Feeling a twinge partway through your cycle?

It could be ovulation pain.

So, what is ovulation pain, you ask?

Well, first up, it might be reassuring to know that painful ovulation is a fairly common condition, with anywhere from 20% to 50% of women experiencing ovulation pain either on a regular basis or at some point in their lives.

If you’re noticing a weird cramp feeling in the middle of your cycle, there’s a pretty high chance it could be ovulation pain.

Also known as “mittelschmerz”, meaning “middle pain” in German (think ‘middle of the month’), it’s usually nothing to worry about, so relax, there’s no cause for alarm!

Here’s everything you need to know about pain during ovulation, medically reviewed by embryologist and fertility expert, Navya Muralidhar.

In this article: 📝

What happens when you ovulate?

Ok, a basic science-y bit.

For fertile women, ovulation is the time in your menstrual cycle when an increase in your luteinizing hormone (LH) levels triggers an egg to be released by an enlarged follicle in your ovary.

The egg is released into a fallopian tube, which contracts in waves to help move the egg along towards your uterus.

If you’re trying to conceive (TTC), hopefully, the egg will be met by some super-keen sperm along that fallopian tube, ready to get the baby-making process started.

If not, the unfertilized egg will make its way to the uterus unaccompanied, to be shed as part of your period.

As you may already know, this time of the month may be accompanied by ovulation pain.

Is it normal to have painful ovulation?

Yes, it’s totally normal to experience pain during ovulation.

In fact, up to half of all people with fertile ovaries may experience ovulation pain at least once in their lives.

And around 1 in 5 people with ovaries have ovulation pain regularly.

How do ovulation pains feel?

Ovulation pain symptoms are commonly either a sharp stabbing pain, or an achy cramp, felt in the sides of your lower abdomen, where your ovaries are.

Some women can track their ovulation pain on both sides, month by month, indicating that each ovary releases an egg alternately each month, despite research suggesting that many women don’t ovulate from each ovary in sequence.

Others only ever feel ovary pain during ovulation on one side, despite ovulating from both.

For some women, feeling pain during ovulation is part of every cycle, for others it’s more of an occasional thing.

Just goes to show how unique our reproductive systems can be!

🔎 Dig deeper: What Does Ovulation Feel Like?

Cervix pain during ovulation

This is the classic ovulation pain ‒ the mittelschmerz that you feel across your abdomen.

If you’re experiencing cervix pain during ovulation, you’re certainly not alone!

Fibroid pain during ovulation

According to the Fibroid Specialists, some of the ovulation pain you may be feeling could actually be fibroid pain during ovulation.

If you have painful periods, pain after your period, and pain during ovulation, check in with your doctor, as it could be a sign of uterine fibroids.

Can your lower back hurt during ovulation?

Back pain during ovulation is a known symptom of ovulating, and could be an example of referred pain, or caused by sensitivity to pain during ovulation, as this study suggests.

So if you’re experiencing ovulation back pain, you’re certainly not alone.

Some ovulation pain also continues a few days after ovulation, so if you have lower back pain after ovulation, that’s also a known symptom.

Upper back pain during ovulation

Just as you can have lower back pain during ovulation, you can also have upper back pain during ovulation.

This could be caused by the same reasons ‒ referred pain from the actual ovulation, or a sensitivity to existing upper back pain.

Breast pain during ovulation

If you have breast pain, ovulation could be knocking on your door, figuratively speaking.

Ovulation breast pain and breast tenderness is a reported symptom of ovulation, as this study suggests.

If you have a more stabbing pain in breast during ovulation, that could be a sign of ovulation, but it could also be an early indicator of a cyst, mastitis, or an abscess.

If you’re concerned about any changes in your breast, including ovulation breast pain, speak with your doctor.

Nipple pain during ovulation

What if you don’t have ovulation breast pain, but nipple pain during ovulation?

Well, this could be another form of ovulation pain, caused by a drop in estrogen and a rise in progesterone ‒ two hormones you’ll get very familiar with if you’re TTC (trying to conceive).

Chest pain during ovulation

If you’re having chest pain during ovulation, it can be quite concerning.

Interestingly enough, feeling chest pain during ovulation can be another fairly common side-effect of ovulation.

But again, if you’re ever concerned about chest pain, even during ovulation, speak with your doctor.

Leg pain during ovulation

Leg and foot pain during ovulation is less common among those who experience ovulation pain, but not unheard of.

However, leg pain during ovulation can be a symptom of endometriosis, too ‒ if you think you may have endometriosis, check in with your healthcare provider.

Bladder pain during ovulation

If you have bladder pain during ovulation, it might actually be interstitial cystitis (also known as painful bladder syndrome), which can be agitated by ovulation.

As this study (admittedly on mice) suggests, painful bladder syndrome symptoms tend to worsen as pain during ovulation.

Ovulation pain during sex

If you’re TTC, you may be on a strict sex schedule, timing your under-the-sheets activities with when you’re ovulating, to increase your chances of conceiving.

But when you get ovulation pain during sex, it can be a bit of a turn-off.

If you do have ovulation pain during sex, try to take it easy ‒ it usually doesn’t last too long.

If it does last for more than two days, have a chat with your doctor.

Rectal pain during ovulation

What if you’re getting ovulation pain more about your butt and perineum?

Well, while pain around the anus is more common during your period, rectal pain during ovulation is a bit more uncommon, and could be a symptom of endometriosis.

Ovulation gas pain

Bloating and gas pain during ovulation are very common.

It’s basically all down to hormones, as always ‒ that pesky progesterone!

Joint pain ovulation

If you’re experiencing joint pain, ovulation might just be the reason for it.

Just like with back pain during ovulation, joint pain could be referred pain or due to sensitivity of your pain threshold when ovulating.

Clomid ovulation pain

Clomid (also known as clomiphene citrate) is a medication used to help with infertility, which works to essentially kick-start ovulation in irregular cycles.

If you’re using Clomid, ovulation pain may be something you’re used to ‒ a lot of people taking Clomid have reported some pretty nasty ovulation pain as a side effect.

But if you’re concerned about your ovulation pain on Clomid, speak with your doctor.

Phantom ovulation pain on birth control

If you’re on the birth control bill, you’re most likely not actually ovulating ‒ most birth control pills actually stop you from ovulating in order to prevent pregnancy.

But some people who take the birth control pill still experience what’s known as phantom ovulation pain.

There have also been a few reports of the birth control pill causing pelvic pain during sex.

If you’re worried about any pain while on the birth control pill, speak with your doctor to discuss alternative birth control methods.

Can you get ovulation pain after hysterectomy?

Sometimes, yes, some people can experience ovulation pain after a hysterectomy.

Some hysterectomies involve removing the uterus and cervix, leaving the ovaries and fallopian tubes intact, which can mean that you’re still ovulating, which can lead to experiencing ovulation pain.

Does ovulation pain mean more fertile?

Yes and no.

While feeling pain during ovulation every month is an indicator that you are releasing eggs regularly, there are far more factors, other than missed or irregular ovulation, that can cause infertility.

On the flip side, if you don’t ever experience ovulation pain, it doesn’t mean you aren’t ovulating or that you have fertility issues.

Ovulation pain and fertility aren’t always linked ‒ people who struggle with infertility can still experience pain during ovulation.

If you’re TTC, it’s probably best to use other detection methods to work out your most fertile days for conception, rather than using ovulation pain alone.

All of us are different, so don’t get too concerned over whether you are – or aren’t – experiencing ovulation cramps.

Why does ovulation hurt so much?

If it’s such a common condition for us women to go through, you’d think that there would be a clear-cut reason why ovulation pain is a thing.

But even after decades of research, the exact cause of pain during ovulation is still under the microscope.

The most likely causes of feeling pain during ovulation are:

The growing follicle

The follicle in your ovary that is home to the egg being released can swell up to 2cm in diameter before ovulation.

The theory is that this swelling triggers tension in the ovary and an inflammatory response resulting in prostaglandins (aka inflammatory compounds) being produced and causing this oh-so-pleasant ovulation pain.

Fluid and blood

When the egg is released, fluid and blood from the ruptured follicle are too, which may irritate the nerves and abdominal cavity which surrounds the ovary, causing pain during ovulation.

Sounds a bit scary, but we’re talking about approximately 5ml, or a teaspoon full!

Despite its small quantity, it can take a while for this excess fluid to dissipate and be absorbed, which is why some scientists believe it to be the reason for ovulation pain that lasts a couple of days.

Scar tissue

Abnormal scar tissue from previous surgeries in that area of your body, like a c-section or appendix removal, can restrict normal function and movement, and add additional pressure onto the ovary, felt especially during ovulation.

When might you feel ovulation pain?

Ovulation usually occurs in the middle of the menstrual cycle, around day 14, although this will vary depending on the length of your cycle.

For some people, ovulation is as regular as clockwork, and ovulation pain can be a telltale sign that it’s that time of the month again.

While it’s unlikely anyone actually knows what the exact moment of ovulation feels like, research has found that ovulation pain often occurs on the same day as LH levels peak ‒ the day before the egg is released.

When you feel ovulation pain is it too late?

Not necessarily ‒ you can still conceive straight after ovulation.

Plus, for some women, ovulation pain is an indicator that now’s the best time to conceive, and for others, it can be a sign that they’re ovulating for the next 48 hours.

How long after ovulation pain is the egg released?

Generally speaking ovulation pain happens just before the egg is released.

So if you’re experiencing ovulation pain, this month’s egg could release in the next 24 hours.

How long does ovulation pain last?

Although the reasons why you may feel pain during ovulation might not be clear, it’s important to know that it’s usually a pretty mild discomfort that will pass by itself.

Ovulation pain can be just a couple of twinges that disappear as quickly as they came on, or they can hang around for a day or two.

If ovulation pains are distracting you from your day, you can usually treat them as you would those typical period cramps by getting under a blanket, eating a bar of chocolate, and binge-watching!

Joking… But seriously, the following might help:

• A heat pack or hot water bottle on the area
  
• A hot shower or bath
  
• Off-the-shelf painkillers, like paracetamol.

If the ovulation pain is so severe that these home treatments don’t help, and you’re concerned there’s something else going on, it might be worth a visit to your doctor.

Severe abdominal pain that fits the description of ovulation pain may be a sign of something else.

An ectopic pregnancy, appendicitis, and Pelvic Inflammatory Disease (PID) can all cause sharp pains and cramps in the side of your lower abdomen, while conditions like endometriosis and ovarian cysts, can make severe ovulation pain more likely.

Ovulation pain can be a helpful guide to where you are in your cycle, or just yet another great symptom of being a woman, but either way, they shouldn’t give you real reason for concern.

Remember, you know your body best, so trust your gut – literally – and seek medical advice if you think you need it.

If you are experiencing ovulation pain, know that you’re certainly not alone.

And if you’re trying to conceive, you’re welcome to join us on Peanut, where you’ll find lots of firsthand ovulation pain and pregnancy success stories.