Ovulation Pain: When It's Normal, When It's Not (2023)

Up to 50% of people who ovulate will experience ovulation pain at least once in their lives. Some of them—about 20%—get ovulation cramps every month. Generally speaking, ovulation pain is normal.

Severe pain, however, is not. Intense or prolonged pelvic pain may be a symptom of endometriosis or pelvic inflammatory disease. Sometimes, the aches you experience have nothing to do with ovulation. If the pain prevents you from having sex or going about your daily life, this is also not normal.

Learn more about ovulation pain, why it happens, how to cope, and when to call your doctor.

Ovulation Pain: When It's Normal, When It's Not (1)

What is Ovulation Pain?

Ovulation pain is abdominal pain experienced between periods, typically around the time of ovulation. Another term for ovulation pain is mittelschmerz. This is German for "middle pain."

Ovulation pain doesn't necessarily occur at the exact moment the egg is released from the ovary. It may occur a few days before or after ovulation.

What Does Ovulation Pain Feel Like?

Most people describe ovulation pain as a dull, achy feeling that lasts for a few hours or even over a couple of days.Other people experience sudden, sharp pain, lasting just a moment.

Though the pain is typically mild, it has been known to land some people in the emergency room for suspected appendicitis—though such a severe reaction is rare.

You may notice that the pain is more frequent on one side than the other. While you may have been taught that the ovaries "take turns ovulating," this isn't always true. It's normal for one side to ovulate more often than the other.

16 Truths About Getting Pregnant and Ovulation

What Causes Ovulation Pain?

No one is sure what causes ovulation pain, but there are a few theories.

  • Swelling or rupturing of afollicleon the ovary.This releases some extra fluid, which may lead to a dull ache.
  • The egg itself, bursting out of the follicle may cause the sharp, sudden pain some people feel.
  • Spasms of the fallopian tubes or uterus as ovulation approaches.

What Causes Severe Ovulation Pain?

Endometriosis, a chronic disorder in which uterine tissue grows outside of the uterus, can cause pelvic pain at any time, but it can be quite severe during your menstrual cycle and near ovulation. Some people with endometriosis experience such bad pain before and during ovulation that they go about their daily activities.

Additionally, for those trying to conceive, endometriosis can make sex feel comfortable or painful near ovulation. This can makehaving sex for pregnancy during their most fertile time more difficult.

(Video) Is it normal to have some pain during ovulation, especially after a tubal ligation?

Endometriosis isn't the only possible cause of abnormal cramping or aching around ovulation, though. For example:

  • Infection of the fallopian tubes canlead to intense ovulation pain
  • Fibroids and ovarian cysts can cause mid-cycle aches
  • Ovarian hyperstimulation syndrome, which usually occurs in people taking some types of fertility drugs, can cause severe pelvic pain

Ovulation Pain and Pregnancy Planning

Some research suggests that ovulation pain can actually signal ovulation. One study found that itcame on the same day that the luteinizing hormone (LH) peaked. LH is the hormone detected by ovulation predictor kits. It peaks during your most fertile time, just before you ovulate.

However, another study used ultrasound technology to connect mid-cycle cramps to actual ovulation anddiscovered that ovulation occurred a couple of days after many people reported the side pain.The ideal way to time sex for pregnancyis to have sex beforeandnot after ovulation. Using ovulation pain to plan when to time sex is unreliable since you can't be sure exactly when in your cycle you are experiencing ovulation pain.

Although it could be a symptom indicating ovulation is imminent, it's probably best not to rely on ovulationpain as a primary way to detect yourfertile window.

Can You Get Pregnant After Ovulation?

Ovulation Pain vs. Implantation Cramps

Some people report cramps during the time of embryo implantation. Embryo implantation takes place a few days to a week after ovulation, so it does not occur at the same as ovulation pain. However, the feeling may be similar.

Because the timing of ovulation and implantation can vary,whether this pain is embryo implantation, ovulation, or something else is difficult to discern. Usually, it's only in hindsight, if you become pregnant and the timing matches up, that you might think the pain you felt could have been from implantation.

In Vitro Fertilization (IVF): What to Expect

How to Treat Ovulation Pain?

Some people will only have ovulation pain in a quick, burst of sharp pain. It hurts! Butthen it’s gone. Others, however, may experience longer-lasting discomfort.

The first thing most people think of doing when they have pain is to take an over-the-counter pain reliever, like ibuprofen or acetaminophen. That is one option for coping with ovulation pain. It's a good idea to consult with your OB/GYN to discuss ways to get relief, including the best medications to take, if needed.

If you are trying to get pregnant, you may want to stick to Advil (ibuprofen), Motrin (ibuprofen), or Tylenol (acetaminophen). Some small studies have found a possible connection between other common pain relievers and an increased time to pregnancy, specifically with naproxen, the active ingredient in such products as Aleve. However, other studies have found no such connection between common pain medications and time to pregnancy.

How Does Ibuprofen Interfere With Ovulation?

(Video) Ovulation pain. To worry or not?

It’s also difficult in these studies to separate causes of pain that can also impact fertility. For example, endometriosis can cause pain—including pain around the time of ovulation—and infertility. People with endometriosis are much more likely to take pain relievers. But how can we know if it’s the endometriosis or the medication that is delaying pregnancy? It’s very unclear.

There are also other remedies to try that can offer relief. Generally, treatments that are good for menstrual cramps may help with ovulation pain. Consider a warm bath, rest, or a heating pad.

When to Call Your Doctor

It's tempting to just hope that pain will go away, but severe pain—at any time of themonth—should be checked out. You should contact your doctor right away if:

  • Your pain is severe
  • You're vomiting or having severe diarrhea
  • You're having trouble breathing

It's possible that what you suspect is "ovulation pain" may be more serious like appendicitis or other abdominal issues. The call or trip to the doctor may seem like a hassle, but it's well worth it.

A Word From Verywell

Ovulation pain can be normal. However, if your ovulationpain is severe or simply interferes with your daily life or causes pain during sexual intercourse, you should make an appointment with your doctor. They can help you pinpoint a cause and offer solutions to improve your discomfort and day-to-day quality of life.

9 Sources

Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Durai R, Ng PC. Mittelschmerz mimicking appendicitis. British Journal of Hospital Medicine (2005). 2009 Jul;70(7):419-. doi:10.12968/hmed.2009.70.7.43133

  2. Kruszka PS, Kruszka SJ.Evaluation of acute pelvic pain in women. Am Fam Physician. 2010 Jul 15;82(2):141-7.

  3. What Is Mittelschmerz (Painful Ovulation)?Cleveland Clinic. 2015

  4. Gartner LP. BRS cell biology and histology. Lippincott Williams & Wilkins; 2018 Nov 1.

  5. Kuznetsov L, Dworzynski K, Davies M, Overton C.Diagnosis and management of endometriosis: summary of NICE guidance. Bmj. 2017 Sep 6;358:j3935. doi:10.1136/bmj.j3935

  6. Sievert LL, Dubois CA. Validating signals of ovulation: do women who think they know, really know?. American Journal of Human Biology: The Official Journal of the Human Biology Association. 2005 May;17(3):310-20.

  7. Ecochard R, Gougeon A. Side of ovulation and cycle characteristics in normally fertile women. Human Reproduction. 2000 Apr 1;15(4):752-5. doi:10.1093/humrep/15.4.752

  8. Wittels K, Sommerkamp SK. OB/GYN Emergencies, An Issue of Emergency Medicine Clinics, E-Book. Elsevier Health Sciences; 2012 Nov 15.

  9. McInerney KA1, Hatch EE2, Wesselink AK2, Rothman KJ2,3, Mikkelsen EM4, Wise LA2. Preconception use of pain-relievers and time-to-pregnancy: a prospective cohort study. Hum Reprod. 2017 Jan;32(1):103-111. doi:10.1093/humrep/dew272

(Video) Ovulation Symptoms | Doctor Explains

Ovulation Pain: When It's Normal, When It's Not (2)

By Rachel Gurevich, RN
Rachel Gurevich is a fertility advocate, author, and recipient of The Hope Award for Achievement, from Resolve: The National Infertility Association. She is a professional member of the Association of Health Care Journalists and has been writing about women’s health since 2001. Rachel uses her own experiences with infertility to write compassionate, practical, and supportive articles.

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(Video) OVULATION PAIN (Mittelschmerz) | What You Need To Know!


Why do I have ovulation pains when not ovulating? ›

There are many causes of consistent mid-cycle pain other than just ovulating. These include ovarian cysts, endometriosis, tubal infections, interstitial cystitis, irritable bowel syndrome, muscle or fascial pain, and nerve injuries.

Why is ovulation painful sometimes? ›

Just before an egg is released with ovulation, follicle growth stretches the surface of your ovary, causing pain. Blood or fluid released from the ruptured follicle irritates the lining of your abdomen (peritoneum), leading to pain.

Can you have ovulation pain and not actually ovulate? ›

In a word, no. There are many different things that can cause pain in the abdomen, and some of them are completely unrelated to your menstrual cycle (digestive issues—like gas! —for example). Without ultrasound evidence, it's impossible to know for sure that pain is associated with ovulation.

What does ovarian cyst pain feel like? ›

But a large ovarian cyst can cause: Pelvic pain that may come and go. You may feel a dull ache or a sharp pain in the area below your bellybutton toward one side. Fullness, pressure or heaviness in your belly (abdomen).

Can fibroids hurt during ovulation? ›

Can Fibroids Cause Pain During Ovulation? It is not widely recognized that fibroids can cause painful ovulation but if a fibroid was growing and exerting pressure on the ovary or fallopian tube, it could interfere and cause pain.

Does PCOS hurt during ovulation? ›

Ovulation pain is often the sign of cysts on the ovaries. Cysts can form, or can burst, during the ovulation period. Women with PCOS (Polycystic Ovarian Syndrome) often experience ovulation pain due to multiple ovarian cysts. Cystic ovaries are the result of a hormonal imbalance, usually related to insulin resistance.

How do you know if you have an ovarian cyst? ›

Symptoms of an ovarian cyst
  1. pelvic pain – this can range from a dull, heavy sensation to a sudden, severe and sharp pain.
  2. pain during sex.
  3. difficulty emptying your bowels.
  4. a frequent need to urinate.
  5. heavy periods, irregular periods or lighter periods than normal.
  6. bloating and a swollen tummy.


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