Ovulation Pain (Mittelschmerz): Causes, Symptoms and Treatment

We’ve all heard of “that time of the month” – it’s usually when you’re bleeding, sore and generally miserable. But what about the other time of the month? For some women, mid-cycle can mean suffering pain and bleeding. Also called mittelschmerz, this happens at ovulation, when the body releases an egg cell to be fertilized. Let’s clear up the facts on ovulation pain and what you can do about it.

Ovulation pain: What is it?

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Ovulation pain is usually felt in or around the ovaries themselves, and occurs within a 3-day span, just before and just after the actual day of ovulation. The severity of these symptoms can vary from person. While many women don’t notice any pain at ovulation at all, others turn up at their doctors looking for treatment.

In a regular 28-day menstrual cycle, ovulation pain generally occurs around Day 13 to Day 15. This should also give some rough indication of when ovulation is occurring.

Ovulation pain, menstrual pain or both? How to tell the difference

Period pain and ovulation pain might feel similar for some people, but in fact they’re very different. Menstrual pain is caused by cramping in the uterus to get rid of the uterine lining, which bleeds out as a period. The uterus contracts are caused by biological active substances called prostaglandins, and hormone imbalance can increase the release of prostaglandins and cause even more pain.

Ovulation pain, on the other hand, happens around the ovulation day. It also tends to be shorter-lived than menstrual pain. Given that ovulation generally occurs about a week after your menstrual period ends, it’s very unlikely that you would get both at the same time.

What causes mittelschmerz?


It’s thought that there are several factors that contribute to pain and cramping around ovulation.

Swelling of the ovaries

Ovulation occurs when a follicle in the ovaries is mature enough to release a fertile egg. In order to mature, the follicle has to grow substantially from its original size. This can a cause a prickling, painful sensation in the ovaries. The swelling subsides after the follicle ruptures at ovulation, and the pain gradually subsides.

Pain from ovulation itself

If you feel a sharp twinge during ovulation period, you might be noticing the moment of ovulation. Although a follicle is extremely small, it’s thought that some women are able to notice the pain of the actual follicle bursting.

Pain from ovulation bleeding

Sometimes, a little bleeding from the uterus may occur during ovulation. This is often called “ovulation spotting,” and doesn’t have any particular ill effects on the body. However, it can cause some mild cramping pain.

What does ovulation pain feel like?

Ovulation pain can vary from person to person. For some people, it may be a strong cramping pain like menstruation, whereas for others, it’s more of a stinging or prickling sensation. Because you have one ovary on each side of the uterus, you may feel ovulation pain on alternating sides of the abdomen from one cycle to another. Rarely, there may be some other symptoms such as lower back pain or headache.

Ovulation pain isn’t the only signs of ovulation, though. If ovulation bleeding occurs, it usually clears up on its own within 2 to 3 days, but you may notice a change in your cervical fluids. These could be stickier and take on a pinkish color.

What is the treatment for painful ovulation?

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It might not happen to everyone, but a little ovulation pain is a physiological phenomenon. Since it’s generally mild and short-lived, many women find they basically don’t need any treatment. However, for some women, it can be just as bad as menstrual pain. If you’re experiencing severe pain mid-cycle, it could indicate an underlying condition, such as endometriosis or pelvic inflammatory disease.

You don’t need to put up with pain, so make an appointment with your doctor or gynecologist. Your healthcare may recommend treatment such as hormonal birth control pills to get your pain under control, and will help investigate any underlying causes for your ovulation pain.

Get to know your body’s rhythms with mittelschmerz

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Ovulation pain can be uncomfortable, but fortunately, it tends to clear up quickly. Once you can tell the difference between ovulation pain and menstrual pain, you can properly deal with the symptoms. Not everyone experiences ovulation pain, so it’s not a foolproof way to see if you’re fertile or not. However, if you’re trying to get pregnant, being aware of ovulation pain could be a useful addition to your ovulation tracking toolkit.