Symptoms and what they mean for fertility

Cramps that occur outside of a menstrual period can be a sign that a person is ovulating. Being aware of the symptoms of ovulation can help a person identify when they are most fertile.

Ovulation cramps occur when one of the ovaries releases an ovum, which typically occurs halfway through a person’s cycle. Doctors sometimes call them “mittelschmerz,which is translated as “middle pain”.

In this article, we examine how ovulation cramps feel and what they mean for fertility. We also look at other symptoms of ovulation and other causes of mid-cycle cramps.

A woman clings to her lower abdomen due to ovulation cramps.Share on Pinterest
Ovulation cramps start about halfway through a person’s cycle, rather than right before or during menstruation.

An ovary usually releases an egg about halfway through a person’s menstrual cycle. This is ovulation.

For some people, ovulation once a month creates a sensation of cramping or pain on one side of the abdomen. If a person has these cramps every month, the sensation can vary from month to month sides, depending on which ovary the egg releases.

Ovulation cramps can occur before, during or shortly after the release of an egg.

Not everyone who menstruates has ovulation cramps. According to the University of Florida, about 1 in 5 people who menstruate have cramps around the time of ovulation.

Some people do not experience the cramps every month or do not have the same amount of discomfort every month.

Ovulation cramps can occur if:

  • the follicle where the ovum develops stretches the ovary
  • the release of blood and other fluid from the ovary irritates surrounding tissue

The sensation of ovulation cramps can range from mild discomfort to intense pain. It can be difficult to identify the cause of the pain, especially if ovulation cramps do not occur every month.

The primary symptom of ovulation cramps is pain on one side of the abdomen, and it usually lasts 3-12 hours. However, a person who has had an ovarian surgery may experience the pain up to and including menstruation.

Below are the characteristics of ovulation cramps:

  • pain or cramps on one side of the abdomen
  • pain or cramps starting halfway through the menstrual cycle
  • pain or cramps that change sides, month by month
  • pain that is sharp and can be severe

Ovulation pain occurs just before, during or immediately after the release of an ovum, which is also when a female is likely to become pregnant. As a result, the sensation can help to recognize fertility.

However, people who do not want to get pregnant should not use ovulation cramps to determine when it is safe to have unprotected sex – this method is not accurate, says the University of California, and can result in unintended pregnancies.

Some people who menstruate do not experience any discomfort during ovulation.

A person can also recognize that they are ovulating at the following signs:

  • increased cervical mucus
  • chest tenderness
  • spotting or light bleeding
  • increased libido
  • elevated basal body temperature

Ovulation cramps occur when one ovary releases an ovum. If sperm does not fertilize the ovum, the menstrual cycle continues: the ovum breaks and the uterus sheds its lining.

If sperm does fertilize the egg, attach the fertilized egg to the lining of the uterus. This attachment is called “implantation”.

Implantation can cause cramps. It can also cause a small amount of bleeding or stains, which can occur 3–14 days after fertilization. Implant bleeding is typically brownish and the flow is light.

In addition to implantation bleeding and cramps, early pregnancy can cause:

  • nausea
  • a frequent urge to urinate
  • fatigue
  • braking

Various health conditions cause abdominal cramps, which can occur in the middle of the menstrual cycle and look like ovarian cramps.

Some other causes of abdominal cramps or pain include:

  • acute appendicitis, which can occur with similar symptoms to ovulation cramps
  • endometriosis, which involves tissue similar to uterine lining tissue that grows outside the uterus and at least 11% of women in the United States between the ages of 15-44
  • uterine fibroids, which are non-cancerous growths in the walls of the uterus and can cause pain, bleeding and a feeling of fullness in the abdomen

Ovulation cramps usually go away on their own. To relieve the pain, the following can often help:

  • over-the-counter pain medications, such as ibuprofen (Advil)
  • a warm compress or bath
  • hormonal contraceptives that prevent ovulation

If ovulation cramps disappear within a few hours, a person usually does not need medical attention.

A person should contact a healthcare provider if they have cramps and:

  • pain lasting longer than 24 hours
  • unusual vaginal bleeding
  • painful urination
  • braking
  • missed a period

Ovulation cramps are often mild and go away after a few hours. It can let people who want to get pregnant know that the time may be right.

However, people who do not want to get pregnant should not rely on ovulation cramps to indicate fertility. This is not an effective way to time unprotected sex.

If the cramps or pain are intense, a hot bath and over-the-counter pain medication can help. Anyone experiencing severe pain or cramps associated with vomiting or unusual bleeding should contact a physician.

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