your menstrual cycle) and “pain.” Here you can find out how to identify and cope with painful ovulation.

EditSteps

EditIdentifying Painful Ovulation

1. Understand your menstrual cycle. Your menstrual cycle is the time from the first day of one menstrual period (this is “day one” of your cycle) to the first day of the next menstrual period. A typical cycle lasts 28 days, but if you chart your menstrual periods on a calendar, you may notice that your own cycle is longer or shorter. During the first half of your menstrual cycle (before ovulation), you menstruate, your uterine lining thickens again, and hormones begin working to trigger ovulation. During the second half of your menstrual cycle (after ovulation), an egg is either fertilized, or the body prepares to shed the uterine lining again.
   
   • Your own menstrual cycle may vary by a few days each month, and this is not something to worry about.
   • However, if your menstrual cycle varies significantly (by a week or more over a period of several months), it is best to see your doctor.
   • Although there are many non-concerning causes for variable periods, there are some that can be helped with treatment (such as polycystic ovarian syndrome, where periods come infrequently due to hormone imbalance), so a doctor's advice is always best if you are in doubt.
2. Know when you ovulate. Ovulation usually occurs at the midpoint of your menstrual cycle — for women with a typical 28-day cycle, then, ovulation occurs around Day 14. If you think you may be experiencing painful ovulation, charting your cycles for a few months can help you confirm the timing.
   
   • The second half of the menstrual cycle (after ovulation) tends to be consistent among women at 14 days (14 days before your next period begins). Therefore, if you happen to have notably longer or shorter intervals between periods (as compared to the average of 28 days), know that ovulation can be calculated by charting 14 days prior to the start of each period.
   • Understand that ovulation is when the egg is released by the ovary. It entails rupturing the membrane of the ovary at the location where the egg exits, which can be accompanied by bleeding and a pressure sensation. For many women, this goes unnoticed; however, for some, the blood in the abdominal cavity and pressure against the ovarian membrane can be a notable source of discomfort.
3. Note your symptoms. If you are experiencing lower-abdominal or pelvic pain or pressure around the midpoint of your menstrual cycle, and if this pain disappears within a day and does not reappear until you ovulate again, you probably have painful ovulation. (It could be pain from other internal organs, but pain with this specific pattern that repeats most cycles is most often from ovulation.)
   
   • You may notice that the pain seems to be on only one side of your abdomen at a time. This is because ovulation occurs only on one side or the other, and this varies with each menstrual cycle (it does not alternate, but switches at random).
   • Pain during ovulation may sometimes be accompanied by minor vaginal bleeding; you may also experience some nausea.
   • The pain from ovulation tends to last anywhere from a few hours to two to three days.
   • Approximately 20% of women experience pain mid-cycle with ovulation. In most cases, it is relatively mild, but in some cases it can be severe and unbearable.
4. Follow up with your doctor. As long as the symptoms are not severe, painful ovulation is probably harmless. Nevertheless, it’s important to see your doctor and rule out other possible causes of your pain (such as ovarian cysts, endometriosis, or if the pain is worse in any particular episode it may be a more severe and urgent condition such as appendicitis).
   

EditTreating Painful Ovulation

1. Wait it out. If your symptoms are minor, or if they tend to disappear quickly (some women experience pain for only a few minutes), you probably don’t need to do anything at all.
   
2. Take over-the-counter pain relievers. Basic pain relievers like ibuprofen, naproxen, and acetaminophen should help relieve your symptoms. Follow the instructions on the label, and do not exceed the recommended dosage.
   
   • Note that different women find different over-the-counter pain medications to be more effective than others, and this varies from woman to woman. If you find that one does not work particularly well, do not hesitate to try another, as you may find greater success in trying another type of medication.
   • Anti-inflammatory pain medications (such as ibuprofen and/or naproxen) are known to be troublesome for people who have been diagnosed with kidney or stomach problems. If you fall into either of these categories, consult your doctor prior to use. Or, if you notice symptoms of upset stomach after starting the medication, consult your physician for further advice.
3. Use heat. Some women report that a heating pad alleviates their symptoms. Apply the heating pad to the lower abdomen, and repeat as necessary.
   
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   • The reason heat works so well is that it enhances blood flow to the area of pain, relaxes muscles, and eases cramps. ^[2]
   • Some women also report that a cold pack or cold compress can help to alleviate pain, so you can try both heat and cold and see what works best for you.
4. Take a bath. A warm or hot bath may work like a heating pad does to relax you and relieve your symptoms.
   
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5. Consider taking birth control pills. If your symptoms are very bothersome, you can try hormonal contraceptive pills. Prescription birth control pills prevent pregnancy, in part, by stopping ovulation. If you begin taking hormonal birth control pills, you will no longer ovulate, and your painful ovulation will therefore disappear.
   
   • Note that birth control pills are the only effective way to prevent ovulatory pain, as they halt ovulation altogether (by suppressing your natural hormones and therefore preventing ovulation).
   • Birth control pills are therefore the most effective mode of treatment for painful ovulation, if home remedies (such as heat or cold) and over-the-counter medications are insufficient.
   • See your doctor to discuss the pros and cons of birth control pills and whether they are the right choice for you. You may also wish to chart your menstrual cycle over a few months time and bring this in to your doctor so that he or she can have a clearer picture of what's going, and perhaps come up with a more specific diagnosis.
6. Watch for symptoms of a more serious problem. For many women, painful ovulation is a bothersome but normal part of the menstrual cycle. Serious symptoms, though, are not normal. If your pain lasts longer than two or three days, or if you experience any of the following symptoms along with the usual mid-cycle pain, seek medical treatment immediately:
   
   • Fever
   • Painful urination
   • Redness or inflammation of the skin on your abdomen or pelvis
   • Severe nausea or vomiting
   • Heavy vaginal bleeding
   • Abnormal vaginal discharge
   • Abdominal swelling

EditTips

• Charting your menstrual cycle can be helpful for a number of reasons. It will help you confirm that your pain is happening with ovulation, but it will also show you when your menstrual periods are due and help you to understand when your fertility is highest. In addition, if you have “mittelschmerz” or any other menstrual, reproductive, or sexual difficulties, an accurate charting of your menstrual cycle can help your doctor diagnose and treat you.
• You may notice that the pain shifts, from month to month, from one side of your lower abdomen to the other. This is because ovulation switches from ovary to ovary with each new cycle (although it does not alternate each month, but rather is random as to which ovary ovulates each month).
• Some women who never experienced symptoms during their teens or twenties begin noticing the symptoms of painful ovulation in their thirties. As long as the symptoms are mild and not accompanied by any of the warning signs listed above, this is not cause for concern.

EditSources and Citations

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