Sharp pain during ovulation: what to know

Ovulation pain, or mittelschmerz, can feel like a sudden pinch, stitch or cramp low in the pelvis. It may last a short time or recur during the same cycle. Stretching of the follicle and irritation from fluid released at egg release are possible explanations.

The same area can hurt for other reasons. Endometriosis may cause pelvic pain with periods, bowel movements or sex. An ovarian cyst can produce pressure, aching or a sharper episode. The presence of pelvic pain does not determine which cause is responsible.

Use a simple diary to capture the cycle day, side, sensation, duration and any bleeding, discharge, nausea, bowel or urinary changes. Heat, rest and gentle movement can be soothing. If you take an over-the-counter medicine, check that it is appropriate for your health needs and follow the package directions.

Make a routine appointment if episodes become more frequent, last longer, recur outside mid-cycle or affect sleep, movement or sex. A clinician can decide whether your history and examination point to further evaluation.

Get urgent medical attention for severe sudden pain, fainting, fever, repeated vomiting, heavy vaginal bleeding, increasing weakness or a hard swollen abdomen. If pregnancy could be possible, one-sided pain with bleeding, dizziness or shoulder-tip pain should be assessed promptly.

Ask whether the timing and duration fit ovulation pain, what other causes match your symptoms, whether a pelvic examination or scan is appropriate, and what changes should prompt urgent care.