Here’s everything you need to know about ovulation pain, including what it feels like, how long it lasts, and whether you need to worry.

By Nicole Harris
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Nearly every woman recognizes the dull cramps that accompany menstruation. As it turns out, about 20% of women also experience pain during ovulation known as mittelschmerz (a German word meaning "middle pain"). Here’s everything you need to know about ovulation pain, including the causes and whether you need to worry.

What Causes Pain During Ovulation?

Ovulation takes place halfway through a woman’s menstrual cycle – usually 14 days before her period, says Dr. Staci Pollack, an Ob-Gyn for the Division of Reproductive Endocrinology & Infertility at Montefiore Health System. Her ovaries grow about 20 eggs in fluid-filled sacs (called follicles) during the first half of the cycle. One dominant egg matures fully and releases from the ovary during ovulation, then it travels down the fallopian tube for 12-24 hours. If sperm fertilizes the egg during this time, a woman can become pregnant. Otherwise the egg absorbs into the uterine lining, and it’s shed during her monthly period.

Doctors don’t know exactly what causes ovulation pain (mittelschmerz), but these factors could trigger it:

  • The egg stretching the ovary as it grows, then rupturing the follicle during release
  • The fallopian tubes contracting when the egg travels to the uterus
  • Fluid from the follicle irritating the abdominal cavity

What Does Ovulation Pain Feel Like?

“Some women experience no ovulation pain at all,” says Rashmi Kudesia, M.D., an Ob-Gyn and reproductive endocrinology and infertility specialist at Houston Methodist and Houston IVF. But those who do detect a sensation that’s either dull, crampy, or sharp.

Since a single egg is released during ovulation, only one ovary is affected by the stretching and rupturing. This means that pain usually centers on one side of the abdomen or pelvis. Don’t be alarmed if ovulation pain switches sides between cycles.

Ovulation pain can range from mild to severe. Some woman also notice a bit of bleeding or discharge during mittelschmerz.

How Long Does Ovulation Pain Last?

Ovulation pain can last anywhere from minutes to a couple of days, says Dr. Kudesia. Some women feel mittelschmerz during every cycle, while others only have it occasionally.

What Are Other Symptoms of Ovulation?

Pain in your abdomen could have many different causes, including gas and sexually transmitted diseases. That’s why it’s important for those trying to conceive to recognize other symptoms of ovulation. According to Dr. Kudesia, these include breast tenderness and an increase in libido, as well as clear stretchy cervical mucus that resembles egg whites.

Keep in mind that pregnancy is most likely to occur on the day of ovulation and five days beforehand (since sperm can survive in the reproductive tract for five days). If you want to pinpoint your ovulation, consider using tools like ovulation predictor kits, fertility monitors, and basal body temperature thermometers. Learn more about finding your six-day fertile window (the time when pregnancy is most likely to occur) here.

How Do I Treat Ovulation Pain?

Mittelschmerz doesn’t last long, but if you need fast relief, try using over-the-counter painkillers. For a long-term solution, consider estrogen-progesterone hormonal birth control pills, which suppress ovulation.

Should I Worry About Ovulation Pain?

Ovulation pain is normal for many women, but mid-cycle abdominal cramping could also signal ovarian cysts, ectopic pregnancy, endometriosis, pelvic inflammatory disease, appendicitis, or infection. If the pain occurs shortly before your period (instead of two weeks before), it may be implantation bleeding. See a doctor if you also experience severe pain that lasts for days, fever, heavy bleeding that isn’t your period, trouble breathing, painful urination, vomiting, or diarrhea.

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