Heavy ovulation pain: what to know

Ovulation pain, also called mittelschmerz, may be felt on one side of the lower abdomen and can coincide with the middle of the cycle. It may last briefly or continue for a while, but the timing and intensity vary. Pain that is much stronger than usual, lasts beyond the expected window, returns frequently, or occurs with pain during sex, painful periods, or difficulty conceiving may fit endometriosis. An ovarian cyst can also cause pelvic pain, especially when pain is sudden or severe.

Track the day of your cycle, which side hurts, how long the pain lasts, its severity, bleeding, discharge, bowel or bladder symptoms, and any chance of pregnancy. Rest, gentle heat, and a pain medicine you can safely take may help mild, familiar symptoms. Arrange an assessment when pain is new, recurrent, interfering with activities, or not settling. A clinician may consider an examination, pregnancy testing, or ultrasound.

Seek urgent medical help for sudden severe or one-sided pain, faintness, shoulder-tip pain, fever, repeated vomiting, heavy bleeding, or a rigid or very tender abdomen. Prompt care is also needed when pregnancy is possible and pelvic pain occurs, because urgent causes can resemble ovulation pain.

Ask whether your timing and symptoms fit ovulation pain, whether an ovarian cyst or endometriosis should be considered, and which pain medicines are suitable for you. Ask whether you need imaging and how to recognise a change that requires urgent care.