Ovulation pain: what to know about mittelschmerz

Have you ever had mysterious lower abdominal pain in the middle of your cycle? Almost 40% of women have it, so you’re not alone.

You’re probably wondering what could cause this pain, what it means, and what you can do about it. Here’s what you should know about ovulation pain. 

The first thing to know is that some pain about 12-14 days before your next cycle is regular. You’ll probably notice it in your lower belly, either on the right or left side. It varies in intensity, from a slight twinge to pulling or even a stabbing type of pain.

Ovulation pain typically lasts from a few minutes to a few hours. If you think you’re having ovulation pain, don’t panic.

For quite a few women, this is a normal part of their monthly cycle. It does not affect your chances of getting pregnant.

On the other hand, you should see a healthcare provider if you’re having intense pain. This pain could be from ovulation or something else. Ovulation pain is sometimes misdiagnosed as appendicitis in women of childbearing age.

Appendicitis is a serious infection that requires immediate attention. 

If your pain is mild or moderate, read on to learn what ovulation pain is and why it happens.

What is ovulation pain?

Ovulation Pain

Ovulation pain is aching or stabbing pain that happens just before you ovulate. It’s called mittelschmerz, which is German for “middle pain”. Some women notice light spotting or discharge around this time as well. 

Ovulation typically occurs 12-14 days before your next cycle. It’s when one of your ovaries releases an egg into the fallopian tube. This is where fertilization happens, and where pregnancy begins. 

Ovulation pain typically coincides with whichever ovary is releasing an egg that month. So if you’re having pain on your right side, you can guess that you’re releasing an egg from your right ovary. 

Some women find that ovulation is accompanied by painful gas as well. Air in your intestines may be passing by the ovaries and putting pressure on them during ovulation. While uncomfortable, this should pass quickly. 

Why is ovulation painful?

We still don’t know why egg release is painful for some women. One theory is that the egg grows larger in the ovary before release. This size increase puts pressure on the ovary. The slight pressure on your ovary could be causing pain just before the egg is released. 

Releasing the egg into the fallopian tube also expels some fluid and blood, causing mild spotting. Another theory is that this blood and fluid could irritate the lining of the abdomen, causing local pain. 

Either one of these causes is a normal part of your menstrual cycle. Now let’s talk about how to tell if your pain is related to ovulation. 

How can I know if my pain is from ovulation?

Pay attention to the location, timing, predictability, and sensation of your pain. 

  • Locating your ovulation pain:
    Ovulation pain typically occurs on either side of your abdomen during every monthly cycle. This is one way to know if your pain is due to your cycle, or something else.
  • Timing your ovulation pain:
    You ovulate about two weeks before your next period. By tracking your periods and ovulation, you can tell if your pain could be related to egg release.
  • Predicting your ovulation pain:
    Women who experience ovulation pain typically notice it every month. While it’s no fun to be in pain, you can use this as a clue.
    If you’re trying to conceive and can tell when you’re ovulating, you can time sex around your most fertile window.
    Of course, even if you don’t have ovulation pain you can track your ovulation with Inito.
    Learn More : Getting pregnant: When are you most fertile?


  • Notice how your ovulation pain feels:
    Many women report that their ovulation pain feels very different from period pain or even implantation pain. For one, the location is on one side of your pelvis. While period cramps may come with pulling or twisting, ovulation pain can feel like stabbing. Some women even say they have pain radiating down their hip or leg. 

Why is ovulation painful for some women but not others?

We’re still not sure why some women can feel themselves ovulating but others can’t. 
A few conditions can make ovulation more painful for certain women. Others can mimic ovulation pain, even if they’re unrelated to your cycle. Let’s talk about them. 

  • Endometriosis:
    Endometriosis is a chronic inflammatory process that affects the lining of the uterus. 1 in 10 women is believed to have this condition. It causes the uterine lining, the endometrium, to grow outside of the uterus and into the abdominal cavity. Excess lining can grow over the outside of the ovaries, fallopian tubes, pelvic cavity, and more.

    Endometriosis and pain go hand-in-hand. For many women who have endometriosis, ovulation pain is much stronger than period pain. If you notice extreme pain from ovulation, ask your healthcare provider to evaluate you for endometriosis. 

  • Ovarian Cysts:
    This is when a fluid pouch forms on the ovary, often around ovulation. They’re common, benign, and usually go unnoticed. Nearly a quarter of women will form a cyst or pelvic growth in their lifetime. Ovarian cysts only become a problem if they burst or cause the ovaries to twist.

    Women describe a sharp stabbing pain from ruptured ovarian cysts. If a cyst grows large enough to apply pressure on the ovary, you may have pain that mimics ovulation pain. This can be accompanied by a bloating and heavy feeling in your abdomen. While ovarian cysts are common, if you’re experiencing these symptoms, you should seek medical attention. 

  • Scar Tissue:
    Scar tissue can form on the ovaries, leading to more pain during ovulation. These are also called adhesions. You’re probably wondering how it’s possible to get scars on your ovaries, and there are several reasons this happens.

    Endometriosis causes scar tissue to form because of the overgrowth of the uterine lining. Scar tissue can also come from abdominal surgeries and pelvic infections. No matter where these scars come from, they can be very painful.

    If you have adhesions, you may have pain around your ovulation, during sex, or while going to the bathroom. If any of these characteristic symptoms sound familiar to you, see your primary care doctor or your OBGYN.  

  • Sexually Transmitted Disease
    Some STDs, like chlamydia, can lead to painful ovulation. Untreated STDs can cause scarring on the fallopian tubes, making egg release irritating. If you have a medical history of STDs or suspect you’ve had one recently, see your healthcare provider. 

What are other possible causes for ovulatory pain?

  • Abdominal problems:
    Inflammatory Bowel Disease, or IBD, can sometimes mimic the pain of ovulation. However, this pain is usually accompanied by other intestinal symptoms such as diarrhea and bloating.
  • Appendicitis:
    Appendicitis is inflammation in your appendix, and it’s a medical emergency. It is unrelated to your fertility cycle, but it can be confused with ovulation pain because of the location. Appendicitis pain is different from ovulation pain in several ways. 
  • Appendicitis pain typically starts at the navel and travels down to the right side of the belly. 
  • Appendicitis pain gets worse with activity and is very severe. 
  • Appendicitis pain worsens quickly and drastically. 

If you notice these characteristics in your pain, seek help from a medical professional immediately. 

Is ovulation pain normal?

Yes. Ovulation pain is a normal part of many women’s monthly cycle. The good news is that it should pass reasonably quickly. Unless you’re experiencing intense pain, it is not something to worry about. 

How long does ovulation pain last?

Most women report ovulation pain lasting from a few hours to a few days. If you’re experiencing pain for longer than two days, it may be time to seek help from your doctor. 

Can I use my ovulation pain to predict the timing of ovulation?

Yes. This is the benefit of having predictable ovulation pain. Ovulation pain happens right before your most fertile window. You can take advantage of this window by having sex within a day of ovulation pain. This ensures that sperm can meet a released egg in your fallopian tubes. 

On the other hand, you can predict ovulation with even more certainty by tracking your hormones. By monitoring your fertility hormones, like follicle stimulating hormone (FSH), estrogen, Luteinizing Hormone (LH), and progesterone metabolite PdG, you can know with absolute certainty when ovulation will happen. 

What should I do if I'm having ovulation pain?

The good news is that ovulation pain goes away on its own. Here are a few easy tips to lessen the pain from ovulation. 

  • Stay hydrated – Being hydrated makes you more resilient to pain. After ovulation, your body needs more fluid in the luteal phase, and you may feel more thirsty during the second half of your cycle. Keeping a water bottle at your desk at home or work is a great way to remind yourself to hydrate more throughout the day.
  • Rest – Pain is your body telling you to slow down and pay attention. Take a break or a nap, and you’ll probably feel better afterward. Lie down with a heating pad or take a warm bath to alleviate your ovulation pain.
  • Pain-relief medication like NSAIDs may help with the inflammation of ovulation pain. Read the label before taking these. They typically need to be taken on a full stomach.
  • Talk to your doctor – If you’re experiencing extremely painful ovulation every month, your doctor may want to investigate you for other causes like endometriosis. 

How can I track my cycle if I don't have ovulation pain?

If you don’t get ovulation pain, you can still track your cycle accurately and efficiently. 

The best way to know more about your cycle is by tracking your fertility hormones. Inito not only predicts when you ovulate but whether or not you do. Inito monitors Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), and estrogen leading up to ovulation, as well as progesterone metabolite PdG after ovulation. So you know exactly when you ovulate, whether you can feel yourself ovulating or not. 



  • Ovulation pain is a normal part of fertility cycles for many women.
  • Ovulation pain is generally not something to worry about, and it doesn’t affect your chances of getting pregnant.
  • Please pay attention to your pain’s timing, location, and sensation to know whether it is from ovulation. 
  • A few conditions make ovulation more painful, and a few mimic ovulation pain. 
  • Ovulation pain can help you predict when you’re most likely to get pregnant, but tracking your fertility hormones is a great way to monitor ovulation as well. 

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