Ovulation pain can be felt when an ovarian follicle ruptures and releases an egg. It can cause symptoms such one-sided pain in the lower abdomen, a feeling of abdominal heaviness and light vaginal bleeding, which are typically experienced on about the14th day of the menstrual cycle.
Although mild ovulation pain can be expected, diseases such as endometriosis, sexually transmitted infections, appendicitis and ectopic pregnancy can sometimes present with similar symptoms, which is why abdominal pain should be assessed regardless.
If you think you may be experiencing ovulation pain, you should consult a gynecologist for assessment the diagnosis. However, if there are other symptoms, such as fever, delayed menstruation or yellowish vaginal discharge, it is recommended to seek emergency care.
Main symptoms
The main symptoms associated with ovulation pain are:
- Pain on one side of the lower abdomen and/or lower back;
- A feeling of heaviness in the abdomen;
- Scant vaginal bleeding;
- Nausea, especially when the pain is intense.
The pain may be described as twinges, cramps or a pulling sensation. It tends to recur every month and is felt about 14 days before menstruation, which is when the egg is released by the ovary. Ovulation pain can be felt on the left or right side of the abdomen, depending on which ovary is ovulating.
How many days does ovulation pain last?
Ovulation pain usually lasts for about 3 to 12 hours, and may take up to 2 to 3 days to go away in some women. Women have had previous ovarian surgery may experience ovulation pain up until a period starts.
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Confirming a diagnosis
An ovulation pain diagnosis is confirmed by a gynecologist, who will start by assessing the characteristics of your pain, the time of the month it occurs, and whether other conditions could be contributing to the pain.
The doctor may order additional testing, like an abdominal or transvaginal ultrasound, to rule out diseases such as endometriosis or ovarian cysts.
Possible causes
Ovulation pain occurs due to the release of the egg from the ovary down the fallopian tubes. These structures contract for the egg to move and meet a sperm cell to become fertilized. When the egg is released, a small amount of fluid and blood can also be released, which can irritate the tissues around the ovary and cause abdominal pain.
This type of pain is common during ovulation. However is pain is very intense or lasts for more than a day, it may be a sign of another condition, like:
1. Endometriosis
Ovulation pain can occur due to endometriosis, which is a condition characterized by the growth of endometrial tissue (that usually lines the uterus) on other abdominal organs, like the ovaries or fallopian tubes. It causes inflammation, abdominal pain, and intense cramping. Learn more about the symptoms of endometriosis.
2. Endometrioma
An endometrioma is a type of benign ovarian cyst composed of endometrial cells that have implanted on the surface or within the ovaries. This condition leads to the accumulation of blood and fluid within the ovary, causing intense abdominal cramping that can occur at any point of the menstrual cycle.
3. Polycystic ovarian syndrome
PCOS is characterized by the formation of small cysts on the ovaries due to an increased production of testosterone in the body. It can cause intense cramping during ovulation or at any point of the menstrual cycle.
This syndrome can lead to irregular periods, difficulty getting pregnant, infertility and excess growth of facial and body hair.
4. Dermoid cyst
A dermoid cyst, or a teratoma, is a benign cyst that can be present on one or both ovaries since birth. It is formed from embryonic cells and therefore may contain hair, skin, teeth, keratin, sebum, and rarely, cartilage.
Although this type of cyst generally does not cause pain, it can be found during imaging tests. Very large cysts can cause ovulation pain due to inflammation and intense cramping.
5. Cystadeoma
A cystadenoma is a type of benign ovarian cyst characterized by the growth of epithelial tissue on the external surface of the ovary. It can cause abdominal pain and cramping outside of a period, including during ovulation.
In addition, this type of cyst can cause changes to period, like a long cycle, breakthrough bleeding, intestinal changes like constipation or diarrhea, and urinary changes like retention.
6. Sexually transmitted infection
STIs are spread through unprotected sex with a partner who is affected. Common infections include gonorrhea, chlamydia or HPV. They can cause pain during inflammation as these infections are associated with inflammation and can lead to scarring of the ovaries and fallopian tubes. Infections can cause cramping as well as a foul-smelling discharge, fever or burning with urination.
STIs require immediate medical attention and treatment. Learn more about common STIs and how they are treated.
7. Scar tissue
Ovulation pain can also occur following a C-section or appendix surgery, due to the formation of scar tissue around the ovaries, fallopian tubes and uterus. In can cause stiffness between these structures, leading to pain and cramping.
8. Ectopic pregnancy
An ectopic pregnancy is characterized by the implantation of an embryo outside of the uterus. It most commonly occurs in the fallopian tubes, but can also occur in the ovary, cervix or abdominal cavity. This condition can cause intense pelvic pain on one side and can also cause pain during ovulation.
An ectopic pregnancy requires immediate treatment from a gynecologist with medication or surgical removal. Learn more about ectopic-pregnancies and how they are treated.
9. Appendicitis
Ovulation pain can occur with appendicitis, which involves inflammation of the appendix. This structure is present in the intestine and can cause right-sided abdominal pain when it is swollen, as well as lack of appetite, nausea, vomiting and fever. This condition requires urgent medical attention. Understand what can cause appendicitis and how it is treated.
Treatment options
Generally, ovulation pain lasts for up to 24 hours and does not require any treatment. However, you can place a warm compress on the abdomen or take a warm bath to relieve any discomfort.
In some cases, if the pain is very intense, your doctor may recommend anti-inflammatories like naproxen or ibuprofen. Women who frequently experience ovulation pain may be advised to start treatment with a birth control pill.
When to see the doctor
Although ovulation pain is a normal finding, very intense, unexpected pain should be assessed by a doctor to rule out another condition.
You should also seek medical attention immediately if your ovulation pain occurs with symptoms like:
- Fever
- Pain or burning with urination
- Foul-smelling discharge
- Yellow, gray or greenish discharge
- Redness or burning abdominal skin, where you feel pain
- Nausea or vomiting
- Loss of appetite
- Vaginal bleeding
- Delayed period
- Pain that lasts for over 1 day
- Pain that does not improve with anti-inflammatories
In these cases, to determine the cause of ovulation pain, the gynecologist will complete a physical exam, evaluate the health history of the patient, collect a vaginal swab and order blood work and other imaging tests, like a pelvic ultrasound, MRI or CT. Treatment can be started with birth control pills or antibiotics, and in some cases, surgery will additionally be advised.