When you are among those who have a 28 day menstrual cycle, you’ll usually ovulate some time between day 10 and day 15 of your cycle. Around the 14th day of your cycle each month, a mature egg bursts through its follicle and travels into the adjoining fallopian tube.
This process is called ovulation, and it’s a critical part of reproduction. Not every woman will feel ovulation. Though the sensation isn’t necessarily cause for alarm, you shouldn’t ignore ovulation pain.
Here’s what you need to know.
The basics of ovulation pain
Ovulation pain is also called mittelschmerz. In German, this means “middle pain.” In most cases, the discomfort is brief and harmless.
You may notice one-sided pain for a few minutes or even a couple hours on your day of suspected ovulation.
After the egg is released, the fallopian tube contracts to help it reach awaiting sperm for fertilization. Blood and other fluid from the ruptured follicle may also enter the abdominal cavity and pelvis during this process and cause irritation.
The sensation can range from a dull ache to sharp twinges. It may be accompanied by spotting or other discharge.
If your pain becomes severe or happens at other points in your cycle, check in with your doctor.
Other causes of pain during your cycle
There are several other reasons why you might be experiencing pain during your cycle. Try keeping track of when and where you feel the discomfort, how long it lasts, and any other associated symptoms. Keeping a record can help you and your doctor figure out the underlying cause.
If your midcycle pain persists, your doctor can perform different tests to identify the source and offer treatment to help.
An ovarian cyst can cause a number of symptoms, from cramping and nausea to bloating. Some cysts may cause no symptoms at all.
Dermoid cysts, cystadenomas, and endometriomas are other, less common types of cysts that might cause pain. Another condition called polycystic ovary syndrome (PCOS) is marked by many small cysts on the ovaries. Untreated PCOS can cause infertility.
Your doctor may order a CT scan, MRI, or ultrasound to help determine if you have a cyst and what type it is. Many cysts resolve on their own without medical intervention. If they grow or are abnormal, though, cysts can lead to complications and may need to be removed.
Endometriosis or adhesions
Endometriosis is a painful condition where tissue from the lining of the uterus grows outside the uterine cavity. Areas affected become irritated when the lining tissue responds to hormones during your cycle, causing bleeding and inflammation outside of the uterus. You may develop scar tissue or endometriosis adhesions that are particularly painful during your period.
Likewise, intrauterine adhesions, also known as Asherman syndrome, can develop if you’ve had previous surgery. This includes a dilation and curettage (D & C) or cesarean delivery. A prior infection in the uterus can also cause these adhesions. You can also develop Asherman syndrome with no known cause.
Since doctors can’t see these conditions during a routine ultrasound, your doctor may order a hysteroscopy or laparoscopy. These are surgical procedures that allow doctors to directly see inside your uterus or pelvis.
Infection or sexually transmitted diseases (STDs)
Is your pain accompanied by unusual or foul-smelling discharge? Do you have a fever? Do you feel burning when you urinate?
These symptoms might indicate a bacterial infection or a sexually transmitted disease (STD) that needs urgent medical attention. Without treatment, infections and STDs can lead to infertility. They can even be fatal.
Medical procedures or even childbirth can cause infections. Sometimes a urinary tract infection (UTI) might cause general pelvic pain. STDs like chlamydia, gonorrhea, and human papillomavirus (HPV) are contracted from condomless sex.
If you think you’re at risk for any of these conditions, see your doctor.
One-sided pelvic pain could be a sign of an ectopic pregnancy.
This occurs when an embryo implants in the fallopian tubes or other location outside of the uterus. An ectopic pregnancy is potentially life-threatening and is usually discovered by the eighth week.
If you think you might be pregnant, see your doctor immediately. If you have an ectopic pregnancy, you’ll require immediate treatment with medication or surgery to prevent your fallopian tube from rupturing.
If you’ve visited your doctor and ruled out any issues, you’re likely experiencing mittelschmerz. Continue to pay attention to any changes in your symptoms. Otherwise, there are some things you can do to ease the discomfort of midcycle pain:
- Try over-the-counter (OTC) pain relievers, such as ibuprofen (Advil, Motrin, Midol) and naproxen (Aleve, Naprosyn).
- Ask your doctor about birth control pills to prevent ovulation.
- Apply a heating pad to the affected area, or take a hot bath.
Get ibuprofen, naproxen, or heating pads online.
When to call your doctor
Obstetricians and Gynecologists recommends women from ages 21 to 29 have a Pap smear to screen for cervical cancer every three years.
Women ages 30 to 65 should have either a Pap smear every three years or a Pap smear and an HPV test, called co-testing, every five years.
Women over 65 don’t need to have cervical screening unless they have a history of:
- abnormal cervical cells
- a number of abnormal Pap test results in the past
- cervical cancer
All women should also have a yearly well-woman visit with their gynecologist to discuss any other concerns about their gynecological health as well receive a full pelvic exam. Yearly exams are recommended, even though you may not need a Pap smear each time.
If you’re overdue for your visit or are having pain and other symptoms, call your doctor today.
Takeaway: Pay attention to pelvic pain
For many women, midcycle pain is simply a sign of ovulation. There are several other conditions that can cause pelvic pain, some of which are serious if left untreated. It’s always a good idea to pay attention to your body and report anything new and different to your healthcare provider.