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Ovulation Pain & Endometriosis: Symptoms and Treatment

While ovulation pain is a common experience, sometimes this pain can be a sign of an underlying medical condition – such as endometriosis.

This comprehensive article will delve into the intricate relationship between ovulation pain and endometriosis. We will discuss:

  • The reasons why endometriosis can cause ovulation pain.
  • How this pain differentiates from regular ovulation discomfort.
  • Practical advice on how to manage endometriosis-related ovulation pain.

We aim to provide you with a deeper understanding of ovulation pain you may be experiencing, and its potential link to endometriosis, empowering you to take control of your reproductive health. With one in five women reporting discomfort during ovulation, it’s important to understand what it means for your body, and when treatment may be necessary.

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Can endometriosis make ovulation painful?

What is Endometriosis?

Endometriosis is a medical condition that causes tissue similar to the uterus lining to grow on other anatomic structures. It is often located in the ovaries, fallopian tubes, and uterus (womb). Endometriosis is one of women’s most common causes of pelvic pain and infertility.

Endometriosis affects one in nine Australian women. However, not all women with endometriosis have debilitating pain; some may not even realise they have it.

Pain caused by endometriosis often increases during menstruation, though sometimes it can be present at other times in the month. It can also occur with symptoms like constipation, diarrhoea, nausea, and vomiting.

Can Endometriosis Cause Ovulation Pain?

If endometriosis involves the ovaries, it has the potential to cause agonising pain as you ovulate each month. The symptoms of ovulation pain are severe cramping or pelvic pain that typically begins in the lower abdomen and slowly spreads to the back and thighs.

The ovaries are the female reproductive organs that produce eggs through ovulation. Ovulation pain occurs in many women due to high oestrogen levels and is caused by the uterus’s endometrial tissue breakdown. If this tissue is left behind on the ovaries, it can cause a condition called adhesions that attach various organs.

Painful chocolate cysts (non-cancerous cysts that typically form deep within the ovaries) can develop on the ovaries and fallopian tubes due to these scars. They can cause more severe pain during ovulation.

You can get an ovulation predictor kit from Fertility2Family to check if the pain occurs during or close to ovulation. This way, you can assess if it’s a result of normal ovulation or not. If you do experience painful ovulation, consider visiting your healthcare provider.

Image courtesy of The Bright Girl Guide by Demi Spaccavento. What is the best treatment for ovulation pain?

How to Know if Your Ovulation Pain is Due to Endometriosis

Understanding whether your ovulation pain is due to endometriosis can be a complex process. However, there are certain symptoms that can help differentiate endometriosis-related pain from other types of discomfort. These include:

Persistent Pelvic Pain

If you experience pain in your pelvis lasting more than two days, it is advisable to seek medical attention. This persistent discomfort could be a sign of this condition.

Pain Accompanied by Gastrointestinal Symptoms

Endo can sometimes cause symptoms such as vomiting or diarrhoea. If these symptoms accompany your ovulation pain, it may be due to endometriosis.

Abnormal Bleeding

Experiencing abnormal bleeding around the time of ovulation is a common symptom of endometriosis. If you notice this symptom, it could be an indication of endometriosis.

Period-Related Debilitation

Another sign can be if your symptoms are mild but become debilitating at the onset of each menstrual period.

Pain During Urination

Endometriosis can cause pain in your bladder or pelvis during urination. If you experience this type of discomfort, it may be due to endometriosis.

Chronic Fatigue

Endometriosis can lead to chronic fatigue. If you’re constantly feeling tired, it could be a symptom of this condition.

Gastrointestinal Discomfort

Endometriosis can cause constipation, diarrhoea, and shooting rectal pain. If you experience these symptoms, particularly in conjunction with ovulation pain, it could be a sign of endometriosis.

These symptoms can provide valuable clues about whether your ovulation pain is due to endometriosis. However, it’s important to consult with a healthcare professional for a definitive diagnosis and appropriate treatment.

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Endometriosis-Related Ovulation Pain

For most women suffering from endometriosis, pain during ovulation is caused by uterine tissue growing outside the uterus. The tissue that lines a woman’s uterus may attach to other organs in the pelvic cavity, resulting in painful symptoms during ovulation. Endometrial tissue may grow and develop outside the uterus or remain confined inside your abdomen.

The severity of the pain experienced is not necessarily related to the severity of endometriosis. Some women with endometriosis experience severe pain during ovulation, while others have no symptoms. Some of the causes of endometriosis-related ovulation pain include:

Formation of Adhesions

Adhesions refer to the development of scar tissue around organs, often a result of endometriosis. This scar tissue can cause organs to stick together, leading to discomfort and pain during ovulation.

Blockage of Fallopian Tubes

Endometriosis can lead to the formation of implants that obstruct the fallopian tubes. This blockage can cause pain during ovulation as it disrupts the normal passage of eggs from the ovaries to the uterus.

Rupture of Large Endometriomas

Endometriomas are cysts caused by endometriosis. When these cysts become large, they may rupture, releasing menstrual blood into the abdominal cavity. This event can cause severe pain, particularly noticeable during ovulation.

What Are The Stages of Endometriosis?

There are different ways to measure the severity of endometriosis. The most widely used scale for measuring endometriosis’s severity is from the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG). Doctors will assign your endometriosis a score based on the tissue’s spread, depth, and location. Based on these results and the fact that this condition is usually chronic, the condition is classified in one of four stages.

Stage 1

Endometriosis can develop during or after your period. Sometimes, the endometrium is in a few places, and at other times, it can be in one or more locations on your ovaries, fallopian tubes, or the tissue around them. You might also have scarring (adhesions) inside the pelvis. If you have endometriosis without signs of scarring, it’s called mild endometriosis.

Stage 2

The endometrial implants or lesions are larger, and there may be some scar tissue. These lesions can be found in your organs or lining your uterus, ovaries, fallopian tubes, pelvic and abdominal tissues, or the spaces between these. Stage 2 lesions may also occur on the ligaments that connect your uterus to your other pelvic organs.

Stage 3

Endometriosis can spread throughout the pelvis. Deep fibrosis occurs, making it harder to pass a fallopian tube through the narrow opening in the pelvis. You may also have small growths called cysts on one or both ovaries. The ovaries also can develop fibrous tissue, which can cause further pain.

Adhesions, or bands of scar tissue, may also develop, which cause pain and swelling, block organs and nerves from moving as they are designed to do, or form a web of attachments between different parts of the pelvis.

Stage 4

Stage 4 sees endometriosis in its most severe stage. This stage is the hardest to diagnose because it is practically impossible to see the disease without surgery. At this point, there are a lot of lesions and adhesions in the ovaries, along with deep endometrium on the pelvic lining and ovaries. Plus, the tissue will have spread to other anatomical organs. Often, women with stage 4 endometriosis will have been on a long journey to a diagnosis and have become quite ill.

Endometriosis can go from one stage to the next over time. That’s because it is not progressive for every woman suffering from it. As we mentioned, it tends to follow a predictable pattern in some women, but that doesn’t mean every woman follows the same course.

For example, endometriosis may stay the same over time for a woman if her symptoms are mild enough and she has a low level of pelvic inflammation or other factors.

Could My Pain be From Normal Ovulation?

Because pain is relative, not all pain during ovulation is considered abnormal. Some women experience mild pain as a normal indication that ovulation has occurred. Normal ovulation pain can be pinpointed by the following signs:


The discomfort is typically felt in the lower abdomen, just above the hip bone. It’s usually localised and can be traced to the side of the body where the ovary has released an egg during that particular menstrual cycle.


Normal ovulation pain often occurs around two weeks before the onset of the next menstrual period, coinciding with the ovulatory menstrual stage.


The pain associated with normal ovulation can last anywhere from a few minutes to 48 hours. However, it typically doesn’t persist beyond this timeframe.


Normal ovulation pain is usually mild and does not cause additional symptoms like nausea. It’s a discomfort that’s noticeable but not debilitating.

When to Seek Professional Help

If you’re experiencing ovulation pain that you believe may be linked to endometriosis, it’s crucial to consult with a healthcare professional, preferably a gynaecologist. They can thoroughly evaluate your symptoms and provide an informed opinion on whether endometriosis could be a potential cause.

However, the definitive diagnosis of endometriosis can only be confirmed through a surgical procedure known as laparoscopy. This minimally invasive surgery allows for the diagnosis of endometriosis and provides an opportunity for immediate treatment.

Endometriosis & Support

While there is currently no definitive cure for endometriosis, various medical treatments and surgical interventions can help manage and alleviate the symptoms associated with this condition. Hormonal contraceptives, for instance, are often used to manage endometriosis-related pain. These medications work by suppressing ovulation, thereby reducing the associated discomfort.

In addition to medical treatments, several self-care strategies can be employed at home to help manage the symptoms of endometriosis. These include:

Applying Heat

A heating pad, self-heating patches, or a hot water bottle can help soothe the pain. Immersing yourself in a warm bath can also provide relief.

Utilising Natural Remedies

Warm baths infused with Epsom salts or essential oils such as lavender and chamomile can offer a natural approach to pain relief.

Using a TENS Machine

Transcutaneous Electrical Nerve Stimulation (TENS) machines send electrical impulses to the nerves, which can help block the transmission of pain signals to the brain, relieving endometriosis-associated discomfort.

Remember, it’s essential to consult with a healthcare professional before starting any new treatment regimen, including natural remedies and TENS therapy. When a medical issue arises, seeking professional help is vital. If you suspect endometriosis, your doctor may request that you see a specialist.

Empowering Your Fertility Journey with Fertility2Family

At Fertility2Family, we understand the complexities of fertility issues like endometriosis. Our blog provides in-depth, reliable information to help you navigate these challenges. 

If you’re experiencing ovulation pain and suspect endometriosis, our affordable ovulation tests and fertility kits can be valuable tools in your journey. Fertility2Family is your partner in understanding and managing your fertility health. For more information, get in touch with us today.


Fertility2Family only uses trusted & peer-reviewed sources to ensure our articles’ information is accurate and reliable.

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Evan Kurzyp
Evan is the founder of Fertility2Family and is passionate about fertility education & providing affordable products to help people in their fertility journey. Evan is a qualified enrolled nurse and has expertise in guiding & managing patients through their fertility journeys.

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