Introduction
Many women suffer from pain during ovulation. It is estimated that up to 40% are affected. Although the phenomenon is widely known, the cause has not yet been conclusively clarified! The range of possible pain is very wide: it ranges from a ” light pulling” to severe abdominal cramps.
Causes of pain
Often the Mittelschmerz does not occur alone, but is accompanied by various other symptoms, which either begin and subside with it, or continue until the end of the cycle. The accompanying symptoms are very varied and can be different in each cycle. Whether the pain occurs on the right or the left side depends in most cases on which ovary in the respective cycle has the best mature follicle (the egg) and thus ovulates.
Ideally, this is alternated, but in principle it is of secondary importance and can also occur several times on the same side. Even if there is no Mittelschmerz, ovulation can occur or have occurred.
- Mood swings,
- Tearfulness,
- Touch sensitive or tense breasts,
- Painful nipples,
- Back pain,
- A worsening of moderate pain when urinating,
- Constipation,
- Irritability of the gastrointestinal tract,
- Pulling and pressure feeling of the abdomen
- And bloated appearance of the abdomen.
Mittelschmerz can radiate into different areas of the body because, among other things, it is believed to be caused by the fluid released when the follicle bursts and the resulting irritation of the peritoneum.
This pain often has its origin in the area of the back or groin, for example. However, it is still possible to determine the most painful location in the right or left lower abdomen. If very strong isolated pains in the back or groin occur that persist over a long period of time, you should have them clarified by a doctor.
Chest pain, also known as mastodynia in the medical terminology, is a common symptom in women around and after ovulation. The breast pain itself is unpleasant but harmless and occurs together with a strong feeling of tension and hypersensitivity of the breast and can occur on both sides or only on one side. The reason for this is suspected to be the interplay of hormones during the female cycle.
While in the first half of the cycle until ovulation the production of the hormone estrogen is in the foreground, from the time of ovulation onwards the hormones progesterone and prolactin dominate. These hormonal fluctuations cause, on the one hand, that more water is stored in the breast tissue and, on the other hand, that the female breast prepares for the production of milk through growth of the tissue cells and increased secretion production. These changes can then cause a painful feeling of tension due to stretching of the breast tissue.
After the period, however, these pains subside again under the changed hormone levels. Abdominal pain during ovulation is a symptom that many women suffer from. Depending on the individual, the pain can be a pulling, cramping or stabbing pain.
These abdominal pains do not necessarily occur at each ovulation and can also vary in intensity and location from cycle to cycle. These abdominal pains during ovulation are almost always harmless. The cause is thought to be a tension in the ovary with irritation of its capsule during ovulation, and the amount of fluid released during ovulation could also irritate the peritoneum, causing abdominal pain.
Even if severe abdominal pain occurs at the time of ovulation, other causes must always be considered. If the pain is persistent and severe, as well as other, additional symptoms if necessary, a doctor should be consulted in order to rule out more harmless clinical pictures such as cystitis or gastrointestinal infections (gastroenteritis), but also serious causes such as appendicitis or kidney disease. At the time of ovulation, many women report pain in the abdomen.
This type of pain, although unpleasant, is harmless and is also known as Mittelschmerz or intermenstrual pain. The pain can manifest itself as a pulling or recurring stabbing pain, but it can also be crampy. Usually the pain in the abdomen occurs only on one side.
This depends on which ovary is currently active in the respective cycle. However, the side can change from month to month and be accompanied by pain that radiates to other parts of the body, such as the back or legs. It is also possible that in some cycles, no abdominal pain is felt at all.
Pain during ovulation in the area of the kidneys often makes itself felt by pulling in this area.Usually, however, the kidneys themselves are not affected. Ovulation-related abdominal or abdominal pain, which radiates over the lower back into the kidney area, is often the cause. This type of pain is temporary and harmless.
However, if the pain increases in severity and persists beyond ovulation, a doctor should rule out kidney disease, such as pelvic inflammatory disease or kidney stones. Since the reproductive organs are located in close anatomical proximity to the bladder, ovulation can also affect them. Pain during urination can therefore occur together with the middle pain.
In this case, emptying the bladder can lead to an increase in the middle pain. If burning, blood in the urine or bladder cramps occur, a doctor should be consulted, as these are more likely to be indications of a bladder infection. You can read more information on this topic here: Pain during urinationPain during sexual intercourse, which occurs around the time of ovulation, is usually caused by an accompanying hypersensitivity of the female body during this time.
If you are already suffering from pain and increased pressure sensitivity in the abdomen or lower abdomen during these days, additional penetration of this body region during sexual intercourse can further increase the pain. However, if this pain persists during intercourse for a longer period of time and also occurs independently of the cycle, one should consult a specialist in gynecology (gynecologist, gynecologist). If pain occurs between ovulation and menstruation, this can have several causes.
On the one hand, some patients generally suffer from severe tension in the lower abdomen area (lower abdomen). If ovulation occurs, patients may experience even greater tension and the tense muscles may cause pain from ovulation until menstruation. More often, however, the cause is a cyst, the so-called corpus luteum cyst.
This cyst develops after ovulation and usually disappears again by the time of menstruation. It is therefore usually a harmless cyst which can cause pain during ovulation until menstruation, but which also disappears again without any problems after menstruation. Nevertheless, it can be unpleasant for the patient if she feels pain over a longer period of time from ovulation to menstruation.
If this pain is recurring, it may be helpful to consult a gynaecologist (gynaecologist), who can either prescribe painkillers or help the patient with hormonal therapy to stop the cysts from forming again and again. Nevertheless, it is important to know that pain from ovulation to menstruation does not always indicate a cyst. It may also be that the patient has tense abdominal muscles or has abdominal pain for another reason, for example cystitis or endometriosis.
Some patients suffer from severe abdominal pain when ovulating. If patients are also taking clomiphene, the pain at ovulation can sometimes be made worse by clomiphene. Clomiphene is used to trigger ovulation in patients who are not ovulating and therefore cannot become pregnant.
For some patients who have not ovulated for a long time, it is possible that they are very consciously aware of their ovulation and therefore have pain when they ovulate due to clomiphene. It is often difficult to distinguish whether this pain is actually triggered by the medication itself or whether the patient is simply sensitized to ovulation to a very high degree. In addition, it is possible that a patient does not have pain at ovulation due to clomiphene, but that the pain also occurs without clomiphene, for example due to a cyst or endometriosis.
For this reason, a detailed gynecological examination should be performed before taking clomifen. The pain caused by clomiphene is not always due to ovulation. It is also possible that a patient may experience general side effects such as abdominal pain due to clomiphene and that she may attribute these to ovulation. However, whether or not ovulation has occurred cannot be judged by the pain, but can ultimately only be determined by a gynecologist using an ultrasound machine. However, if a patient suffers from pain at ovulation when taking clomiphene, a gynecologist should always be consulted to make sure that the side effects are not too great and that there are no serious complications.More information can be found in our next article: Side effects of Clomifen
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