If you have ever experienced a spasm or cramp in your lower abdomen midway through your menstrual cycle, you might be familiar with ovulation pain, also known as Mittelschmerz. This discomfort, which affects up to 40% of women of reproductive age, typically occurs between days 7 and 24 of the cycle. For many, it is a monthly occurrence closely tied to hormonal changes before and during ovulation. 

However, sometimes this pain can be more intense due to conditions like Endometriosis, Fibroids, or Ectopic pregnancy, which require prompt medical attention. Knowing why this pain happens and how to manage it can make a big difference in your monthly routine. This article looks into ovulation pain symptoms, causes, and treatments, helping you find effective relief and better navigate your cycle.

What is ovulation pain?

Ovulation pain, as the name suggests, is a type of pain many women suffer during the ovulation cycle. The pain may feel dull, sharp, or sudden and intense. It is one of the stages of the complex menstrual process and involves the release of a mature egg (ovum) by rupturing follicles. 

Ovulation occurs 14 days before menstruation and lasts for 24 hours each month. Once the egg is released, it can live for 12 to 24 hours without fertilization. Further, in the absence of fertilization, the egg sheds with the uterine lining, resulting in menstruation.

Moreover, pain during ovulation does not indicate pregnancy in women. Rather, it denotes the release of a mature egg and impending menstrual bleeding. While it may seem similar to period pain, they occur in different phases or times of the menstrual cycle and, thus, are less likely to occur simultaneously.

What causes ovulation pain?

Ovulation pain happens when an egg is released from the ovary during the menstrual cycle. While the exact cause is not entirely clear, it is thought to be linked to the swelling of the ovary surface before the egg is released, followed by the rupture of the follicle holding the egg.

A recent study by Nathan R. Brott and Jacqueline K. Le sheds light on this phenomenon. They propose that ovulation pain aligns with the Luteinizing Hormone (LH) surge, during which follicles enlarge without rupturing. This enlargement and LH-triggered contraction in the ovaries can result in discomfort.

Fact
The peak in Estrogen levels during the ovulatory phase triggers a brief surge in the levels of Luteinizing Hormone within 24 hours that can be maintained for up to 48 hours.

How long does ovulation pain last?

Pain during ovulation may last for a few minutes to up to 48 hours and subside on its own after ovulation. However, certain medical conditions may cause intense and unbearable pain during ovulation. We have discussed those medical conditions in the following section.

Other causes of ovulation pain

Some other causes of pain during ovulation are as follows:

Endometriosis ovulation pain

Endometriosis is a painful condition in women that occurs when tissue similar to the uterus develops outside the uterine cavity and causes inflammation. Endometriosis around the ovaries or fallopian tubes may elevate the symptoms and cause pain during ovulation.

If Endometriosis is around the rectal region, it causes rectal pain during ovulation. It can also cause the uterus, fallopian tubes, ovaries, or bowels to stick together. It is called Adhesion and can also result in pain during ovulation.

Ectopic pregnancy

Ectopic pregnancy, a serious medical condition, happens when the fertilized egg implants and begins to develop outside the uterus, often in the fallopian tube. This abnormal implantation can cause severe complications, including rupture of the tube and life-threatening bleeding. Therefore, if experiencing ovulation pain, it’s crucial to consider the possibility of an ectopic pregnancy and seek immediate medical attention. 

Fibroid pain during ovulation

Abnormal pain during ovulation or during and after periods can indicate Fibroids in the uterus. In approximately 30% of women, Uterine Fibroids cause pelvic pain and heavy periods.

Scar tissue

Scar tissue from surgery, particularly after a Caesarean section, can contribute to painful ovulation. Adhesions form around the surgical site, affecting the normal function of nearby organs, including the ovaries. These adhesions can cause discomfort during ovulation and may require medical intervention for relief.

Ovulation pain symptoms

A women experiencing nausea
A women experiencing nausea

Ovulation pain can show the following symptoms in women:

Ovary pain during ovulation

Every month, an egg is released from one side of the ovary, and the pain may depend on which side the egg is released from. However, some women may have persistent pain during ovulation, irrespective of which side of the ovary is releasing an egg.

Breast pain

Ovulation primarily affects the lower abdominal region of the female body and causes pain in the uterus, cervix, ovary, or rectum. However, some women may also feel pain in the breast during ovulation. 

This pain happens due to hormonal fluctuation and is accompanied by breast swelling and tenderness. Further, breast pain intensifies before menstruation and substantially decreases after bleeding.

Other symptoms

Some other symptoms of ovulation include the following symptoms:

  • Nausea and vomiting
  • Light spotting or discharge
  • Mucus secretions
  • Changes in basal body temperature
  • Breast tenderness and pain
  • Changes in appetite
  • Abdominal bloating
Warning
Intense ovulation pain can signal serious conditions like Ovarian cysts or Endometriosis. Immediate medical attention is crucial for accurate diagnosis and timely treatment to prevent complications.

How is ovulation pain diagnosed?

A healthcare provider may diagnose the pain based on its timing. In such instances, the practitioner can examine the abdominal or pelvic region to determine the underlying cause of the pain.

The pelvic examination tests are important to distinguish between regular pain during ovulation and pain caused by Fibroids or Endometriosis. Further, a swab test may also be performed to check the cervix and test for infections.

Ovulation pain treatment and management

The painful symptoms of ovulation can be alleviated with the following treatment:

  • Take pain relievers, such as Acetaminophen, or anti-inflammatory drugs, such as Ibuprofen (Brufen 400) or Naproxen (Naprosyn 500 +)
  • Consult a healthcare practitioner and take prescribed birth control
  • Do stretching exercises 
  • Take a hot bath
  • Use a heating pad to relieve the pain

Conclusion

Ovulation pain, also called Mittelschmerz, is a pain that many women face every month during the menstrual cycle. This may cause symptoms such as pain in the ovaries and the breast or even light spotting and bloating.

The pain is caused by a peak in LH when follicles are enlarging, causing ovarian contractibility. However, some medical conditions, including endometriosis and fibroids, can also cause pain during ovulation. 

Also, pain can be caused by Ectopic pregnancy and scar tissue. Thus, depending on the time of pain, it is important to consult a healthcare practitioner and get a diagnosis of the condition. A healthcare practitioner can prescribe certain medications to relieve pain during ovulation with tips to alleviate pain with heating pads or exercises.

Frequently Asked Questions

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