Exploring the Causes of Ovulation Pain: Causes and Insights

2024-01-12

Ovulation is part of the female menstrual cycle. An egg is released from an ovary and moves along a fallopian tube towards your uterus. Ovulation usually happens once monthly, about two weeks before your next period. Ovulation can last from 16 to 32 hours.

Ovulation pain, sometimes referred to as mittelschmerz, is a common symptom that many women experience during this phase (1). For decades, women have been fascinated by this phenomenon that causes discomfort or pain in the abdomen. In this piece, we examine the several facets of ovulation pain, its origin, and the mechanics underlying this distinct physiological phenomenon.

Understanding Ovulation

Before delving into ovulation pain, it is essential to grasp the basics of the ovulation process. Typically occurring around the middle of the menstrual cycle, ovulation occurs by an increase in luteinizing hormone (LH), which stimulates the mature follicle to release an egg from the ovary. The released egg then travels down the fallopian tube, awaiting fertilization by sperm (2).

 

Ovulation Pain: An Overview and Statistics

The pain or discomfort some women feel during ovulation is known as ovulation pain or mittelschmerz (German for middle pain). Although not all women experience ovulation pain, research indicates that over 40% of women may do so at some point throughout their reproductive years (3).

 

The Nature of Ovulation Pain

Usually described as a dull ache or cramping sensation on one side of the lower abdomen, ovulation discomfort is localized. It often lasts from a few hours to a few days, right around the time the egg is released. It is interesting to note that depending on which ovary produces the egg, some women may feel pain during ovulation on different sides (4).  

While the exact causes aren’t clear, some theories explain the phenomenon (5). 

Theories for Ovulation Pain

  1. Follicular Distension: A common notion links the discomfort experienced during ovulation to the ovarian wall expanding as the mature follicle grows larger before releasing the egg. Pain receptors may be stimulated by this stretching and pressure on the ovarian tissue, leading to discomfort.
  2. Irritation of Peritoneum: According to a different theory, the egg may irritate the peritoneum, the membrane that lines the abdominal cavity, as it is released. This inflammation may cause pain, indicating that ovulation has taken place.
  3. Prostaglandin Release: Prostaglandins are chemicals that resemble hormones and are involved in some physiological functions, such as pain and inflammation. According to some researchers, some women’s discomfort may be due to the release of prostaglandins during ovulation.
  4. Ovulatory Follicle Rupture: A tiny amount of pelvic pain or bleeding may occur as the mature follicle bursts to deliver the egg. This could cause discomfort and suffering during ovulation.

 

Factors Affecting Pain During Ovulation

Both the probability and severity of ovulation pain may be influenced by the following factors: 

  • Age and Parity: Younger women and those who have not given birth seem to experience ovulation pain more frequently.
  • History of Menstruation: Fertility pain during ovulation may be more common in women with irregular menstrual cycles.
  • Pelvic Inflammatory Disease (PID): PID is an example of an inflammatory condition of the reproductive organs that can raise the risk of ovulation pain.
  • Endometriosis: Endometriosis is a disorder in which tissue resembling the lining of the uterus grows outside the uterus. It may make ovulation pain more common in women with this illness. 

 

Conclusion

Ovulation discomfort, which combines physiological, hormonal, and biological elements, is still an intriguing feature of the female reproductive system. Although Mittelschmerz is explained by several ideas, the question remains. Knowing the reasons for ovulation pain gives women a chance to understand their bodies better and get insight into the complexities of the menstrual cycle. Further findings about this long-standing mystery could be revealed as research on reproductive health progresses to expand our knowledge of women’s health and fertility.

 

Written by: Manvi Taxali (MSc Public Health)