Temporal occurrence
Ovarian pain at the time of ovulation is also called Mittelschmerz, because it occurs in the middle of the menstrual cycle. Some women do not experience them at all or only as a slight pulling, while other women experience them as strong, cramp-like pain. The intensity and duration of the pain varies from woman to woman and can last from a few minutes to several days.Typically, Mittelschmerz is unilateral, namely at the ovary that is active in this cycle and releases the mature follicle.
The exact cause of the middle pain has not yet been clarified. It is assumed that the maturing follicle leads to irritation of the ovarian tissue and nerves there, which is intensified when the follicle bursts and can cause the typical symptoms. In addition, fluid leaking out of the follicle can irritate the peritoneum and cause pain.
In some women, ovulation is also accompanied by a slight bleeding. Women who are taking the contraceptive pill should not feel any medium pain, as ovulation is suppressed by the contraceptive. Accordingly, no follicle can mature and the middle pain cannot develop.
However, the Mittelschmerz is not a reliable means of contraception or planning a pregnancy, because although it occurs around ovulation, it can also be over before it actually occurs. Basically, Mittelschmerz is not a cause for concern. However, if the pain is very severe and lasts unusually long, a doctor should be consulted.
The ovaries are very sensitive to the different phases of the female cycle. Although pain in the ovaries can theoretically occur at any point in the cycle, upon closer examination, it is noticeable that this pain is mainly observed in the second half of the cycle. This is due to the hormonal balance and structural changes in the female reproductive organs in the 2nd half of the cycle.
During this time, which is defined as the time between ovulation and the next menstruation, hormones such as progesterone and estrogen are produced in increased quantities. The mucous membrane of the uterus restructures itself to absorb a fertilized egg and the egg cell migrates in the fallopian tubes towards the uterus in the first week of the second half of the cycle. The migration of the egg in the fallopian tube can often be misinterpreted as pain in the ovaries.
The ovaries are also remodeled. Here, the remains of the cracked egg are converted into so-called corpus luteum. All these processes can cause pain in the ovaries in the second half of the cycle, especially in the first week after ovulation, which is mainly caused by the ovarian conversion processes into the corpus luteum.
The further the cycle goes towards its end, the less frequent and pronounced the pain of the ovaries. Relaxing and calming measures such as hot water bottles and bed rest can provide relief. Only in a few cases is a clinical picture in need of treatment behind slight pain in the second half of the cycle.
However, if you regularly suffer from severe pain, a specialist examination is recommended. Pain in the abdomen before and during menstruation is also called menstrual pain. Typically, they occur 1-2 days before the start of bleeding and can become worse during bleeding.
The pain can be different for each woman. Some women have no menstrual pain at all, others have to lie in bed with nausea and severe pain. The pain is particularly severe in very young and slim women, as well as in childless women.
If there is no other organic cause for the pain, it is also called primary dysmenorrhea. The pain is caused by the cramp-like contraction of the uterus. These muscle contractions are triggered by certain messenger substances, the prostaglandins.
However, these also cause pain, as they lead to irritation of the nerves. The abdominal pain can therefore also be located in the area of the ovaries, although this is not the primary cause of the pain. The more the woman produces of these messenger substances, the stronger the pain becomes.
Mental stress or psychological problems can also cause pain during menstruation. In general, especially in women who suffer from very severe symptoms, a clarification of possible other causes should be made. Endometriosis can also lead to similar symptoms depending on the cycle.
Endometriosis is the mucous membrane of the uterus which has settled in other organs, e.g. in the ovaries or abdomen, but which nevertheless changes depending on the cycle. Compression of the foreign tissue can cause severe, cramp-like pain. Even women who have never had any symptoms before or during their menstruation, but who subsequently develop them, should mention this during a visit to the gynecologist.
If the pain can be explained by another cause, e.g. psychological stress or organic changes, it is called secondary dysmenorrhea.The fertilization as such is not perceived by the woman herself. Therefore, no ovarian pain can occur after fertilization. However, many women notice their ovulation as a kind of pulling pain in their lower abdomen.
A cramping pain is also often described. This so-called Mittelschmerz occurs immediately after ovulation and is unilateral. It is felt in the ovary, which was active during the cycle and releases the mature follicle.
The fertilization itself, however, is painless. When coughing, the pressure in the abdominal cavity increases considerably for a short time, i.e. pressure is exerted on the organs. Some women feel a pulling or a stabbing pain in the abdomen in the area of the ovaries.
This is a very unspecific symptom and can have many causes. It is possible that the woman is just in the days around her ovulation. During this time, the ovaries are slightly irritated.
If pressure is then exerted on the tissue when coughing, this can cause pain. Coughing can therefore also cause pain in the ovaries during menstruation. Of course, other causes can also cause the symptoms.
For example, pregnancy can be the trigger, but changes in the ovarian tissue, such as cysts or inflammation, can also be potential triggers. If the pain becomes stronger or persists for several days, a doctor should be consulted, who can then determine the cause of the pain through a closer examination. The menopause is the complex hormonal change in a woman after her last menstrual period.
After the menopause, ovulation and menstruation no longer occur and the activity of the ovaries is low. Therefore, post-menopausal ovarian pain should always be taken seriously, as many harmless causes of ovarian pain disappear after menopause. Painful ovulation or irritation due to the hormone-induced cycle-dependent restructuring of the ovaries no longer occurs.
In old age, reasons such as malignant neoplasms or inflammatory processes come to the fore. In the case of severe, sudden onset of pain, stem rotation or ovarian vein thrombosis must also be considered. Heat and painkillers can initially alleviate the symptoms.
If the pain in the ovaries does not disappear after a few days or if it gets worse, it is advisable to consult a specialist soon. Many women experience pain in the ovaries from time to time during pregnancy. This is not always a cause for concern, but should be clarified by a gynaecological examination.
During pregnancy, ovulation does not take place in the ovaries as usual, but hormones are still produced there. Sometimes cysts develop in the ovaries during this time. These are benign blood or fluid-filled cavities that can cause pain due to the compression of the tissue.
The cysts often regress by themselves or burst, which can lead to heavy bleeding. Sometimes the cysts must also be removed by a doctor. Severe pain in the ovaries can also indicate a so-called ectopic pregnancy in early pregnancy.
In this case, the fertilised egg does not nestle in the uterus as usual, but remains in the fallopian tube on its way there and continues to develop there. This can cause severe pain and bleeding and must be remedied at all costs, otherwise the fallopian tube may rupture. More harmless causes of temporary pain in the ovaries during pregnancy are the irritation of nerves running there due to the pressure the unborn child exerts on the pelvis.
The organs are compressed by the child’s own weight. Depending on the position of the child, this can lead to pain in various areas, including temporarily painful ovaries. In addition, the uterus, including the surrounding tissue, must first stretch and adapt to the growing child. The pull on the connective tissue can also irritate nerves, which can cause pain. Nevertheless, persistent pain should be discussed with a gynaecologist so that the cause can be determined promptly.
