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Severe Ovulation Pain: 7 Causes and Treatment Options

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Many women suffer from dull, sudden, sharp or cramping pain in the lower abdomen during ovulation. Painful sensations can be located on the right or on the left, depending on where ovulation occurs. Pain can spread to the lumbar region, sacrum or groin and intensify with active physical exertion, a sharp movement, and sexual intercourse. Painful sensations may be accompanied by vaginal bleeding (spotting). In addition, some women experience weakness, nausea, and even vomiting during ovulation.


In some women, pain can accompany each ovulation, while other women can experience it from time to time. The duration of pain can vary from a few minutes to 24 hours. This is one of the features that distinguishes ovulatory syndrome from gynecological diseases (endometriosis, inflammatory diseases of the pelvic organs). In this article, we gathered seven causes and treatment options for severe ovulation pain.

1. “Middle pain”

Most often, pain during ovulation occurs on the one side. However, the side can change during the next ovulation. The discomfort lasts from a few minutes to half an hour and can be accompanied by bloating and slight nausea. In medicine, it is called the German term Mittelschmerz which means "middle pain”.

If the sensations pass by themselves and the pain is not too strong, a warm bath and pain medication can be enough. For severe pain, it is better to make an appointment with your doctor and discuss taking low-dose hormonal contraceptives.

2. Endometriosis

Endometriosis is a condition in which the cells of the endometrium (the inner lining of the uterus) begin to grow outside it. It can affect pelvic organs like Fallopian tubes, ovaries, intestines and bladder. Endometriosis can cause pain during ovulation and other unpleasant symptoms including infertility.

In the case of mild endometriosis, hormonal and anti-inflammatory treatment options are the most common. If the condition becomes severe, it may require surgery.


Women who have long and irregular periods, as well as excessive body hair, can suffer from polycystic ovary syndrome (PCOS). This condition can have serious complications, from infertility to cancer. That’s why if you experience severe pain during ovulation, you should see a doctor.

After the diagnosis, the treatment may be different. However, the most common treatment options usually include a special diet and hormonal medications.

4. Ectopic pregnancy

Ectopic pregnancy occurs if the fetal egg attaches outside the uterus, for example, in the fallopian tubes. The pain is usually one-sided and begins around the ovulation time.

Ectopic pregnancy can be diagnosed with the help of an ultrasound scan. Then the doctor can prescribe you medications or surgery.

5. Pelvic inflammatory disease

Pelvic inflammatory disease (PID) is a condition that usually develops from an untreated infection like chlamydia or gonorrhea. It can cause severe pain, abnormal vaginal discharge, bleeding after sex, and fever.

Pelvic inflammatory disease requires timely and proper treatment because it can lead to serious complications like infertility, chronic pain, and even cancer. In most cases, the doctor prescribes antibiotics and the infection passes along with the pain.

6. Salpingitis

Salpingitis is a condition that means the inflammation of Fallopian tubes. It can cause severe pain in the pelvic area. Salpingitis is usually caused by infections.

Salpingitis may develop without any symptoms and cause obstruction of the fallopian tubes (and subsequently infertility). If the doctor found that you have this condition, he or she will prescribe you antibiotics.

7. Hyperstimulation of ovulation

Women that have fertility issues can undergo hormonal therapy. One of the most common signs of such hormonal medication is pelvic pain during ovulation.


Fortunately, it is easy to diagnose this condition because abdominal pain and nausea usually occur 10 days after the intake of hormones. In order to get rid of pain, you can take painkillers and drink plenty of fluids.

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