Ovulation pain

Around one in five women experience a noticeable pain every month at the time of ovulation – and about half of all women are thought to have experienced ovulation pain at least once. 

This ovulation pain is referred to clinically by the German word ‘Mittelschmerz,’ which means ‘middle pain.’ 

What does ovulation pain feel like?

The experience of ovulation pain can be quite different from woman to woman. Some women report a dull ache in their lower abdomen or pelvis that is similar to period pain. The aching ovulation pain can last for an hour or two, or in some cases, can drag out for a few days. 

Other women report that they regularly experience one short, sharp and intense pain midway through their cycle that lasts for just a few seconds. 

While ovulation pain is usually bearable, women who experience sharp pain lasting for more than a few minutes have been known to mistake ovulation pain for appendicitis. 

Where does ovulation pain occur?

Ovulation pain is an internal pain, which typically occurs on either the left or the right side of the lower abdomen, inside the hip bone. 

Some women always experience ovulation pain on one side of their body (typically the right side), while others experience the pain on either side. Less commonly, women may experience the pain in both sides of the abdomen simultaneously. 

Why does ovulation pain occur?

There are several explanations for ovulation pain

The growth of follicles in the ovaries prior to ovulation

• The rupture of the ovarian wall that occurs each month at ovulation
• Muscular contractions of the fallopian tube and the ovaries that occur after ovulation 

How do you know if this is ovulation pain?

Ovulation pain varies from woman to woman and can be a dull ache that lasts for more than a day, or a sudden sharp pain that goes away after a few minutes. If you have experienced similar pain before and the pain is occurring around the middle of your cycle, then it is likely to be ovulation pain. 

There are many other reasons for abdominal pain. If the pain is unusual, or does not pass in the time indicated, or if you have any other reason to be concerned, you should see your doctor. 

What symptoms are not related to ovulation pain?

Seek medical advice if you are experiencing any other symptoms at the same time as abdominal pain, particularly if you experience the following:

• High temperature of more than 1 ºC above normal temperature, lasting for more than an hour
• Dizziness or fainting
• Vaginal bleeding unrelated to your usual menstrual period
• Persistent nausea and vomiting
• Swollen abdomen
• Painful, uncomfortable or stinging urine
• Passing blood in urine or stool
• Difficulty breathing 

What pain (other than ovulation pain) might be the cause of abdominal pain?

It is important to seek medical advice if the pain you are experiencing is not occurring at the appropriate time for ovulation pain or if the pain is quite severe or if it does not go away after a reasonable period of time. 

This is particularly important if you do not usually experience ovulation pain, or if your experience of ovulation pain is usually quite different. 

Other possible explanations for abdominal pain, which is not ovulation pain, include:

• Ectopic pregnancy – when the fertilised egg implants outside the womb, usually in the fallopian tubes, urgent medical attention is needed
• Pelvic Inflammatory Disease or inflammation of the fallopian tubes
• Endometriosis – when the endometrium (lining of the womb) grows outside the womb, such as the ovary, fallopian tubes, pelvic cavity or in the bowels
• Ovarian cyst
• Appendicitis
• Perforated ulcer