What should you know about intense pain during ovulation?

A predictable ache near the middle of the cycle may be uncomplicated ovulation pain. Endometriosis can present with pelvic pain that extends beyond ovulation and may include painful periods or pain with sex. Ovarian cysts can present with one-sided pelvic pain, pressure, or a sudden change in symptoms. These conditions can overlap, so a history and examination are more useful than timing alone.

Keep a cycle diary with the pain's side, onset, duration, severity, bleeding, discharge, and digestive or urinary changes. Gentle heat and rest may ease mild discomfort. Before taking an anti-inflammatory medicine, check that it is suitable if you could be pregnant or have stomach, kidney, bleeding, or medicine-related concerns. Recurrent intense pain warrants a planned assessment and may lead to pelvic imaging.

Go to urgent care for abrupt severe pelvic pain, fainting, marked weakness, heavy bleeding, fever, repeated vomiting, or pain during a possible pregnancy. Contact a clinician soon if the pain is interfering with work or sleep, is becoming more frequent, or comes with painful periods, pain during sex, unusual discharge, or a swollen abdomen.

Could this be ovulation pain or something else? What features would suggest endometriosis or an ovarian cyst? Should I have an ultrasound or pregnancy test? What pain relief is safe for my circumstances? How should I monitor the pattern?