Around cycle day 14 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
According to the Mayo Clinic, ovulation pain is also called mittelschmerz. In German, this means “middle pain,” and 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.
Ovulation involves a follicular cyst swelling and then rupturing to release the egg with your body’s surge in luteinizing hormone (LH). 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 during this process and cause irritation.
The sensation can range from a dull ache to sharp twinges and 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 Possible Causes of Cycle Pain
There are several other reasons 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. 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 to nausea to bloating. Some cysts may cause no symptoms at all.
Dermoid cysts, cystadenomas, and endometriomas are other, less common types of cysts and might cause pain. Another condition called polycystic ovary syndrome (PCOS) is marked by many small cysts on the ovaries. PCOS can cause infertility without proper attention.
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, however, cysts can cause complications and may need to be removed.
Endometriosis or Adhesions
Endometriosis is a painful condition where menstrual tissue from your uterus grows outside the uterine cavity. Areas affected become irritated when the tissue has nowhere else to go. You may develop scar tissue or adhesions that are particularly painful during your period.
Likewise, intrauterine adhesions, also known as Asherman’s Syndrome, can develop if you’ve had previous surgery such as a dilation and curettage or cesarean delivery. According to the Newton-Wellesley Hospital, you can also develop Asherman’s with no known cause.
Since these conditions cannot be seen during a routine ultrasound, your doctor may order a hysteroscopy or laparoscopy.
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 STD that needs urgent medical attention. Without treatment, infections and STDs can lead to infertility. They can even be fatal.
Infections can be caused by medical procedures or even childbirth. Sometimes a urinary tract infection might cause general pelvic pain. STDs like chlamydia, gonorrhea, and human papillomavirus (HPV) are contracted from unprotected sex.
If you think you’re at risk for any of these issues, 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. The Cleveland Clinic shares that ectopic pregnancy is potentially life-threatening and is usually discovered by the eighth week.
Think you might be pregnant? See your doctor immediately. If you have an ectopic pregnancy, you will require immediate treatment with medication or surgery to prevent your fallopian tube from rupturing.
Pain Relief Methods
If you’ve visited your doctor and ruled out any issues, you are 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 pain relievers.
- Ask your doctor about birth control pills to prevent ovulation.
- Apply a heating pad to the affected area or take a hot bath.
When to Call Your Doctor
The American Congress of Obstetricians and Gynecologists (ACOG) recommends having a Pap smear to screen for cervical cancer every three years. You should also have a yearly well woman visit with your gynecologist to discuss any other concerns you have with your gynecological health.
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.