Okay, let’s talk about mittelschmerz (German for “middle pain”), the confusing and sometimes not-so-friendly pain party that happens around ovulation. It’s like a mystery guest at your cycle’s shindig – sometimes shows up, sometimes doesn’t, and always leaves you wondering if it’s just you. But hey, news flash: you’re not alone!
So let’s go ahead and explore what ovulation pain feels (and doesn’t feel) like, what might cause it, and whether it can accurately pinpoint ovulation.
What Does Ovulation Pain Feel Like?
Ask a bunch of different women to describe ovulation pain and you’ll get a whole range of responses! While it generally involves cramps or achiness around the ovaries, specific symptoms vary dramatically:
- Dull ache or tugging sensation in the ovaries/pelvis
- Sharp stabbing pain on one side or the other
- Sudden pinching and tingling
- Bad period-like cramps
- Brief but intense jolt of pain
- General heaviness in the lower abdomen
There doesn’t seem to be any consistent “normal” ovulation pain – it’s incredibly subjective.
What Percentage of Women Experience Ovulation Pain?
Despite how commonly discussed ovulation cramps are in TTC groups, studies estimate only 20-30% of women consistently notice mittelschmertz. However, that number may be higher among women actively trying to conceive who tune into their cycles closely.
When I informally polled women in TTC groups, over 50% reported getting ovulation pain. That’s a huge difference from the general population! When you’re PURPOSEFULLY tuning into your cycle, you tend to notice every little change. Those who aren’t actively trying or preventing pregnancy just ignore subtle twinges.
I occasionally get ovulation discomfort, but definitely not every single month. Now that I know it’s “a thing,” I pay closer attention! But before TTC, minor cramps around ovulation probably happened without me blinking an eye.
What Causes Ovulation Pain?
Unfortunately, experts aren’t entirely sure what causes mittelschmertz! There are a few theories though:
Some believe the pain is from the mature follicle rupturing and leaking irritating fluid into the abdomen. But interestingly, one research study found that the pain often started before the follicle ruptured (as they confirmed through ultrasound).
Another popular theory is that the ovaries contract to release the egg, similar to menstrual cramps. However, the follicle shouldn’t need strong contractions to rupture each month. Plus, many women have ovulation pain lasting days after confirmed ovulation, so this theory doesn’t quite line up either.
Estrogen and LH surge right before ovulation then quickly drop off once the egg releases. These fluctuations could spark cramps in some women. But it’s unclear exactly how hormone shifts would lead to you feeling ovulation discomfort.
The precise cause remains a mystery! But if you experience tell-tale cramps, know it may not be “all in your head.” There are several plausible explanations, even if experts can’t pinpoint one definite cause.
Can Ovulation Pain Predict the Day You’ll Ovulate?
Here’s the big question – can you use ovulation cramps as an accurate predictor of your ovulation date? Unfortunately, mittelschmertz doesn’t pinpoint the precise moment you ovulate. Here’s why:
It Can Start Before Ovulation
For some women, the pain begins 12-24 hours BEFORE the egg fully ruptures from the follicle.
It Can Persist After Ovulation
Ovulation pain can also linger for hours or even days after you’ve already ovulated. I have a friend who has serious mittelschmertz that lasts for 2-3 days, often continuing a while after she notices a spike in her basal body temperature.
It May Coincide Perfectly
FOR SOME women, the onset of pain does seem to align closely with ultrasound-confirmed ovulation. But even then, is it the start, peak, or end of pain that signals the egg’s exit?
It Can Switch Sides
Typically if you feel ovulation pain on the left one month, then the left side is the side you ovulated from. But it’s not a perfect system! You can feel right-sided pain while ovulating from the left, and vice versa. One of the studies I mentioned earlier showed that in some women, this mittelschmerz occurs on the same side every month, even though ultrasounds show that these women ovulated from alternate sides every month. I got a message from someone the other day who said she felt sharp pains on her right side, while her ultrasound showed she ovulated from the left. Our bodies aren’t great at pinpointing internal sources of pain.
So whether ovulation pain means ovulation is imminent, happening right now, or just occurred, you can’t use cramps alone definitively time ovulation. Consider these mittelschmertz (mittelschmertzes?) helpful context, but confirm with OPKs, BBT, and cervical mucus too.
How Long Does Ovulation Pain Last?
There’s no consistent duration – everyone seems to experience something unique! Possible timelines include:
- Quick sharp pains lasting just seconds or minutes
- Dull aches coming and going over several hours
- Heavier cramping persisting 1-3+ days
I feel like I’m getting a bit repetitive here, but just like everything we’ve talked about so far… there doesn’t appear to be a “normal” length either.
Best you can do is track your unique pattern over a few cycles. Consistency can help you identify mittelschmertz even if it feels different each month.
Do You Need Ovulation Pain to Get Pregnant?
Here’s some good news if you’ve never experienced mittelschmertz – you definitely don’t need to feel ovulation cramps in order to get pregnant! There are plenty of women who conceive without ever noticing tell-tale ovulation discomfort.
In fact, I didn’t have ANY ovulation pain the cycles I conceived. And I hear from women in TTC groups all the time who got pregnant despite having no cramping around ovulation.
Lack of ovulation pain doesn’t mean you aren’t ovulating or can’t get pregnant. While ovulation pain gives you some interesting context, it’s not a fertility necessity. So don’t lose hope if you never notice any twinges or cramps around your ovulation date!
When To Worry About Ovulation Pain
In most cases, mild or moderate ovulation discomfort is harmless and very normal. But severe or persistent pain could indicate an underlying condition. Contact your doctor if you have:
- Pain lasting more than 3 days
- Pain so bad it disrupts your day
- Difficulty walking, moving, or standing
- Fever, vomiting, concerning symptoms
- Heavy bleeding along with pain
Ovulation itself shouldn’t be THAT uncomfortable. If cramping is extreme or unusual for your body, go see your doc and get that checked out!
Takeaways on Ovulation Pain
While confusing and inconsistent, mittelschmertz is pretty common. But don’t worry if you sail through your cycle pain-free! While 20-50% of women experience some discomfort around ovulation, it’s equally common (and totally normal) not to feel a thing.
Want to get to know your cycle better? Tracking your ovulation symptoms over a few months can be insightful, but remember: ovulation pain is just one piece of the puzzle. To get the full picture, consider charting cervical mucus changes, using OPKs, and confirming ovulation with BBT tracking.
Good luck and babydust to you!