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If you’ve ever felt a sharp twinge of pain, one-sided cramps, or a sensation of uncomfortable pressure on the side of your lower abdomen around 12-16 days before your period starts, you may have experienced ovulation pain.
Ovulation, or the release of an egg from your ovary, typically occurs about two weeks before the start of your next menstrual period. For many, ovulation comes and goes with no prominent signs that it’s happening. For some, however, the ovulation phase can be worse than PMS. So how do you know when it’s run-of-the-mill ovulation pain, or when to consult your doctor?
Why does ovulation pain happen?
To get a grasp on why ovulation pain, also called “Mittelschmerz” (a fitting German term meaning middle pain), happens, it helps to have a deeper understanding of what’s taking place inside your body during the ovulation portion of your menstrual cycle.
Throughout an average menstrual cycle, eggs will grow inside a follicle, a small fluid-filled sac found inside the ovaries. Your follicles play a major role in your cycle and fertility health, releasing a variety of hormones that work to influence the stages of the menstrual cycle. When it comes time for ovulation, a follicle will stretch and break open to release an egg. Both the follicle stretching and the egg bursting through the follicle may cause ovulation pain. This is a normal part of the menstrual cycle and the ovulation process.
During your cycle, the rising of luteinizing hormone (LH) levels will "trigger” ovulation to occur, with LH levels generally being at their highest around 10-12 hours prior to ovulation.
What are the symptoms of ovulation pain?
Any pain in your abdomen can cause even the most level-headed of us to dive head first into a Dr.-Google-Anxiety-Spiral, but fear not: in the majority of cases, ovulation pain doesn't require medical intervention, and in fact, is usually experienced as a minor discomfort.
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Thankfully, over-the-counter pain relievers such as ibuprofen, paired with home remedies like heating pads and exercise (yes, another reason to make sure you’re moving your body!) are often effective at alleviating Mittelschmerz.
The timespan of ovulation pain can vary from person to person, and even from cycle to cycle. Generally, Mittelschmerz pain can be expected to persist anywhere from a few minutes to a couple of days. This pain can feel:
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One-sided within your lower abdomen. This is because ovulation pain occurs on the side of the ovary releasing the egg that cycle. Because of this, it’s not uncommon for the pain to switch sides every other month.
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Like a dull aching throughout the day
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Similar to period cramps
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A sharp and sudden twinge that comes and goes
Okay, but how do I know for sure it’s ovulation pain?
Unfortunately, for those of us who ovulate and experience menstrual cycles, the aches and pains that go along with it can sometimes feel scary. Knowing the symptoms is one thing, but how can you determine if the pain is, in fact, due to ovulation?
Cycle-tracking can be beneficial for countless reasons, but in the case of pinpointing ovulation pain, it can be especially helpful to put your mind at ease when you feel that signature twinge or discomfort. Cycle tracking doesn’t have to be overcomplicated, either — simply keep track of your menstrual cycle for several months and note when you feel lower abdominal pain. There are apps available that do wonders at organizing this information, but you can also go the notes-app-on-your-phone route, or even use an old-school pen-and-paper method. When it comes down to it, the best cycle-tracking tool will be whichever one you’ll actually remember to use.
After tracking for a few cycles, if you find that your suspected ovulation pain occurs mid-cycle and goes away without treatment, it most likely is indeed Mittelschmerz.
Should I see my doctor about ovulation pain?
Rarely, ovulation pain will be so severe that you need medical attention. However, it’s always a good idea to contact your medical provider if abdominal or pelvic pain is new to you, becomes severe, the pain occurs at a time other than the middle of the cycle or endures for several days. In cases where the pain is intense, it may likely be caused by an issue more serious than standard ovulation pain.
Other causes of similar pains can include pelvic inflammatory disease (PID), ectopic pregnancy, polycystic ovary syndrome (PCOS), endometriosis, irritable bowel syndrome (IBS), or fallopian tube infections.
In any case, it’s always important that you don’t dismiss your pelvic pain. When in doubt about pain felt during any time of the month, the best course of action is to speak to your doctor.
Lindsey Williams is a library worker and writer who lives in Arizona with her daughter, husband, and their dog, Peaches.
This article was medically reviewed by Dr. Jessica Ryniec.