Ovulation pain: Can you really feel yourself ovulating?

The majority of women and people who menstruate will ovulate — when the ovaries release an egg for fertilization — once a month, as long as they’re not on hormonal contraception. But did you know it’s actually possible to feel this happening?

Ovulation pain is an ache in the lower abdomen, usually on one side, that occurs when you ovulate. It happens roughly midway through your cycle and can vary in how it feels. 

Considering a human egg is just 0.1 mm in diameter — basically, tiny — it seems odd to imagine that anyone would be able to feel theirs being released. But ovulation pain is actually quite common. As Dr. Sara Twogood, an obstetrician-gynecologist (OB-GYN) based at Cedars-Sinai Medical Center in Los Angeles, notes: “It’s hard to know exactly how many people experience it, [but] many resources state about 40% of ovulating females have symptoms.” 

Here, Dr. Twogood takes us through all the need-to-knows on what causes ovulation pain, what it feels like, and how to make sure you’re not mistaking it for anything else.

What causes ovulation pain? Is it normal?

First things first: Let’s do a quick refresher on ovulation, the point in your cycle when you’re at your most fertile. During ovulation, a mature egg is released from the ovary. It then passes through the uterine tubes and stays there for 12 to 24 hours, at which point it could be fertilized by sperm. If it’s not fertilized, the egg disintegrates into your uterine lining and sheds as part of your monthly period.

As a general rule of thumb, for those with an average 28-day menstrual cycle, ovulation typically happens somewhere right in the middle, around day 14, explains Dr. Twogood. Everyone has different ways of determining when they’re likely to be ovulating. Using an ovulation calculator is one option, or using a period tracker like Flo is another good place to start. Then, of course, there’s ovulation testing (which you can read more about here). All of these methods can be used in conjunction with natural signs from your body. Some people start to notice symptoms like a change in cervical mucus or a slight increase in basal body temperature just after ovulation. Or, you might experience ovulation pain, which can show up as a twinge or cramp.

Some researchers suggest 1 in 5 women experience ovulation pain each month, while another study from 2013 puts the figure higher, noting that 35% of participants “experienced mid cycle pain.” As we know, Dr. Twogood points to research suggesting it could be as many as 40%. Whatever the specific figure, ovulation pain is common enough to warrant its own word: “mittelschmerz” — a German word literally meaning “middle pain,” which refers to the lower pelvic pain experienced during ovulation.

Experts can’t quite agree on the precise cause of mittelschmerz. Some say this kind of cramping is due to the egg bursting from its follicle. Others think follicular swelling can cause achiness in the pelvis, which is when the follicles housing the growing eggs in your ovaries swell up as they prepare to be released. Then there are the experts who believe that it’s hormonally induced pain since mittelschmerz coincides with the LH (luteinizing hormone) peak, which happens right before ovulation. 

Ovulation pain location: Where does the pain occur?

Typically, ovulation pain is felt in the lower abdomen (the midsection of your body) and pelvis. Discomfort is usually only experienced on one side of the body — although it changes from month to month. That’s because only one ovary releases an egg each month. 

“The side alternates every month, but the left side may be more ‘protected’ by the colon [the longest part of the large intestine], so [pain on] the right side may be more obvious,” explains Dr. Twogood. Since it’s not always identified as something cycle-related, a sudden pain in the lower right side of the pelvis can sometimes be confused with appendicitis.

How long does ovulation pain last?

Ovulation pain doesn’t have a fixed time frame, says Dr. Twogood, explaining that it can last “anywhere from a few hours up to two or so days.” Typically for those with regular cycles, the pain occurs 14 days before your next period is due, but you won’t necessarily feel it every month.

If you’ve experienced pain during ovulation in the past, you’re likely to continue experiencing it on and off. “If the pain is cyclical [recurring at a similar time] and self-limiting [not painful enough to require any prescription treatment], those are reassuring signs,” Dr. Twogood explains.

What does ovulation pain feel like?

Ovulation pain isn’t a “one-size-fits-all” symptom, according to Dr. Twogood. “It can feel different for different people,” she says. 

“Many people describe it as a sudden sharp pain on one side of their low abdomen and pelvis. Often it lingers for a day or two and then resolves on its own. Some people find it very painful, while others report a mild but noticeable discomfort.”

What do Flo users say ovulation pain feels like? It seems it varies for everyone.

• “I feel ovulation pain every month like clockwork.”
• “I get pelvic pain and ovulation pain, mainly in the right ovary.” 
• “I usually have severe ovulation cramps with no cervical mucus to show for it.”
• “I’ve been having horrible pain on my left side. It feels like gas moving around.”
• “I’ve always felt ovulation pain on my lower right side, and the pain lasts for a day or two.”
• “I can immediately feel the ovulation process start. I get light cramping.”
• “I’ve only felt ovulation pain a few times. It’s like a little sharp stabbing pain in my side.”

Dr. Twogood notes that there may also be other ovulation signs which occur at this time in your cycle. In addition to mittelschmerz, some people will also experience: 

• Mild ovulation back pain
• Spotting or bleeding
• A change in vaginal discharge (it becomes stretchy and transparent, similar in consistency to an egg white)

After ovulation, you may notice some other symptoms. These are often caused by a change in hormones. “After ovulation, in the luteal phase of the cycle, progesterone is the more dominant hormone,” Dr. Twogood explains. Progesterone helps to prepare your uterus for pregnancy, among other body functions. Meanwhile, estrogen — a female sex hormone that plays a key role in your reproductive health — decreases. This new balance of hormones can cause:

• Breast tenderness/swelling
• Mood changes

When should you worry about ovulation pain?

Ovulation pain isn’t generally anything to be concerned about, but if you find it’s recurrent and painful, oral contraceptives (the pill) have been shown to improve symptoms since they stop ovulation. Speak to your health care provider if you’d like to explore this option.

However, there are some other conditions that could cause a similar, one-sided pain and have nothing to do with the monthly release of an egg. These include:

• Ectopic pregnancy (when a pregnancy grows outside of the uterus, often in the uterine tubes)
• Ovarian cysts (including rupture of ovarian cysts)
• Ovarian torsion (when the ovary twists, cutting off its blood supply)
• Musculoskeletal pain (affecting the joints, bones, and muscles)
• Appendicitis
• Gas pain (also known as wind)
• Constipation
• Infection of the bowel (also known as gastrointestinal infection)
• UTIs
• Kidney stones
• Inflammatory bowel diseases like Crohn’s disease or ulcerative colitis

Some of the above conditions would require medical attention, while others can be dealt with using simple self-care methods. “Symptoms that would be concerning and warrant [medical] evaluation would be severe pain, significant nausea and vomiting, pain that does not resolve on its own, and fever,” says Dr. Twogood. “If someone is worried and there are other minor symptoms, seeking evaluation may also be recommended.”

Frequent pelvic pain — during ovulation, your period, and sexual intercourse — could also be a sign of endometriosis. It generally tends to start out moderate before becoming more extreme as your period approaches, so reach out to a health care professional if you suspect this is what you’re experiencing. They’ll be able to run some tests if necessary.

For those with milder symptoms, Dr. Twogood recommends the following: 

• Rest
• Heat packs
• A warm bath
• Stretching
• Abdominal massage or pressure (if it feels good) 
• Pain medication like ibuprofen (if it’s needed)

Is there a link between ovulation pain and getting pregnant?

While knowing the signs of ovulation can help you plan conception sex during peak fertile days (if you’re trying to conceive), ovulation pain is just that — a pain. But it won’t impact your chances of conception in any way.

Dr. Twogood explains that while there is no link between ovulation pain and getting pregnant, feeling discomfort when you release an egg can be useful in terms of indicating you’re fertile. “It’s a sign of ovulation, so that can sometimes be reassuring to people to confirm they ovulated.”

Ovulation pain: The takeaway

Ovulation pain is relatively common, and it shows up as dull cramps or sharp stabs on one side of the body around the time your body releases an egg. It may cause you some discomfort, but beyond that, it’s really nothing to worry about. If you notice the twinge moves from one side to the other month-to-month, again, that’s perfectly normal and is just linked to whichever ovary has released the egg that month.

Other symptoms like an achy back or sore nipples may also occur around the time of ovulation (these are related to hormonal shifts rather than ovulation itself). But remember: any pain associated with ovulation should stop within 48 hours and shouldn’t be severe or accompanied by nausea and a fever. If you’re experiencing this, it’s recommended that you seek medical help.

Experiencing ovulation pain isn’t pleasant. By tracking your cycles and symptoms with an app like Flo, you’ll know when you’re at your most fertile, helping you to plan conception sex. You’ll also be better prepared for any oncoming pain.

Note: Ovulation predictions should never be used for birth control