Ovulation Pain: Is It a Sign of Ovulation?

By Heather Frame, BSN, RN | December 27, 2022

Do you occasionally feel twinges and cramps in the middle of your menstrual cycle? It could actually be a sign that ovulation is approaching or has already occurred. Ovulation pain is common – affecting around 35% of women of childbearing ages – and is typically not a cause for concern.

Experiencing pain near ovulation time may be a reassuring sign of fertility; however, not all women encounter this and it is not necessarily a reliable indicator of fertility.

What does ovulation pain feel like

For those who do experience ovulation pain, is it often described as follows:

A dull, crampy, or sharp sensation located in the lower abdomen and/or pelvis on either the right or left side
Does not last more than a few minutes to a couple of days
Does not increase in intensity

Though the exact cause of this pain is not certain, it is believed to be a combination of follicular swelling before ovulation in anticipation of releasing a mature egg and peritoneal lining irritation from the fluid that is expelled after the egg is released.

Does mid-cycle pain mean I am ovulating?

Though pain in the middle of your cycle can indicate that ovulation is approaching or has passed, it is not a perfect guarantee that it is occurring.

Ovulation pain you experience is best confirmed in conjunction with the following tools and methods:

Ovulation predictor kits (OPKs)
Testing luteinizing hormone (LH) daily after your period ends to find your LH peak
Tracking basal body temperature (BBT) daily for ovulation confirmation

Tracking ovulation through the means of OPKs in addition to observing clinical signs, like cramping, gives a more in-depth look at what is happening in your body each cycle. Ovulation tests detect LH levels in the urine. LH is the hormone that surges right before the release of an egg. Testing daily to identify your LH surge helps to pinpoint when ovulation will most likely happen each month.

While your body is capable of communicating signs of increased fertility, it does not always result in successful ovulation. Charting your BBT daily, in addition to ovulation testing, is important because it can actually confirm ovulation. During the luteal phase (after ovulation), basal body temperature increases indicating that progesterone is now dominant as opposed to estrogen. We want this progesterone dominance because not only does it confirm ovulation has occurred, it supports early pregnancy!

To efficiently track BBT, you’ll need a basal body temperature thermometer. After sleeping for at least 3 consecutive hours, check your temperature immediately upon waking, before getting out of bed. Try to temp at the same time each day to ensure accuracy and look for the spike in temperature that should occur within 1 to 3 days after ovulation.

Feel empowered with Premom while trying to conceive

Studies have shown that tracking your cycle with an app increases your likelihood of pregnancy! By using the Premom app, you will have the ability to track various symptoms of ovulation, access to an in-app camera that will read LH tests for you, a detailed BBT chart that can confirm ovulation, and for members, a physician designed cycle analysis report and cycle comparison report that can identify your unique cycle patterns for better ovulation prediction in future cycles.

Premom's medical team is also available for virtual consultations through the Premom app or over in ‘Ask An Expert’ – please feel free to reach out if you are having trouble understanding your fertility signs or if you are just wondering how to track your cycles more efficiently!

When should I be concerned about ovulation pain?

Ovulation pain is quite common but if you are experiencing severe pain that impacts your ability to perform daily activities with or without other symptoms like heavy bleeding, shortness of breath, or painful intercourse, it’s certainly worth reaching out to your doctor. There are several conditions that can cause similar pain including, but not limited to, cysts, ectopic pregnancy, endometriosis, appendicitis, and pelvic inflammatory disease. You are always your own best advocate. If you feel that something is not quite right, never hesitate to seek medical advice!

About Author

Heather Frame is a compassionate Women's Health nurse. She specializes in obstetrics, postpartum, newborn care, and lactation counseling. She is committed to providing women the support they need to achieve pregnancy and thereafter. As a personal user of Premom, she can attest to how important charting your cycles is in conjunction with achieving pregnancy.

References

Johnson, Sarah, et al. "Increased Likelihood of Pregnancy Using an App-Connected Ovulation Test System: A Randomized Controlled Trial." Journal of Women's Health. Jan 2020. 84-90. http://doi.org/10.1089/jwh.2019.7850

Poonam, D., et al. "The Role of Ultrasound in Ovulation Detection Compared To BBT and Other Methods." Nepalese Journal of Radiology, 3(2), 57–64. https://doi.org/10.3126/njr.v3i2.9608

Won HR, Abbott J. "Optimal management of chronic cyclical pelvic pain: an evidence-based and pragmatic approach." Int J Womens Health. 2010 Aug 20;2:263-77. doi: 10.2147/IJWH.S7991. PMID: 21151732; PMCID: PMC2990894.