When we talk about menstrual pain, we’re usually referring to those pesky period cramps that show up before or during our periods (PMS problems? Download my PMS meal plan here). The less talked about type of pain that affects nearly 1 in 5 women is ovulation pain. It’s so common that the Germans even have a word for it: mittleschmerz, which translates to mid pain. If you experience ovulation pain, this article is for you!
What does mittleschmerz feel like?
All bodies are unique, and different women experience the pain differently. You might experience the following sensations:
- A dull ache in the lower abdomen or lower back that persists for a few minutes to a few hours
- Sudden, sharp pain in the lower abdomen or back that only lasts a moment
- A sudden twang, pop or twinge in the lower abdomen – sometimes painful, other times just a bit surprising!
- For some people, ovulation pain is also accompanied by ovulation bleeding
Usually, the pain or discomfort occurs on one side of the abdomen. It may alternate sides from cycle to cycle (this alternation happens randomly, because ovulation happens on a random side each cycle). Some cycles you might not feel it at all!
Mittleschmerz can certainly be a bit painful but it shouldn’t cause severe pain. If you are experiencing pain in the middle of your cycle that disrupts your day or requires painkillers, please ensure that you see a qualified health professional to get to the bottom of what might be causing the extreme discomfort. You can book a Free Hormone Freedom call with me, here.
What causes ovulation pain?
The short answer: we’re still not really sure. Researchers have been attempting to answer this question since the mid-1800s, but over 100 years later, the answer is still unclear. There are several hypotheses for the cause:
- Swelling of ovarian follicles prior to ovulation: early in your cycle, multiple follicles (the sacs that contain your eggs) begin maturing, with one of them eventually becoming dominant. Follicles mature on both sides of the ovaries before dominant follicle selection, which may explain why ovulation pain is occasionally experienced on both sides of the abdomen.
- Ovarian wall rupture: at the time of ovulation, the egg breaks through the walls of the ovaries. This may cause pain for some women.
- Muscle contractions: At the time of ovulation, smooth muscles in the ovaries and its surrounding ligaments go through contractions in response to increased levels of prostaglandins (these are the inflammatory compounds that are also responsible for your period cramps).
Is it mittleschmerz or something else?
The short answer: listen to your body and track your symptoms! Like I mentioned earlier, Mittleschmerz can certainly be a bit painful but it shouldn’t induce severe pain. Always talk to your healthcare provider about any moderate to severe abdominal pain. Other causes of pain in the general area of your ovaries include:
- Ovarian Cysts
- Infections or sexually transmitted diseases
- Ectopic Pregnancy
- Gastrointestinal disturbances – IBS, gas, bloating, stomach upset
If you’re interested in keeping track of your ovulation pain so that you know what to expect and when to expect it, here are a few tips:
- Use a journal or an app on your phone (I like MyFlo or Clue) to track your cycle, your symptoms and lifestyle factors like exercise, digestive issues, libido and more. Apps can give you predictions for when you’ll get your period, when your PMS might flare up, and when you can expect ovulation and ovulation pain.
- Track how long it happens – most people report that their ovulation pain lasts between 6 and 12 hours
- Track the sensation or severity – is it dull or sharp? Mild or moderate? If you notice the pain increasing from cycle to cycle, talk to your healthcare professional to make sure something more serious isn’t going on.
- Track whether you feel it on the left side, right side or both. All are normal.
Is mittelschmerz a reliable way to detect your fertile window?
The short answer: no. Your fertile window is the period of time in your cycle during which you are able to get pregnant. This typically includes the day you ovulate and the five days preceding ovulation.
There are many different things that can cause pain in your abdomen, some of which are completely unrelated to your menstrual cycle (see above for a list). Without ultrasound evidence, it’s impossible to know for sure that pain is associated with ovulation.
Even if mittelschmerz is associated with ovulation, evidence is mixed that ovulation pain happens at the precise moment of ovulation. The pain might happen before, during, or after ovulation, and there is no easy way to know how the pain you experience correlates to ovulation.
Mittelschmerz is one among many fertility signs. The most accurate predictions of your fertile window are made when looking at the overall picture given by multiple different fertility signs including basal body temperature temperature, resting pulse rate, and cervical mucus.
Bottom line: it’s never a bad idea to track your cycle, whether you’re trying to conceive or not! Being aware of your own ovulation patterns is an amazing first step in taking control of your own health, so that you can feel your best & crush your goals – even if you’re hit with a little mittleschmerz from time to time.