Pain during ovulation


Many women experience pain during ovulation. It is estimated that up to 40% are affected. Although the phenomenon is widely known, the cause has not yet been conclusively clarified!

The range of possible pain is very wide: it ranges from a "slight pull" to severe abdominal cramps.

Causes of pain

To this day, experts still disagree on why many women feel pain during ovulation. Different theories have currently been developed that could be the cause either alone or together.

1.) Irritation of the peritoneum

During ovulation, the egg cell and the follicle water are flushed out of the follicle. With a follicle size between 18 and 25mm, the amount of fluid that escapes is very small. The sensitive peritoneum (lat .: peritoneumHowever, it is likely that even the smallest amount of fluid can irritate and cause pain.

2.) Tension of the capsule and tearing of the ovary

The paired ovaries are where the egg cells mature. In sexually mature women, they are about the size of a plum and acquire a pitted surface with age. But why is that so? The ovaries are surrounded by a tough capsule (lat .: Tunica albuginea). Every time ovulation occurs, the mature follicle bulges forward, creating tension. Eventually he breaks the capsule and can release the egg cell. Over many years, the constant cracking and bursting causes a pitted surface.

Some experts suspect this is the cause of ovulation pain.

Endometriosis pain

Some patients experience pain during ovulation. This can have different causes.

Among other things, endometriosis can cause pain during ovulation. The reason for this is that endometriosis is mucosal tissue (endometrium) that is not only found in the uterus as usual (uterus) but also in other places such as the fallopian tube (Tuba uterina) occurs. As a result, endometriosis can cause ovulation pain.

So-called ovarian endometriosis, in which the lining of the uterus accumulates in the ovary, can also lead to pain during ovulation as endometriosis.

Some patients experience ovulation pain even without endometriosis. As a result, ovulation pain does not have to be associated with endometriosis, and both can occur separately.

Nevertheless, pain during ovulation can indicate endometriosis, which is why the pain should definitely be mentioned to a specialist in gynecology. The gynecologist can then use the ultrasound to determine whether the ovulation pain is due to endometriosis or whether the patient is actually healthy.

If you are further interested in this topic, please read our next article at: Symptoms of Endometriosis & Treatment of Endometriosis

Pain from a cyst

Some patients feel an uncomfortable twitching in their abdomen during ovulation, which can worsen or is perceived as very painful for some patients. This can have different causes.

Among other things, a cyst can cause pain during ovulation. There are also cysts that arise when ovulation does not occur. These non-ovulating cysts can also cause pain. They are known as Follicular cysts, whereby the cyst is often harmless and regresses within a few weeks.

After ovulation, a cyst, known as a cyst, can also develop on the ovary Corpus luteum cyst. This "after-ovulation" cyst can cause pain, but is usually harmless and usually resolves on its own. Nevertheless, it can happen that the patient has pain after ovulation due to the cyst and this pain can sometimes last for several days, which is why a doctor for gynecology should be consulted. The so-called endometriosis cyst can also be the cause of ovulation pain. By tensing the muscles (Contracture) pain occurs in the cyst during ovulation, whereby the pain for the patient is projected into the abdomen and the patient often feels severe abdominal pain on one side.

In general, few cysts cause ovulation pain. However, since there are cysts that develop before or after ovulation and can then lead to pain, many patients associate ovulation pain with cysts. However, it is important to note that while most cysts are more likely to be painful during intercourse or general abdominal pain, the cyst rarely causes pain during ovulation.

Concomitant symptoms

Median pain often does not occur alone, but is accompanied by various other symptoms that either begin and subside, or persist until the end of the cycle.

The accompanying symptoms are very diverse and can be different in each cycle.
Women report about it particularly often

  • Mood swings,
  • Tearfulness,
  • touch-sensitive or tight breasts,
  • sore nipples,
  • Back pain,
  • worsening of the median pain when urinating,
  • Constipation,
  • Irritability of the gastrointestinal tract,
  • Pulling and feeling of pressure in the abdomen
  • and bloated appearance of the abdomen.

In most cases, whether the middle pain occurs on the right or left depends on which ovary is the most mature in the respective cycle follicle (the egg cell) and thus ovulates.

In the ideal case this is alternating, but in principle it is of minor importance and can also take place several times on the same page.
Even if not If middle pain occurs, ovulation may or may not have occurred.

Read more on the topic: These symptoms cause my ovulation

Back pain when ovulating

Middle pain can radiate into different areas of the body because, among other things, it is assumed that it is caused by the bursting of the Follicle released fluid and the resulting irritation of the peritoneum occurs.

Often these pains are trunk-emphasized, for example in the back or groin area. However, the most painful place in the right or left lower abdomen can still be determined.

If very severe isolated pain occurs in the back or in the groin that persists over a long period of time, this should be clarified by a doctor.

Chest pain when ovulating

Chest pain, also known as Mastodynia are a common symptom in women around and after the time of ovulation. The chest pain itself is uncomfortable but harmless and occurs together with a strong feeling of tension and hypersensitivity of the chest and can occur on both sides as well as only on one side.

This article could also be of interest to you: Pain in the nipple

The reason for this is suspected to be the interplay of hormones during the female cycle. While the production of the hormone estrogen is in the foreground in the first half of the cycle until ovulation, the hormones progesterone and prolactin dominate from the time of ovulation. These hormonal fluctuations mean, on the one hand, that more water is stored in the breast tissue and, on the other hand, that the female breast prepares itself for the production of milk through the growth of the tissue cells and increased secretion production. These changes can then cause a painful feeling of tightness by stretching the breast tissue. After the period, however, this pain subsides due to the changed hormone levels.

Are you interested in this topic? You can read more information in our next article: Chest pain when ovulating

Abdominal pain when ovulating

Abdominal pain during ovulation is a symptom that many women suffer from. Depending on the individual, the pain can be pulling, cramping or stabbing pain. These abdominal pains do not have to occur every time you ovulate and can vary in intensity and location from cycle to cycle.

This ovulation abdominal pain is almost always harmless. The cause of this is suspected on the one hand to be a tension in the ovary with irritation of its capsule during ovulation, on the other hand the amount of fluid escaping during ovulation could also affect the peritoneum (peritoneum) irritate and thus cause abdominal pain.

Even if severe abdominal pain occurs at the time of ovulation, other causes must always be considered. In the event of persistent, severe pain or other additional symptoms, a doctor should be consulted in order to avoid more harmless clinical pictures such as bladder infections or gastrointestinal infections (gastroenteritis), but also serious causes such as appendicitis (appendicitis) or rule out kidney disease.

Read more on the topic:

  • Abdominal pain and nausea or abdominal pain and diarrhea
  • Left Side Stomach Pain - What Do I Have?
  • Right Side Abdominal Pain - What Do I Have?

Abdominal pain when ovulating

At the time of ovulation, many women report pain in the lower abdomen. This type of pain, while uncomfortable, is harmless and is also known as middle or intermenstrual pain.

The pain can manifest itself as a pulling or recurring stinging, but it can also be spasmodic. Most of the time, the pain in the lower abdomen only occurs on one specific side. This depends on which ovary is currently active in the respective cycle. The side can change from month to month and be accompanied by pain that radiates to other parts of the body, such as the back or legs. It is also possible that in some cycles no abdominal pain is felt at all.

Read more on the topic:

  • Cramps in the abdomen
  • Right lower abdomen pain
  • Pain in the left lower abdomen

As with pain in the abdominal area during ovulation, the cause is irritation of the peritoneum (peritoneum) suspected due to escaping fluid or tension in the ovary due to the expulsion of the egg cell.

As with ovulation-dependent abdominal pain, abdominal pain in the middle of the cycle should see a doctor in the event of severe, persistent pain in order to determine other causes such as appendicitis, kidney disease, ectopic pregnancy, endometriosis or diverticulitis (disease of the large intestine with preferably left-sided lower abdominal pain) to exclude.

Kidney pain when ovulating

Pain in the kidney area during ovulation is often noticeable as a pulling in this area. As a rule, however, the kidneys themselves are not affected. Ovulation-related abdominal or abdominal pain, which radiates over the lower back to the kidney area, is often the cause.

This type of pain is temporary and harmless. However, if the pain worsens and persists beyond ovulation, a doctor should rule out kidney disease such as pelvic inflammation or kidney stones.

Painful urination

Since the sex organs are in close anatomical proximity to the bladder, ovulation can also affect it.
Pain when urinating can thus occur together with the middle pain. In this case, emptying the bladder can lead to an intensification of the median pain.

If burning, blood in the urine, or bladder spasms occur, a doctor should be seen as these are more likely to be signs of a bladder infection.

You can read more information on this topic here: Painful urination

Painful intercourse

Pain during sexual intercourse that occurs around the time of ovulation is usually caused by an accompanying hypersensitivity of the female body during this time. For those who are already suffering from pain and increased tenderness in the abdomen or abdomen these days, additional penetration of this body region during sexual intercourse can intensify this pain. However, if this pain persists during sex and occurs independently of the cycle, you should consult a specialist in gynecology (gynecologist, gynecologist).

Read more on the topic:

  • Pain in the cervix
  • Pain during intercourse
  • Vaginal pain

Pain up to period

If pain occurs between ovulation and menstruation, there can be several causes. On the one hand, some patients generally suffer from strong tension in the lower abdomen (abdomen). If ovulation occurs, the patient may cramp even more and the tense muscles will cause pain from ovulation to menstruation.

More often, however, the cause is a cyst, the so-called yellow body cyst (Corpus luteumcyst). This cyst occurs after ovulation and usually disappears by the time you have your period. Mostly it is a harmless cyst that can cause pain during ovulation up to your period, but disappears without any problems after the period. However, it can be uncomfortable for the patient to experience pain for a long time from ovulation to her period.

If this pain occurs again and again, it can be helpful to visit a gynecologist so that he can either prescribe painkillers or help the patient with hormonal therapy to stop the cysts that keep forming.

Still, it's important to know that pain from ovulation through to your period doesn't always necessarily indicate a cyst. It may also be that the patient is tense or has abdominal pain for another reason, for example due to a bladder infection (Cystitis) or due to endometriosis.

Ovulation pain and clomiphene

Some patients experience severe abdominal pain during ovulation. If patients also take the drug clomiphene, ovulation pain can sometimes be exacerbated by clomiphene.

Clomiphene is intended to ensure that patients who do not ovulate and therefore cannot become pregnant are ovulated. For some patients who have not ovulated for a long time, they may be very aware of ovulation and therefore have ovulation pain from clomiphene. It is often difficult to differentiate whether this pain is actually triggered by the drug itself or whether the patient is simply sensitized to a great extent to ovulation.

Furthermore, it can happen that a patient does not have pain during ovulation due to clomiphene, but that the pain also occurs without clomiphene, for example due to a cyst or due to endometriosis. Therefore, a thorough gynecological examination should be carried out before taking clomiphene. The pain from clomiphene is not always due to ovulation. A patient may also experience general side effects from clomiphene, such as lower abdominal pain, and attribute them to ovulation.

Whether or not ovulation has occurred cannot be judged by the pain, but can ultimately only be determined by a gynecologist using an ultrasound device. However, if a patient suffers from ovulation pain when taking clomiphene, a gynecologist should always be consulted to ensure that the side effects are not too great and that there are no serious complications.

For more information, see our next article under: Side effects of clomiphene

Diagnosing ovulation pain

Many people, especially young women, are concerned when they experience the pain for the first time and go to the gynecologist. In most cases, a detailed survey (anamnesis) is sufficient to make the diagnosis. The time at which the pain occurs is typical, namely exactly in the middle of the cycle. Doctors therefore often speak of "middle pain". Furthermore, it is almost always noticeable on one side in the abdomen. The pain intensity fluctuates considerably: some women report only a slight “pushing” or “pulling”, whereas other women have severe pain.

In order not to overlook any accumulations of fluid or other changes in the lower abdomen, the gynecologist can perform an ultrasound examination. If patients suffer from severe unilateral pelvic pain regardless of their ovulation, other diseases should be excluded. For right-sided pain, e.g. appendicitis (appendicitis) should be thought.

Therapy for ovulation pain

Ovulation pain can be very uncomfortable. If they also come back on a monthly basis, those affected can use some aids or medication.

Many patients find warmth to be particularly pleasant and relaxing. For this purpose, e.g. Hot water bottles or warm compresses. Alternatively, you can take a hot full bath to relieve the pain.

Movement can help with mild pain! In some cases, magnesium supplements can help.

However, if the symptoms are severe or even interfere with everyday life, painkillers can be used. It may be advisable to start taking oral contraceptives ("the pill"). Just ask your gynecologist for advice!

What can you do about the pain?

Women who suffer from pronounced ovulatory pain can use various aids to make the ovulation time more comfortable.
In general, there are many methods of dealing with middle pain and not all of them help to the same extent for every woman.

If the middle pain is less pronounced, exercise can have a positive effect on the symptoms.
Furthermore, heat is often perceived as pain reliever. Well-tried methods here are placing a hot water bottle or a cherry stone pillow.

But other warming methods such as a hot bath can also reduce the pain.

If these persist anyway, are intolerable, and none of the home remedies provide relief, pain relievers can still be taken. For this purpose, it would be useful to consult a doctor in order to discuss the duration of the medication intake, as well as the dosage, and to rule out other causes.

Homeopathy for the pain of ovulation

Many women also turn to alternative healing methods in search of median pain relief.
These should have a supportive and regulating effect.

There are many different offers on the market, such as specially formulated teas, globules and salts.
Taking certain herbal supplements can also be helpful.

Especially in gynecology, there have always been plants such as monk's pepper, lady's mantle, evening primrose and black cohosh, to which healing effects are attributed. You should discuss with your doctor beforehand whether it is worth taking such a tea or preparation, as not every herb is equally suitable for every woman.

Duration of pain

The duration of the middle pain (also: Ovulatory pain) can vary from woman to woman. The length can vary widely - from a few hours to several days.

Whether the pain lasts for hours to days or occurs at all depends entirely on the individual factors of the respective cycle and cannot be predicted.
Not every woman experiences middle pain during her cycle: only 25-40 percent of women feel it at all. The ovulatory pain is not necessarily the same length, intensity or on the same side in every cycle.

Depending on which ovary is prominent in each cycle, the middle pain is mostly localized on the same side. However, if the median pain persists much longer or causes unusual, very severe pain that is otherwise unknown, you should consult a doctor to rule out other causes.

frequently asked Questions

Pain despite the pill - is that possible?

Depending on which contraceptive method is used, a further occurrence of middle pain is to be expected.
It all depends on whether or not the method of contraception interferes with ovulation.

For example, contraception with a combined hormonal contraceptive (“micropill”) should not result in median pain, as this type of contraception suppresses ovulation.

Since there is no contraceptive that 100% prevents pregnancy, in very rare cases ovulation and middle pain can also occur with this medication. However, this is very rare.
The situation is different, for example, with pure progestin preparations with levonorgestrel, whose mechanism of action does not work by inhibiting ovulation.

Read more on the topic: Hormonal contraceptives

Ovulation pain - can you be pregnant?

Some patients experience pain during ovulation and hope that this is a sign that they may be pregnant. However, this is not necessarily the case.

If a patient ovulates, the patient may perceive this as pain because the so-called follicle, i.e. the mature egg, bursts.

If a patient has sexual intercourse with her partner on the day of ovulation, the chances are high that she will also become pregnant.
Thus, the pain during ovulation can motivate women who want to become pregnant to sleep with their partner if possible during this time, as conception is only possible during ovulation.

For many patients, it is unimaginable to get pregnant while ovulating despite the pain, as they experience such severe pain during ovulation that they do not feel like having sex. Then a specialist in gynecology (gynecologist) so that they can help the patient to minimize the ovulation pain, possibly with the help of medication, so that pregnancy is possible despite the ovulation pain.

At the same time, it is important to know that ovulation pain does not mean that fertilization has occurred and therefore it does not automatically mean that ovulation pain leads to pregnancy.

Read more about this at: Signs of pregnancy

If you have ovulation pain, when will you be fertile?

The exact period of the fertile days cannot be precisely determined using the middle pain.

Most often, ovulatory pain occurs around ovulation. However, it can both precede it and follow it.
Therefore, determining the fertile days with the help of the median pain alone is not one hundred percent suitable for safe contraception or family planning.

However, since middle pain often occurs near ovulation, it can be assumed that this occurs shortly before or after the fertile days. They are to be measured with a maximum of 72 hours. However, it must be noted that sperm can survive in the vaginal environment for up to a week, i.e. the egg cell could possibly also be fertilized if sexual intercourse took place before the fertile days and ovulation.

Medical digression

Cycle and ovulation

Sexual maturity begins between the ages of 12 and 16, and with it menstruation (menstrual bleeding). So a regular menstrual cycle is an expression of normal fertility!

By definition, the first day of your menstrual period is the start of a cycle. It ends on the day before the start of the next menstrual period.

A normal cycle is divided into different phases, which on the one hand are due to the hormonal changes in the ovary (lat .: Ovary), on the other hand on the simultaneous fluctuations in the uterine lining (lat .: Endometrium) To refer to. The female cycle usually lasts around 28 days, with fluctuations not uncommon. However, ovulation takes place relatively constant on the 14th-15th Day instead!

Please also read: How does the discharge change during ovulation?

Menstrual phases

Most women have a menstrual cycle of about four days. It can be divided into two phases:

1st desquamation phase (1st-2nd day)

During the desquamation phase, the superficial layer of the uterine lining is shed. Small blood vessels are damaged and close, so that the part to be rejected no longer receives enough nutrients and dies. Finally, special enzymes open the closed vessels. Dead mucous membrane and blood leak out and cause menstruation. As a rule, the blood loss is around 50-100 ml. Responsible for the process is a decrease in the hormone progesterone, also known as the yellow body hormone.

2nd regeneration phase (3rd-4th day)

In the regeneration phase, the wound surfaces begin to heal.

The remaining phases of the monthly cycle now follow:

2.1 Follicular phase / proliferation phase (5th-14th day):

Under the influence of the follicle-stimulating hormone (FSH), a dominant follicle in the ovary matures. In the follicle is the egg cell, which fuses with the male sperm during fertilization. As the follicle matures, so does the production of the hormone estrogen. It causes a renewal (regeneration) the lining of the uterus.

2.2 Ovulation (14th-15th day):

During ovulation (lat .: ovulation) tear the follicle wall and release the egg cell. It is washed out together with the follicular fluid and is carried away by the fringed branches of the fallopian tubes (lat .: Tuba uterina) recorded. From there the egg cell is transported through the fallopian tube to the uterus. If fertilization does not take place after a maximum of 24 hours, the egg cell dies. Ovulation is caused by high levels of the hormones LH and FSH.

You might also be interested in: Ovulation and temperature - what is the relationship?

2.3 Secretion phase (16-28 days):

After ovulation, the luteal body (lat .: Corpus luteum). In this context, the release of the corpus luteum hormone increases sharply. However, if the egg has not been fertilized (i.e. there is no pregnancy), the hormone concentration drops again. As a result, the lining of the uterus is shed and menstruation occurs.

Our next topic could also be of interest to you: Period pain - what to do?