Ovulation and the Menstrual Cycle
The female body undergoes cyclical changes to prepare her for pregnancy. This is called the menstrual cycle, where the uterus thickens to make it ready for implantation of a fertilized egg. If fertilization does not occur the lining of the uterus, which is made up of blood vessels, is shed off and results in bleeding or menstruation. These changes occur under the influence of the hormones estrogen and progesterone.
Approximately two weeks before menstruation, which is usually the middle of a cycle, ovulation or release of an egg from the ovary occurs. The egg is contained in a sac, called a follicle, at the surface of the ovary. Around mid-cycle, the follicle enlarges and causes painful stretching of the surface of the ovary until it finally ruptures, releasing an egg which is ready for fertilization. During this process a small amount of blood or fluid coming from ruptured follicle may trickle to the peritoneum or the membranes in the abdomen and likewise cause irritation and pain.
Cramps During Ovulation
Ovulation pains or cramping is experienced by one in five women during their reproductive years. It is also known as mittelschmerz, a German word that means “middle pain,” and may or may not occur at every menstrual cycle. To some it is perceived as a mild pain or discomfort in one side of the lower abdomen (when either the left or right ovary releases an egg), but to others it may be a severe cramping type of pain. Still some may describe it as a dull ache, while others may complain of a sudden stabbing pain.
These pains, cramps or discomfort in the pelvic area during ovulation may last for a few minutes, to several hours, or up to a day. Depending on which ovary is ovulating, the pain may switch sides every month or so. There may be months when the woman does not perceive any discomfort, and some months when the pain is more severe than before.
Usually ovulation pains disappear on their own, without the woman even noticing it is over, but to some the discomfort may need more than just reassurance. Although ovulation cramps are natural and harmless since they are just symptoms of ovulation a woman may need some treatment to relieve her of these pains.
Treatment for Ovulation Pains
Cramping that lasts for more than a few minutes may need to be treated with analgesics like acetaminophen (like Tylenol), naproxen (like Aleve) or ibuprofen (Advil, Motrin, etc.). These are over-the-counter nonsteroidal anti-inflammatory drugs that may be taken orally to reduce symptoms of ovulation.
Other home remedies a woman can use are to apply a heating pad or warm compress over the affected side and to soak in a warm bath. These may help relax blood vessels and tense muscles over the area and ease the pains.
Prevention of ovulation pains is unknown, except when hormones are used to prevent ovulation itself. There are no complications from ovulation symptoms.
Ovulation cramps are usually diagnosed from personal history; there are no significant or abnormal physical or laboratory findings. However, if there are doubts as to the diagnosis because of the intensity and duration of pain, especially if there are other accompanying symptoms like nausea and vomiting, further investigation must be done. Medical consultation must be sought, because of the possibility of other conditions such as appendicitis.
Mayo Clinic, “Mittelschmerz”, https://www.mayoclinic.com/health/mittelschmerz/DS00507
Medline Plus, “Mittelschmerz”, https://www.nlm.nih.gov/medlineplus/ency/article/001503.htm