Is Ovulation Pain Normal?

Ovulation Pain as a Fertility Sign, Why It Happens, and When You Should Worry

Woman with hand over ovulation pain / abdomen
The side from which you feel ovulation pain may actually indicate which ovary you ovulated from!. Photo: Brejeq / iStock

Up to 50 percent of women will experience ovulation pain at least once in their lives. Some women -- about 20 percent -- get ovulation cramps every month. Generally speaking, this is normal.

Severe pain, however, is not. Intense or prolonged pelvic pain may be a symptom of endometriosis or pelvic inflammatory disease. If the pain prevents you from having sex or going about your daily life, this is also not normal.

And sometimes, the aches you experience have nothing to do with ovulation. 

Ovulation Pain Symptoms: What's Normal

Another term for ovulation pain is mittelschmerz, which is German for "middle pain." Ovulation pain may occur a few days before or after ovulation. It doesn't necessarily occur at the exact moment the egg is released from the ovary.

Some experience a dull, achy feeling. It may last for a few hours or even over a couple of days. Other women experience a sudden, sharp pain, lasting just a moment.

Ovulation pain is typically mild, but has been known to land some women in the emergency room for suspected appendicitis. Though such a severe reaction is rare, it does happen.

Is Ovulation Pain a Reliable Ovulation Symptom?

Research has found that ovulation pain actually can signal ovulation.

One study found that ovulation pain came on the same day that the hormone LH peaked. LH is the hormone detected by ovulation predictor kits.

LH peaks during your most fertile time, just before you ovulate.

Another study used ultrasound technology to connect mid-cycle cramps to actual ovulation. They discovered that ovulation occurred a couple of days after women reported the side pain.

Although it can be a symptom indicating ovulation is imminent, it's probably best not to rely on ovulation pain as a primary way to detect your fertile window.

  

Some women may feel twinges after ovulation. This would make ovulation pain a less than ideal way to time sex for pregnancy since you need to have sex before and not after ovulation

What's the Difference Between Ovulation Pain and Implantation Cramps?

Some women report cramps during the time of embryo implantation. Embryo implantation takes place a few days to a week after ovulation. 

Certainly women feeling cramps are experiencing real pain. But the whether this pain is embryo implantation, ovulation, or something else is unknown. 

Why Does Normal Ovulation Pain Occur?

No one is sure what causes ovulation pain. But here are a few theories.

During ovulation, a follicle on the ovary ruptures and expels an egg. This releases some extra fluid, and the extra fluid may lead to a dull ache. The sharp, sudden pain some women feel may be caused by the egg itself, bursting out of the follicle.

Spasms of the fallopian tubes or uterus as ovulation approaches may be another possible cause.

You may notice that the pain is more frequently on one side than the other.

While you may have been taught that the ovaries "take turn ovulating," it's normal for one side to ovulate more often than the other.

Could Ovulation Pain Be a Symptom of Endometriosis? 

Endometriosis can cause pelvic pain at any time, but it can be quite severe during your menstrual cycle and near ovulation.

Some women with endometriosis experience such bad pain before and during ovulation that they can't have sex comfortably. This can make timing sex for pregnancy difficult. 

If you're experiencing pain during sex, this is something you should consult your doctor or healthcare professional about. 

Endometriosis isn't the only possible cause of abnormal cramping around ovulation. Infection of the fallopian tubes can also lead to intense ovulation pain.  Fibroids and ovarian cysts can also cause mid-cycle aches. 

Severe pain -- at any time of the month -- should be checked out. If you're taking fertility drugs, severe pelvic pain could be a symptom of ovarian hyperstimulation syndrome.

You should contact your doctor right away if...

  • your pain is severe
  • you're vomiting or having severe diarrhea
  • you're having trouble breathing

You may be confusing "ovulation pain" for something more serious like appendicitis.

If the pain is not especially severe, but it interferes with your daily life or causes pain during sexual intercourse, you should make an appointment with your doctor. 

More on ovulation:

Sources:

The American College of Obstetricians and Gynecologists. "Chronic pelvic pain" (Accessed Sept. 2015).

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