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Ovulation cramps: Symptoms, Cause and Relief

Ovulation cramps: Symptoms, Cause & Relief

Mittelschmerz If this is the first time you’re hearing this term, you might assume that the only link it has with your menstrual cycle is the first letter of the alphabet. This term is a German word that means “middle pain,” and it’s a literal description of the lower abdominal pain most women feel on one side during the middle of the menstrual cycles which is referred to as ovulation cramps.

Generally, mittelschmerz or ovulation pain affects about 40% of women over their reproductive age. About 1 in 5 Australians experience ovulation cramping and discomfort during ovulation every month. Others do not feel any pain, and others fall in the middle.

Are you wondering if you have experienced little mittelschmerz in the past, or do you find the subject intriguing like most women in Australia?  Allow us to tell you more about this usually harmless sensation that affects a significant number of women during their reproductive age.

How to relieve mittelschmerz: cramps during ovulation
How to relieve mittelschmerz cramps during ovulation

Does ovulation cramps mean the egg is being released?

Ovulation occurs within 1 to 2 days during each menstrual cycle, and it’s the time when an egg is released from the ovary. This ovulation day is included in your 6-day fertile window. The pain one feels on one part of the lower abdomen occurs around this time of the month when you are ovulating.  Some women experience the pain every month, while others do not feel pain at all.

Ovulation pain & cramps can occur for two reasons: The egg stretches the ovary surface as it develops and gets ready for ovulation, or there is a release of cystic fluid and blood after the follicle rupture, which irritates the abdominal lining. Mittelschmerz usually feels like menstrual cramps, but the only difference is the location of the pain and its period during your cycle.  Now that you understand the bigger picture concerning ovulation pain, let us dive into the finer details to educate more women in Australia about ovulation cramps.

Do ovulation cramps happen before or after you ovulate?

Your menstrual cycle can be divided into phases: follicular (the time when your menstrual periods happen and ovarian follicles develop), ovulation, and luteal. The length of these three phases varies from one person to another, with the ovulation phase always being the shortest one lasting about 1 to 2 days in each menstrual cycle. For instance, if you have a 28-day menstrual cycle, ovulation will occur on day 14. The five days before the ovulation day are considered the most fertile days of your cycle ‘fertile window‘ because having unprotected sexual intercourse closer to the ovulation day increases your chances of conceiving.

The ovulation process is usually triggered within 24 to 48 hours after having an increased level of the luteinizing hormone (LH) in the blood. This is the hormone that ovulation predictor kits measure to determine if you have an LH surge. The LH hormone surge promotes the release of a developed egg from the ovary so it can travel to the fallopian tube and meet sperm for fertilization.

From the fallopian tube, the egg will have two potential paths:

  1. If it finds sperm and gets fertilized, both the sperm and egg will form a zygote that will travel down the fallopian tube into the uterus, where it will be implanted in the lining. This is the beginning of the pregnancy phase.
  2. If the egg is not fertilized because there were no sperm, it will disintegrate and prepare to leave the body, along with the uterus lining that was ready to accommodate the zygote. This process is what we call the menstrual flow.

Why do women experience cramping during ovulation?

A primary cause of ovulation cramps is still not clear up to date, but some things happen during the ovulation process that likely causes the ‘middle pain’ for some women.

Your ovaries know that they need to develop and prepare an egg for ovulation every other cycle, and they normally alternate this role. As the egg grows and gets ready for ovulation, it may stretch the ovary surface, causing discomfort. Immediately an egg is prepared, the ovarian follicle that was housing it will rapture, releasing cystic fluid or blood along with the egg. These components can easily irritate your abdominal lining, causing pain.

Typically, we can conclude that the ovulation process is a seemingly intense phenomenon bound to occur every other month. That micro-level rupture that allows the egg to explode out of an ovary is not an insignificant occurrence. No wonder most women feel that they have ovulated and experience pain.

How can I ease ovulation pain?

However, it is important to note that not every woman will experience mittelschmerz, and even those that get the cramping may not feel it every other month. The good news is that ovulation cramps disappear within 24 hours, so you will not need treatment to alleviate the pain.  Most at-home remedies can help you ease the discomfort.  For instance, you should consider taking a warm bath or over-the-counter nonsteroidal anti-inflammatory medication like naproxen, ibuprofen, and Aleve, which have been proven to assist with ovulation cramps and are easily available in Australia.

If you take the over-the-counter pain medication and still feel uncomfortable due to the excruciating pain or the ovulation cramps continue for more days, consult a physician for a detailed evaluation. Once they isolate the pain, as mittelschmerz, they may prescribe a birth control pill or other hormonal contraceptives like the ring or patch to prevent ovulation. However, make sure this aligns with your goals, as it might interfere with your plan to get kids right away. You should only consider this option if you don’t intend to get kids soon.

How long do ovulation cramps last?
How long do ovulation cramps last?

Is ovulation cramping the same as PMS?

Although ovulation cramping may feel similar to premenstrual syndrome period pain, they are totally different. The sources of pain in both cases vary, and the pain is experienced at different times in each cycle. Here is a table to help you differentiate ovulation pain from period cramping.

Ovulation pain (mittelschmerz)Period cramps (dysmenorrhea)
• Pain starts in the middle of a menstrual cycle, two weeks before your subsequent menstrual flow.• The pain aligns with the menstrual flow, so it will occur before or during the period.
• Cramps will occur on one side of the body, in the lower back or abdominal area.• The pain radiates throughout the lower back, the lower abdominal area, or thighs.
• The cramping usually lasts for a few minutes or hours, but it can continue for days in some instances.• Cramping is often mild and lasts for about 24-48 hours each cycle but can sometimes be severe for some women.
• Some women also experience nausea, light vaginal bleeding, or discharge.• In some severe cases, women might experience other symptoms such as vomiting, diarrhea, nausea, and headaches.

Can ovulation cramping indicate that you have another problem?

Ovulation cramping pain is generally harmless and doesn’t signify that you have an underlying issue or a reason for concern. But if you notice that something does not seem right (maybe the pain is becoming severe or lasts for more than a day), you should book an appointment with your physician.

In some instances, the sharp or severe pain in the abdomen may indicate that you have a more severe condition like ectopic pregnancy (a case where the egg is implanted outside the uterus) or appendicitis. The cramping may also represent something that may cause fertility issues such as sexually transmitted infections, endometriosis, or pelvic inflammatory disease. So do not ignore the severe pain if it lasts longer than a day.

Mittelschmerz and ovulation pain

Mittelschmerz or ovulation cramping is a pain naturally occurring when you are about to ovulate (in the middle of your menstrual cycle). This pain should not be confused with menstrual cramping as it is usually one-sided and covers the lower back and abdominal area. The pain only lasts for a few hours or minutes (2 days max), and it signifies that an egg is preparing for ovulation or being released from the follicle leading to discomfort and irritation. Some people claim that ovulation pain will help you know when you ovulate, but ovulation tests offer a science-backed view of ovulation and the fertile window.