Is it Normal for Ovulation to be Painful?

Each month, women will experience some of the common symptoms associated with her menstrual cycle including headaches, bloating, cramping, and even constipation or diarrhea. However, there are some women who experience a more unique symptom known as mid-cycle ovulation pain. As a matter of fact, this pain is more common than you might think, affecting approximately 20 percent of women. While the pain associated with this symptom can make many women believe that there is something seriously wrong, the condition rarely poses any serious threats.

When severe, painful ovulation is known as mittelschmerz, a word that translates from German to mean “middle pain”. For most women, this condition is associated with a sharp pain that diminishes into a dull ache. However, there are a few women who will experience debilitating pain as a result of this condition, a condition often likened to appendicitis. Additional symptoms might include nausea and menstrual spotting throughout the six to eight hours that mittelschmerz persists. However, it’s important to note that in fewer cases, the condition can last for 24 to 48 hours.

Although the discomfort associated with mittelschermz can manifest on either side of the abdomen, most women experience the sensation on the right. Intercourse poses the potential to aggravate this pain, causing it to occur or persist in greater intensity. Physical activity such as working out might also exacerbate symptoms. Aside from the pain and discomfort, there are some women who will experience gastrointestinal symptoms and more frequent urination. While there are some women who will experience painful ovulation on a monthly basis, it is more common to experience it every third to fourth cycle.

Why Does Mittelschmerz Occur?

It is believed that a minor leakage of blood from the ovary during ovulation causes mittelschmerz to occur. While the blood is later reabsorbed, 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.

Other factors that can affect the amount of pain that you feel is related to the space between your ovary and the abdominal wall. There are no additional medical issues that result from mittelschmerz; however, conditions such as PCOS or fibroids on the ovaries can cause the onset of painful ovulation. If you ever become concerned about any of these conditions, it is best to contact your doctor.

Diagnosing Mittelschmerz

Ovulation generally occurs approximately two weeks after the first day of the menstrual cycle, making the painful symptoms of mittelschmerz easily recognizable. Charting when the pain occurs is one of the most straightforward methods to use when it comes to diagnosing painful ovulation, especially because you can then show your doctor the precise times at which you’re experiencing the pain. When examined in conjunction with your medical history and used with a physical examination, it will be possible to diagnose whether or not mittelschmerz is the cause of your problems.

Laparoscopy is required for some women in order to make a positive diagnosis, as inserting a narrow tube below the navel allows for a direct view of your abdominal wall and the pelvic organs. If irregularities are present or the pain is too severe, x-rays are sometimes used to determine why you’re experiencing pain.

The pain associated with mittelschmerz can cause anxiety, often manifesting in symptoms similar to appendicitis. Don’t allow yourself to be misled into undergoing unnecessary surgeries as a result and always rule out mittelschmerz before pursuing other options.


Last modified: March 24, 2014