Painful Ovulation (Mittelschmerz)

Mittelschmerz is the pelvic and lower abdominal pain that some women experience during ovulation which usually occurs about midway between menstrual cycles.

The pain of ovulation can range from a mild twinge to severe discomfort and usually lasts from minutes to hours.


  • Pain on one side of your lower abdomen (depending on which ovary is releasing the egg during that cycle)
  • Dull and cramp-like sharp and sudden
  • Mild vaginal bleeding or discharge
  • Rarely, severe

Who Has Painful Ovulation?

Many women never experience painful ovulation. Some women, however, have mid-cycle pain every month and can determine by the pain that they are ovulating.

What Has Painful Ovulation?

Mittelschmerz occurs during ovulation when the follicle ruptures and releases its egg. Some women have this every month; others have it only occasionally.
The exact cause is unknown, but possible reasons for the pain include these:
Just before an egg is released with ovulation, follicle growth stretches the surface of your ovary, causing pain.
Blood or fluid released from the ruptured follicle irritates the lining of your abdomen, leading to pain.

How Do I Know If my Pain Is Due to Ovulation?

Ovulation usually occurs about two weeks after the first day of each menstrual cycle, so the timing of the pain makes Mittelschmerz easy to recognize. To help determine if your pain is related to ovulation, you may need to chart your menstrual cycles, noting any episodes of pain, as well as the location of the pain.

How Is Painful Ovulation Treated?

Most of the time treatment is not needed. Over-the-counter pain relievers may be needed if the pain is intense or lasts a long time, applying a heating pad to the lower abdomen or taking a warm bath may also help ease discomfort.

Can Painful Ovulation Be Prevented?

Preventing ovulation, which can be done with birth control pills, is the only way to effectively prevent Mittelschmerz.

When Should I Call My Doctor About Painful Ovulation?

Call your doctor if you experience any of the following symptoms during ovulation:

  • Fever
  • Pain with urination,
  • Vomiting,
  • Redness or burning of the skin at the site of the pain
  • Mid-cycle pain lasting longer than a dayYou should also call your doctor if you missed your last menstrual period.

Your doctor also may perform an abdominal and pelvic exam to help rule out other possible causes of pain, such as endometriosis or a cyst on your ovary.

Some serious medical conditions such as appendicitis and ectopic pregnancy can mimic the pain of ovulation. A woman should go to the hospital if it is possible one of these conditions is causing the pain.

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