Mid-Cycle Pain - Is It Ovulation?

Mid-cycle pain affects women differently. Some women are rendered incapacitated for a day or two while others simply feel a twinge and it's over. Pain and discomfort during ovulation is quite normal and usually nothing to be concerned about. However, it can also be indicative of a medical condition that may require treatment.

The Pain in the Middle - Mittelschmerz

During the menstrual cycle, which usually occurs between 25 and 32 days apart, there is a phase midway that is called ovulation. It is during this phase of the menstrual cycle that a woman can conceive a pregnancy because an egg has been released from an ovary. Most women experience ovulation once a month from the time they begin menstruation until they are menopausal - excepting when they are either pregnant or nursing.

One in five, or about 20% of women experience ovulation pain, known as mittelschmerz, which is a German word meaning ‘middle pain'. It can be severe and last for a few minutes or up to 48 hours, or, as mentioned, it can come and go in a blip. There are certain attending symptoms that make mittelschmerz easier to identify:

· Lower abdominal pain that occurs just inside the hip bone

· It occurs about 14 days from the time menses is due to arrive

· Pain can be on either side of the abdomen (depending upon which ovary released the egg)

· The pain may switch from side to side, or it can stay on one side through several cycles

· The pain varies with the individual, from a twinge to a cramp or sharp pain

· The duration of the pain can be anywhere from a couple of minutes to two days

There is no confirmed cause for the pain of mittelschmerz. Some of the theories surrounding the pain include the suggestion that the mature follicle emerging from the ovary causes the membrane of the ovary to stretch, causing pain. Another says that when the mature egg bursts out of the follicle the abdominal lining could be irritated by the rupture. Sometimes there is bleeding with ovulation and this might explain it.

This Could Be Gas ...

Since ovulation pain, in whatever way it manifests itself, is common in many women, some choose to use it as an indication for the fertile window in which they can become pregnant. It probably wouldn't be wise to do that on a consistent basis - it could be gas pain and not ovulation. However, using mittelschmerz to confirm other signs of ovulation, like cervical mucus or temperature change, is fine.

... Or Worse - OHSS

If a woman is taking fertility drugs in a bid to become pregnant, severe ovulation pain may occur and if it does, it needs to be checked out immediately by a physician. Severe abdominal pain that comes around the time of ovulation if a woman is taking fertility drugs may indicate ovulation hyperstimulation syndrome. Fertility drugs are designed to cause an increase in ovulation, with more than one egg being released from the ovary at a time. This can cause discomfort and swelling of the ovaries. If the pain is severe, or if there is vomiting, dizziness, diarrhea, or trouble breathing that accompanies the pain, contact the doctor immediately.

Ovulation pain that is severe enough to interrupt life or makes timing for pregnancy sex difficult could also be an indication of other serious conditions. Intense pelvic pain at the time of ovulation could be a symptom of endometriosis. Although the signs of endometriosis vary from woman to woman, the most common symptom is pelvic pain.

The pain of endometriosis appears and feels like normal cyclical pain when it is in the early stages, which makes it so hard to catch. It is only as time goes on that the pain increases with each cycle heralding the decline of both general and reproductive health for the woman.

If a woman is experiencing severe abdominal pain at the time of ovulation, or at any other time, it could be nothing serious or it could be very serious. Have the pain checked out. If it is nothing more than mittelschmerz, an OTC pain reliever and a hot water bottle works wonders. If it's more than that, appropriate treatment should be applied.

Do you have questions about your menstrual cycle or reproductive health? This section has some answers for you.