Cramping on left side day after ovulation

Up to 50% of people who ovulate will experience ovulation pain at least once in their lives. Some of them—about 20%—get ovulation cramps every month. Generally speaking, ovulation pain is normal.

Severe pain, however, is not. Intense or prolonged pelvic pain may be a symptom of endometriosis or pelvic inflammatory disease. Sometimes, the aches you experience have nothing to do with ovulation. If the pain prevents you from having sex or going about your daily life, this is also not normal.

Learn more about ovulation pain, why it happens, how to cope, and when to call your doctor.

What is Ovulation Pain?

Ovulation pain is abdominal pain experienced between periods, typically around the time of ovulation. Another term for ovulation pain is mittelschmerz. This is German for "middle pain."

Ovulation pain doesn't necessarily occur at the exact moment the egg is released from the ovary. It may occur a few days before or after ovulation. 

What Does Ovulation Pain Feel Like?

Most people describe ovulation pain as a dull, achy feeling that lasts for a few hours or even over a couple of days. Other people experience sudden, sharp pain, lasting just a moment.

Though the pain is typically mild, it has been known to land some people in the emergency room for suspected appendicitis—though such a severe reaction is rare.

You may notice that the pain is more frequent on one side than the other. While you may have been taught that the ovaries "take turns ovulating," this isn't always true. It's normal for one side to ovulate more often than the other.

What Causes Ovulation Pain?

No one is sure what causes ovulation pain, but there are a few theories.

• Swelling or rupturing of a follicle on the ovary. This releases some extra fluid, which may lead to a dull ache.
• The egg itself, bursting out of the follicle may cause the sharp, sudden pain some people feel.
• Spasms of the fallopian tubes or uterus as ovulation approaches.

What Causes Severe Ovulation Pain?

Endometriosis, a chronic disorder in which uterine tissue grows outside of the uterus, can cause pelvic pain at any time, but it can be quite severe during your menstrual cycle and near ovulation. Some people with endometriosis experience such bad pain before and during ovulation that they go about their daily activities.

Additionally, for those trying to conceive, endometriosis can make sex feel comfortable or painful near ovulation. This can make having sex for pregnancy during their most fertile time more difficult.

Endometriosis isn't the only possible cause of abnormal cramping or aching around ovulation, though. For example:

• Infection of the fallopian tubes can lead to intense ovulation pain
• Fibroids and ovarian cysts can cause mid-cycle aches
• Ovarian hyperstimulation syndrome, which usually occurs in people taking some types of fertility drugs, can cause severe pelvic pain

Ovulation Pain and Pregnancy Planning

Some research suggests that ovulation pain can actually signal ovulation. One study found that it came on the same day that the luteinizing hormone (LH) peaked. LH is the hormone detected by ovulation predictor kits. It peaks during your most fertile time, just before you ovulate.

However, another study used ultrasound technology to connect mid-cycle cramps to actual ovulation and discovered that ovulation occurred a couple of days after many people reported the side pain. The ideal way to time sex for pregnancy is to have sex before and not after ovulation. Using ovulation pain to plan when to time sex is unreliable since you can't be sure exactly when in your cycle you are experiencing ovulation pain.

Although it could be a symptom indicating ovulation is imminent, it's probably best not to rely on ovulation pain as a primary way to detect your fertile window.

Ovulation Pain vs. Implantation Cramps

Some people report cramps during the time of embryo implantation. Embryo implantation takes place a few days to a week after ovulation, so it does not occur at the same as ovulation pain. However, the feeling may be similar.

Because the timing of ovulation and implantation can vary, whether this pain is embryo implantation, ovulation, or something else is difficult to discern. Usually, it's only in hindsight, if you become pregnant and the timing matches up, that you might think the pain you felt could have been from implantation.

How to Treat Ovulation Pain?

Some people will only have ovulation pain in a quick, burst of sharp pain. It hurts! But then it’s gone. Others, however, may experience longer-lasting discomfort.

The first thing most people think of doing when they have pain is to take an over-the-counter pain reliever, like ibuprofen or acetaminophen. That is one option for coping with ovulation pain. It's a good idea to consult with your OB/GYN to discuss ways to get relief, including the best medications to take, if needed.

If you are trying to get pregnant, you may want to stick to Advil (ibuprofen), Motrin (ibuprofen), or Tylenol (acetaminophen). Some small studies have found a possible connection between other common pain relievers and an increased time to pregnancy, specifically with naproxen, the active ingredient in such products as Aleve. However, other studies have found no such connection between common pain medications and time to pregnancy.

It’s also difficult in these studies to separate causes of pain that can also impact fertility. For example, endometriosis can cause pain—including pain around the time of ovulation—and infertility. People with endometriosis are much more likely to take pain relievers. But how can we know if it’s the endometriosis or the medication that is delaying pregnancy? It’s very unclear.

There are also other remedies to try that can offer relief. Generally, treatments that are good for menstrual cramps may help with ovulation pain. Consider a warm bath, rest, or a heating pad.

When to Call Your Doctor

It's tempting to just hope that pain will go away, but severe pain—at any time of the month—should be checked out. You should contact your doctor right away if:

• Your pain is severe
• You're vomiting or having severe diarrhea
• You're having trouble breathing

It's possible that what you suspect is "ovulation pain" may be more serious like appendicitis or other abdominal issues. The call or trip to the doctor may seem like a hassle, but it's well worth it.

A Word From Verywell

Ovulation pain can be normal. However, if your ovulation pain is severe or simply interferes with your daily life or causes pain during sexual intercourse, you should make an appointment with your doctor. They can help you pinpoint a cause and offer solutions to improve your discomfort and day-to-day quality of life.

Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

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By Rachel Gurevich, RN
Rachel Gurevich is a fertility advocate, author, and recipient of The Hope Award for Achievement, from Resolve: The National Infertility Association. She is a professional member of the Association of Health Care Journalists and has been writing about women’s health since 2001. Rachel uses her own experiences with infertility to write compassionate, practical, and supportive articles.

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