You knew that cramps came with the period package. But what about abdominal pain between your periods, in the middle of your cycle? There’s a very good chance you could be experiencing ovulation pain — a completely normal (if unpleasant) result of your ovary releasing its monthly egg.
Not everyone experiences ovulation pain. But if you do, ovulation pain can be a helpful sign to track if you’re trying to get pregnant.
Here’s what you need to know about ovulation pain or cramps, including what it feels like, ovulation pain symptoms, how long it lasts and other conditions that might cause severe pain.
What is ovulation pain?
When an ovary releases an egg in the middle of your menstrual cycle, you may experience ovulation pain on one side of the lower abdomen or pelvis. Known in medical circles as "mittelschmerz" — German for "middle" and "pain" — it’s possible to experience ovulation pain occasionally or during every cycle.
What does ovulation pain feel like?
Around two weeks before you expect to get your period, ovulation may cause a dull and crampy achiness, mild twinges or sharp and sudden pain on one side of your lower abdomen.
You may feel pain on a different side each month, or on the same side for several months in a row, depending on which ovary releases an egg.
Keep in mind that abdominal pain at any other point in your cycle isn’t linked to ovulation. You might have menstrual cramps or another pelvic or abdominal condition. If it’s severe, check in with your doctor.
How long does ovulation pain last?
Ovulation pain usually occurs for a few minutes to a few hours, although it can last for up to one or two days.
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Symptoms of ovulation pain and cramps
Ovulation pain symptoms may include:
- Pain on one side of the lower abdomen or pelvis
- Light vaginal bleeding or discharge
- Nausea, if pain is severe
Causes of ovulation pain and cramps
Experts aren’t sure exactly what causes ovulation pain, but there are a couple of prime suspects:
- Normal follicle growth before ovulation stretches the outside of the ovary, causing discomfort
- When a follicle naturally ruptures and releases an egg during ovulation, it also releases blood and fluid that may irritate surrounding abdominal tissues
Is pain during ovulation normal?
Ovulation pain is completely normal: About 1 in 5 women experience some pain and discomfort around the time they ovulate.
That said, you shouldn’t experience ovulation pain if you’re on the pill (a combination pill that contains both estrogen and progestin) or have a hormonal IUD because those types of birth control stop ovulation.
To figure out if the abdominal pain you’re experiencing is linked to ovulation, track your cycle for two to three months. If symptoms consistently happen about two weeks before each period, it’s likely ovulation pain.
To treat ovulation pain, try a painkiller like acetaminophen. Skip the ibuprofen if you’re trying to get pregnant, as some (though not conclusive studies) indicate that it might lead to an increased risk of miscarriage.
What does it mean if I have severe ovulation pain?
Many times, it’s normal to experience some pain around the time you ovulate. However persistent or severe abdominal pain could indicate another problem that requires medical attention, including:
Appendicitis
A blockage in the lining of the appendix can cause an infection and inflammation, resulting in pain that begins in the lower right side of your abdomen or around your belly button and worsens when you cough. You may also feel nauseous and have a fever, constipation, vomiting or diarrhea.
Because the appendix can eventually rupture, causing a potentially deadly abdominal infection, it’s important to contact your doctor right away if you think you might be experiencing appendicitis symptoms.
Ectopic pregnancy
Rarely, fertilized eggs can implant outside of the uterus (usually in a fallopian tube), causing sharp and crampy abdominal pain that’s often accompanied by vaginal bleeding and early signs of pregnancy like nausea.
See your doctor right away, especially if a pregnancy test comes back positive, as an ectopic pregnancy can be life-threatening.
Ovarian cysts
While most ovarian cysts are small and don’t cause symptoms, a larger cyst can cause sharp or dull pain on one side of the lower abdomen that may come and go. Larger ovarian cysts may also cause bloating, pressure and swelling in the lower abdomen. If the cyst ruptures, it can cause sudden and severe pain.
Endometriosis
Sometimes tissue that normally lines the inside of the uterus grows on other parts of the pelvic area and gets trapped outside the uterus, where it bleeds with each menstrual cycle. Because the blood has nowhere to go, it irritates surrounding tissues and eventually leads to painful adhesions and scar tissue that can make it harder to get pregnant.
Unlike ovulation pain, however, endometriosis pain tends to worsen during — not between — periods.
Sexually transmitted infections
STIs like chlamydia can result in scarring around the fallopian tubes if left untreated, which can cause abdominal pain and fertility problems. Other symptoms to watch out for include painful urination and unusual vaginal discharge. Many STIs, however, cause no symptoms at all.
Pelvic inflammatory disease (PID)
Usually linked to an untreated STI, this bacterial infection of the reproductive tract often causes abdominal pain along with a foul-smelling vaginal discharge and vaginal bleeding between periods and after sex. Symptoms often develop slowly, but the sooner pelvic inflammatory disease is addressed, the better.
Scar tissue
Scarring due to C-section or other abdominal surgery can restrict the ovaries and surrounding structures, potentially resulting in severe ovulation pain and problems getting pregnant.
When to call the doctor about pain during ovulation
To rule out conditions like appendicitis or an ectopic pregnancy, check in with your doctor if you experience a new or sudden, severe pain in your lower abdomen, or if pain lasts more than a couple of days.
Also contact your doctor if abdominal pain is accompanied by:
- Fever
- Nausea and vomiting
- Diarrhea or constipation
- Early signs of pregnancy and/or a positive pregnancy test
- Vaginal bleeding between periods
- Foul-smelling or otherwise unusual vaginal discharge
Ovulation pain is usually nothing to worry about. In fact, if you’re trying to conceive, knowing the signs of ovulation — which can include ovulation pain — can help you to get pregnant faster.
After all, timing sex around ovulation is the best way to help sperm meet egg. But if you’re concerned about severe pain or other symptoms, it’s always a good idea to check in with your health care practitioner.
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