Ovulation pain (mittelschmerz): what it feels like and what helps

What ovulation pain feels like

Not everyone feels ovulation, and that's normal. For those who do, it can be anything from a vague awareness to a pain sharp enough to stop you in your tracks.

• A dull, cramp-like ache or a sudden, sharp twinge low on one side
• On the side of the ovary releasing the egg, so it may switch sides from month to month
• Lasting minutes to hours, sometimes up to a day or two
• Sometimes with light spotting or more egg white discharge
• Occasionally with mild nausea or bloating

Why ovulation hurts

The exact cause isn't certain, but there are two main theories. Before ovulation, the follicle holding the egg grows and stretches the surface of the ovary. When it releases the egg, a little fluid or blood can escape and irritate the lining of the pelvis. Both can cause a short-lived pain. Some people also feel contractions of the fallopian tube.

Can ovulation pain help you find your fertile window?

It can be a clue. Pain often comes just before or at ovulation, and your fertile window includes the five days before ovulation plus the day itself. But pain alone isn't precise enough to rely on. Combining it with cervical mucus, ovulation (LH) tests and a temperature rise gives a far better picture. Our ovulation calculator gives a rough starting estimate.

What helps ovulation pain

1. Heat: a hot water bottle or warm bath relaxes the area.
2. A simple painkiller: ibuprofen or paracetamol, if they're suitable for you. Avoid NSAIDs around ovulation if you're actively trying to conceive and talk to a doctor, as very high doses may affect ovulation.
3. Gentle movement and stretching.
4. Track it. If you know your pain usually comes on day 13 or 14, it's less alarming, and you can plan around it.
5. Hormonal contraception that stops ovulation can prevent the pain if it's severe and you don't want to get pregnant. Talk to a doctor.

Other causes of mid-cycle pain

Pain in the lower tummy around mid-cycle isn't always ovulation. Similar pain can come from endometriosis, an ovarian cyst, an infection such as chlamydia or pelvic inflammatory disease, scar tissue from previous surgery, appendicitis (usually on the right side), constipation, or an ectopic pregnancy. If the pain is different from your usual pattern, keep a note of when it comes.

One helpful test is timing. True ovulation pain turns up at roughly the same point in each cycle, about two weeks before your period, and fades quickly. Pain that comes at random times, lasts for days, keeps getting worse, or arrives with fever, unusual discharge or bleeding points away from ovulation and toward something worth checking.

Ovulation, mood and energy

For many people the days around ovulation are among the best of the month: estrogen peaks, energy and confidence rise, and sex drive often goes up. A twinge of ovulation pain can be a small reminder that you're in that phase. If you also notice a short mood dip after ovulation, you're not alone: read about ovulation mood swings.