Pain with ovulation


Do you get pain with ovulation? Perhaps you are wondering if it is normal? Or maybe the pain is quite debilitating & you are wondering why it is happening.

Let’s discuss pain with ovulation, what’s normal & what’s not, along with some causes of painful ovulation.


Hello, I am so thrilled to be here.

For those of you that don’t know me, my name is Michelle Cooke, Period & Hormone Naturopath, Natural Fertility Educator & Naturopathic Emotional Release (NER) Practitioner. I help women struggling with their menstrual cycles, have easy, pain-free periods, balanced hormones & emotional wellbeing. I’m the Founder and Director of Reproductive Wellness, a clinic located in Melbourne. I see patients online and face-to-face.


Ovulation pain


About 40% of women will experience Mittelschmerz (a German word for ‘middle pain’). This is because the pain will take place in the middle of the cycle around the time ovulation would be happening. For these women this pain it can occur every month just before ovulation takes place or sporadically.


It will generally happen a few years after menarche (after your first period) when ovulation is well established. The pain can be anywhere from a mild ache or sharp but not severe type of pain to being agonising & debilitating.


The reason why it happens is still being understood.


This is potential reasons why it might be happening:

  • When there is a peak in LH (luteinising hormone) levels when the follicle is growing in maturity, but it has not yet been released (ovulation hasn’t happened yet).

  • Or it could be due to when the follicle enlarges when it matures which can stretch the surface of the ovary causing pain.

  • Or it could be due to fluid or blood being released from a follicle that has ruptured or broken & those fluids irritating the lining of the abdomen (peritoneum)


The pain is typically felt on the same side as the ovary that is almost ready to release an egg (an egg or oocyte contains a follicle inside it being matured ready for ovulation). But it could also take place during or after just after ovulation as well. The pain can alternate from month to month or it might remain on the same side for several months, depending on which one of your ovaries is ovulating.


Symptoms of ovulation pain


Usually, the pain for the mild version, lasts for a few minutes to a few hours or for some women a day or two.


  • Occurs in the lower abdomen on one side

  • Pain can be similar to period cramps – achy and dull

  • Pain can be like a mild twinge

  • Pain can be sudden & sharp

  • Pain can be severe for some women

  • You may get cervical mucus that is fertile in consistency (like raw egg white, stretchy or slippery) or spotting / light bleed


 Is it normal to have ovulation pain?


If it is a mild type of pain & doesn’t impact your day-to-day life then this is fine & normal for some women to experience this. However, if it severe and difficult to cope with, it affects your day-to-day life, and you are thinking ‘why is my ovulation pain so bad’ then this is NOT normal and this is a sign that there is something wrong.


 What are the causes of ovulation pain?


The mild form of ovulation pain is due to:


  • The LH (luteinising hormone) rise increasing the ovarian muscle contractions due to prostaglandins (which are substances that arise in pain)


The severe form of ovulation pain may be due to:


Hormone Imbalance – Typically high oestrogen levels – It is normal for oestrogen to rise prior to ovulation but when it is in excess it is not good & can contribute to pain.


Endometriosis – Endometriosis is when tissue similar to that of the uterine lining grows in an area where it shouldn’t be (outside the uterus). It causes a lot of inflammation and can also arise in adhesions & scar tissue formation.


Most commonly it can occur either on or around the reproductive organs or in the pelvic region:


  • Ovaries

  • Fallopian tubes

  • Lining of pelvic cavity

  • Ligaments around uterus (uterosacral ligaments)

  • On the outside surface of the uterus


Other areas where it can grow:


  • Space between uterus and rectum or bladder

  • On your bowels (small or large intestine)

  • Cervix

  • Bladder

  • Rectum

  • Stomach (abdomen)

  • Vagina or vulva


Some other types of conditions that can cause a pain similar to this:


  • Ectopic pregnancy – when the egg is developing in another spot apart from the uterus – typically the fallopian tubes

  • Ovarian tortion – when the ovary twists and cuts off blood supply

  • Ovarian Cysts – It is a sac filled with fluid that forms on or inside an ovary. It becomes an issue when it becomes large, bleeds

  • Ovarian Cyst rupture – including when the cyst breaks open

  • Adhesions formed – scar tissue from previous surgery

  • Appendicitis – inflammation of the appendix

  • Sexually transmitted infections – can arise in painful ovulation

  • UTIs – Urinary tract infections

  • Pelvic inflammatory disease – this can cause pain around ovulation and sex due to scarring taking place in the pelvic organs and fallopian tubes


 Can a Naturopath help with ovulation pain?


Yes, absolutely. I would suggest seeing a Naturopath that specialises in Periods & Hormones like myself; to help support you. Particularly if you are concerned about your ovulation pain. If necessary, I will refer you to a doctor to diagnose the reason why it is occurring for you.


Treatment wise, we would be using Natural medicine: including herbal medicine & nutritional medicine based on the reason why it is occurring for you, along with diet & lifestyle. I also use NER (Naturopathic Emotional Release) to look at underlying emotional contributors.


If you would like support with ovulation pain, I would love to help you, go ahead and book a FREE 15 min discovery call to find out more about how we would work together and if we are a good fit. Here is the link:


If you have any questions or comments, pop them in the comments box below 🙂