Ovulation pain
During ovulation, when an egg is released from an ovary follicle, some women experience a sensation commonly referred to as ovulation pain. Ovulation pain is also known as mittelschmerz, which is German for ‘middle pain’.
Women describe ovulation pain in very different ways: from a dull ache and middle pain to a sharp and sudden twinge.
Ovulation pain: a bit of anatomy
Let’s start with a very interesting fact about the peritoneum.
I can’t believe I just said that when writing about what, for some means, severe pain but this statement is not just true but it is key to understanding what causes ovulation pain.
The peritoneum is a membrane, rather like a lining inside the abdomen and pelvic area. It covers and protects all of the abdominal organs, apart from the ovaries and the fallopian tubes. The only reason the peritoneum doesn’t cover the ovaries is because of ovulation. A monthly breakage in the ovary wall would irritate the peritoneum, causing severe pain.
Ovulation pain symptoms
What are the symptoms of ovulation pain? Women usually describe ovulation pain as a sudden twang, pop, twinge or feeling of pressure in the lower abdomen.
This coincides with the ovulatory stage of the menstrual cycle and it’s usually a one-sided pain – felt on the side where ovulation is occurring. However, as women have two ovaries, the pain might switch sides from month to month.
Although many consider ovulation pain to be common, it might come as a shock to hear that pain during ovulation is actually not normal.
Of course, many women will feel it when they ovulate and, for them, it isn’t a big deal. But some women would describe ovulation as being painful and, in some cases, it can be severe pelvic pain that might be debilitating.
Severe ovulation pain
Acute, severe, stabbing or debilitating pain in your lower abdomen during ovulation is not normal.
If the level of pain you experience requires an over-the-counter painkiller, or if the pain stops you from getting on with your day, then you need to see your healthcare professional as soon as possible.
You should ask for a referral to see a reproductive specialist, who can get to the bottom of the problem for you and treat ovulation pain holistically, rather than just offer you some stronger painkillers or a hormonal contraceptive, to prevent you from ovulating. Doing that will just mask the underlying problem and risk further damage or deterioration to your mental and physical health and, possibly, your fertility.
How long does ovulation pain last?
For most women, ovulation pain might last for about 6-12 hours. Other women might experience this for minutes, and others for a day or two at most.
If you experience ovulation pain for three days or longer, see your healthcare professional as soon as possible, especially if the pain is accompanied by other unexpected symptoms, such as vaginal bleeding. Request a referral to a reproductive specialist who can look for the underlying cause of the pain.
Pain during ovulation – 7 most common causes
When your ovary releases an egg you shouldn’t feel pain. You might feel bloated and uncomfortable but you shouldn’t experience pain. Painful ovulation is a warning that you have an underlying health problem that should be addressed.
In fact, some of the underlying causes that make you experience painful ovulation can result in fertility problems, which might prevent you from getting pregnant.
Here are the most common causes of ovulation pain:
#1. Cysts on the ovaries
Ovulation pain is often the sign of cysts on the ovaries. Cysts can form or can burst, during the ovulation period.
Women with PCOS (Polycystic Ovary Syndrome) often experience ovulation pain due to multiple ovarian cysts.
Cystic ovaries are the result of a hormonal imbalance, usually related to insulin resistance.
Sugar and grains in the diet cause spikes in blood sugar levels and can also cause inflammation in the body. Significantly reducing or eliminating sugars and grains can be highly beneficial.
Doctor Andrew Orr, a specialist in reproductive medicine and women’s health, with a Master’s degrees in both fields, recommends following a diet containing low-GI foods, or a paleo or low-carb style of eating.
Find out more information on how to possibly reverse polycystic ovaries with low carb at the Diet Doctor website.
Read more in BellyBelly’s article How To Get Pregnant With PCOS | 4 Tips And Lifestyle Changes That Can Help.
#2. Endometriosis
Endometriosis is an inflammatory disease that affects the ovaries and fallopian tubes.
It can also cause pain during the ovulatory period.
Other symptoms of endometriosis include pain during intercourse, migraines, constipation, headaches and dizziness.
Some women with endometriosis can be asymptomatic.
That is why it’s important to see a specialist if you’re experiencing any fertility problems.
Endometriosis ovulation pain
The endometrium is the inner layer of the uterus, which gets shredded every month with your menstrual period. Endometriosis occurs when this tissue grows outside the endometrium. It can happen almost anywhere in the woman’s body, which is why endometriosis can be responsible for ovulation and pelvic pain.
If you suspect you might have endometriosis, or your doctor has mentioned this to you, please see our article Endometriosis treatment – What Are My Treatment Options?
#3. Adhesions from prior surgery
Perhaps you’ve had a c-section, had your appendix out, or have had other abdominal surgery.
Adhesions are hard to avoid after having surgery and are quite common. Unfortunately, they can result in ovulation pain.
How? Sometimes, an ovary can adhere to the bowel or other internal parts; this can cause pain during ovulation. It happens because of the scar tissue that forms after surgery. Scar tissue behaves differently from untouched tissue and is much more prone to adhesions.
#4. Bacteria from medical procedures
Bacteria can be introduced into the pelvic cavity through catheters, during surgery and even during childbirth.
The bacteria can cause inflammation and infection, resulting in ovulation pain and menstrual pain.
#5. Sexually transmitted infections
Sexually transmitted infections (STIs) are also possible causes of ovulation pain.
They can cause inflammation in the fallopian tubes, scarring and pelvic inflammatory disease (PID).
Chlamydia, a silent STI, can also cause another condition, which results in the fallopian tubes being blocked with pus. This causes inflammation and pain and can affect your future fertility.
#6. Hormonal imbalance
The menstrual cycle is regulated by a range of hormones. Most of the female hormone regulation happens in the ovaries. The pituitary gland in the brain, however, is also responsible for specifically female hormonal balance.
Any malfunction in the normal flow of hormones can lead to ovulation pain.
#7. Autism
One of the many characteristics of autism is having extremely heightened sensitivity, which makes people much more aware of what they feel through each of their senses. Autistic people tend to feel much more, earlier and deeper – to the point where they feel pain, including ovulation pain, in situations where others can hardly feel anything. Research shows that autistic people can experience intense, sharp pain more frequently than those who aren’t autistic.
‘But my doctor said ovulation pain is normal…’
Doctor Andrew Orr says you should never let anyone tell you that pain during ovulation is normal.
‘Many general practitioners don’t know that much about gynecology. Remember, it’s not their field of expertise; they are general practitioners. Always get a referral to see a specialist’, Dr. Orr insists.
He strongly advises women with symptoms of ovulation pain to be investigated by a professional reproductive specialist.
When you feel ovulation pain, is it too late?
If you’re trying to get pregnant and you can physically feel when ovulation occurs, it’s not too late for that egg to become your next baby. However, an egg is usually viable for just 24 hours, so stop reading and go get that sperm, lady! The earlier the better.
