Mittelschmerz and Ovulation Pain

Ovulation Pain - Mittelschmerz

Most women are fully aware that their period can come with pain and cramping, but what about the cramping that occurs during the middle of your cycle, around the time of ovulation?

About 1 in 5 women will experience ovulation related cramping, mittelschmerz, about two weeks before their period is due to start. For most women, this condition is associated with a sharp pain that diminishes into a dull ache.

Mittelschmerz – What It Means

The word, mittelschmerz, is German in origin and literally means:

Mittle = Middle or Medium
Schmerz = Pain

It is a very accurate description of what is going on for some women – pain in the middle of your menstrual cycle.

What is Mittelschmerz and What Causes It

The exact cause of ovulation related cramping and pain isn’t fully known. Typically, people assumed that you feel the pain when ovulation actually occurs and your egg breaks out of the follicle. It is believed that a minor leakage of blood from the ovary during ovulation causes mittelschmerz to occur. It is believed that when it does leak, it irritates the abdominal wall and causes the painful ovulation. Depending upon your unique pain threshold and the amount of blood that does leak, mittelschmerz might affect you differently than others.

The University of Melbourne conducted a study that presented another possible cause of the ovulation pain. The research suggests that the majority women feel the pain before they actually ovulate. The pain seems to be associated with the the lutenizing hormone (LH) peaking and causing ovarian muscle to contract.

Recognizing Mittelschmerz (Ovulation Related Cramping)

  • Timing – If you are going to feel mittelschmerz, it will typically happen about 14 days before your period is due to arrive. This pain may last for a couple of hours or as long as a couple of days.
  • Location – Ovulation cramping is usually felt on one side of your body, near the hip bone. If you have ovulation pain every month, the side may vary depending on which ovary is releasing the egg that month.

  • What it Feels Like: The way women feel the pain varies. It could feel like uncomfortable pressure, twinges, sharp pains or cramps. If you are feeling cramps, they will feel different from menstrual cramps. This is because the location the cramping is different. When you have period cramps, your whole uterus is a player in the pain, but where mittelschmerz is concerned, the cramping will be located off to one side, where the ovary is located.

Mittelschmerz as an Ovulation Sign

If you are actively trying to get pregnant, you know that the best time to get pregnant is around when you ovulate. Besides the normal signs of fertility, like egg white cervical mucus, mittelschmerz is a major ovulation indicator. If the pain isn’t too bad, you might want to cue your significant other in on the fact. Timing wise, now would be the best time to have sex if you are trying to get pregnant.

What Can I Do to Relieve Ovulation Pain?

No specific treatment is required for ovulation pain as this only occurs for a short time. Nevertheless, there are ways to make this time of your monthly cycle much easier. Take plenty of time to rest until the pain is gone, taking warm (not hot) baths to feel relaxed, and drink plenty of fluids to keep you properly hydrated.

For women with severe ovulation pain, over-the-counter pain relievers, like ibuprofen or aspirin, and a heating pad applied over the abdomen will usually provide relief from the pain of mittelschmerz. You can also try pain relievers that are marketed for menstrual pain such as Midol.

However, if the pain becomes severe and intolerable and pregnancy is not something you want to achieve for now, then oral contraceptives can be prescribed by a physician.

When Should I Be Concerned?

For most women, ovulation pain and cramping is not a sign of a serious problem.
There are a number of things that can cause ovulation pain. It could be caused by the ovary cramping, or a ruptured or emerging follicle. If the pain was caused by the follicle rupturing when you ovulated, you may end up seeing a bit of ovulation bleeding.

When to Contact Your Doctor

  • If you are super concerned about the pain. Seriously, doctors are there to support you. If you are concerned, get checked out.
  • Pain is lasting longer than 24 – 48 hours.
  • You are in so much pain that it is impossible to cope.
  • If spotting is too heavy to qualify as spotting.
  • Having sex causes too much pain to bear.

Ovulation pain can also be caused by other medical issues like endometriosis, ovarian cysts, or even appendicitis. If you have pain every month during ovulation, you should talk to your doctor. It may be indicative of another medical problem, which can often be treated. Your doctor can do an exam, use blood tests, ultrasounds and more to help diagnose what exactly is going on.

Talking to your doctor and getting to the root cause of ovulation cramping will help increase the likelihood that, if there is a fertility concern going on, you will have the necessary tools to address it.

Last modified: October 24, 2016