Pain in the side during ovulation: what to know

Ovulation pain, sometimes called mittelschmerz, may feel like a twinge, cramp, or sharper ache on either side of the lower abdomen. It can switch sides between cycles and may occur near the middle of a cycle. Gas, bowel discomfort, urinary problems, pelvic muscle tension, endometriosis, or an ovarian cyst can feel similar. Endometriosis can cause recurring pelvic pain, especially when it follows a cycle. Ovarian cysts may cause pressure or pain if they stretch, bleed, or twist the ovary.

Note which side hurts, when the pain begins, how long it lasts, and whether bleeding, discharge, nausea, fever, or urinary symptoms occur. Rest, gentle movement, warmth over the lower abdomen, and fluids may help. Use an over-the-counter pain medicine only if it is suitable for you and follow its label. If pregnancy is possible, consider a pregnancy test and check with a clinician before taking medicines. Arrange a routine appointment if the pain returns, changes, interferes with activity, or is not settling.

Seek urgent medical help for sudden severe or worsening pain, fainting, marked dizziness, shoulder-tip pain, heavy vaginal bleeding, fever, repeated vomiting, or a rigid or swollen abdomen. Get prompt assessment for one-sided pain with a positive pregnancy test or a missed period, because an ectopic pregnancy can become an emergency.

Ask whether the timing and examination fit ovulation pain, whether an ultrasound or pregnancy test is appropriate, and which symptoms should change your plan. Mention any history of endometriosis, cysts, pelvic surgery, or fertility treatment.