Side pain during ovulation: what to do if, during or after the release of the egg, there is a pulling in the left or right side of the abdomen, what are the reasons and how to relieve the discomfort?

Let's understand the term "ovulation"

The duration of the menstrual cycle is determined from the first day of the previous menstruation to the first day of the next. Its duration varies and normally ranges from 21 to 35 days. The ideal menstrual cycle is considered to be a cycle lasting 28 days, which corresponds to a full lunar cycle. The menstrual cycle consists of several phases:

Follicular phase

The follicular phase is caused by the action of estrogens, under the influence of which a dominant follicle is determined in the ovary, in which the future egg matures. This phase lasts an average of 12–18 days, depending on the length of the cycle. With a 28-day period it is 14 days. Towards the end of the follicular phase, the dominant follicle has reached its maximum development, is tense and is preparing to burst.

Ovulatory phase

The shortest phase of the menstrual cycle, its duration is 12 – 36 hours. During this phase, estrogen levels drop, causing the main follicle to burst and release a mature egg, ready for fertilization. What is characteristic is that it is during the ovulatory phase that the level of both estrogen and progesterone is quite low (estrogens are no longer synthesized, since the dominant follicle and egg have already “matured”, and progesterone is not yet produced in sufficient quantities under the influence of luteinizing hormone due to the still unformed corpus luteum in place of the main follicle).

Luteal phase

The synthesis of progesterone increases, under the influence of which proliferative processes occur in the uterine mucosa, preparing it for implantation of a fertilized egg. In the case of unsuccessful fertilization, by the end of the luteal phase, the level of progesterone decreases (the corpus luteum of menstruation dies) and the functional layer of the endometrium is rejected, which is called menstruation.

So, ovulation is nothing more than the process of the release of a mature egg from the dominant follicle at the moment of its rupture. And painful ovulation is called ovulatory syndrome or Mittelschmertz syndrome.

Why does the lower abdomen feel tight and painful after ovulation?

Considering the features listed above, it becomes clear where abdominal pain comes from during ovulation. However, what does discomfort after this process, which began, for example, on days 4–5, indicate? Can the consequences of a ruptured follicle really last that long? Probably not. This symptom often indicates a more interesting situation - the onset of pregnancy.

The process of implantation of the embryo into the wall of the uterus can be felt 4–7 days after conception. But you should know that this condition does not last long - from several hours to 1 day. The pain after ovulation is not clearly expressed, it slightly pulls the lower abdomen, and sometimes it can also pull the lower back. During this period, there may be pinkish or brownish discharge. With such symptoms, you should confirm your pregnancy with a test after a week to know for sure.

In addition to the aching stomach, there are other signs that help more accurately determine conception:

slight dizziness;
spontaneous mood changes;
chest pain;
odor aversion;
lack of appetite;
restless sleep;
irritability.

If your stomach hurts after ovulation for more than a day, the intensity of the pain remains unchanged, and there are other accompanying symptoms, this may be a consequence of disturbances in the functioning of the genitourinary system. In this case, it is better to get examined.

The presence of fever and nausea on days 1–3 of the ovulatory process bears little resemblance to signs of pregnancy, and therefore can cause problems such as:

genital tract infection;
oncology;
hormonal disorders;
pathological processes in the body;
improper functioning of the uterus or appendages.

If, 7–10 days after ovulation or at any other time not related to this process, the stomach feels tight as before menstruation, you must immediately visit a medical facility for examination. Similar symptoms warn of the following diseases:

Apoplexy of the ovary.
Cyst rupture.
Inflammation of the appendages.
Urinary tract infection.
Pathologies of the cervix.
Viral or bacterial disease of the ovaries.

Depending on the side of the pain localization, left or right, it is possible to identify where exactly the inflammatory process occurs. The nature of the pain is very pronounced and can radiate to the lower back.

If pain sensations are practically zero, but there are some changes in behavior and physical condition, then there is a high probability of having postovulatory syndrome.

Signs of ovulation

Ovulation (from the Latin word for “egg”) has characteristic signs, and every woman experiencing discomfort or pain associated with it can almost accurately determine its onset:

Pain in the right side or left

Pain occurs on a certain side, depending on which ovary “works” in a given menstrual cycle (most often, right-sided pain is observed, which is associated with better blood supply to the right ovary and its innervation, as well as with the close proximity of the appendix).

As a rule, the pain is minor and may cause only mild discomfort. In some cases, women characterize the pain as cutting, stabbing or cramping. This feeling does not last long, from an hour to a day or two. The intensity of pain depends on:

character - emotional representatives of the fairer sex feel pain more clearly
the presence of gynecological diseases contributes to increased pain
pain sensitivity threshold - the higher it is, the less pain a woman experiences during ovulation.

Thus, ovulation itself is short-lived, and pain in the lower abdomen after ovulation may persist for one to two days. Since only one ovary is involved in ovulation in each menstrual cycle, they function alternately, that is, pain can be on the right in one month and on the left in another.

In rare cases, when both ovaries are involved in the work, 2 eggs mature at the same time, which, if fertilized successfully, leads to multiple pregnancies. In such a situation, a woman feels pain on both sides or a diffuse aching pain in the lower abdomen.

Increased libido

Libido, or sexual desire, increases somewhat during the period of ovulation, which is inherent in nature itself (after all, ovulation is the most favorable moment for conception, and therefore for procreation).

Discharge

On the eve of ovulation, at the moment of its completion, and for another couple of days, the nature of vaginal discharge changes. They become more liquid, stretchy and look similar to egg white. These changes in secretions are necessary to create favorable conditions for the penetration of sperm into the uterine cavity to fertilize a mature egg. The liquid consistency of the discharge in the slightly expanded cervical canal facilitates the passage of the “live animals” into the uterus.

Changes in discharge color

During ovulation and some time after it, the color of the discharge may also change. They take on a pinkish tint or a few drops of blood are found on the underwear (see spotting in the middle of the cycle). This is due to a slight detachment of the endometrium (estrogens are no longer produced, and progesterone has not yet begun to be synthesized).

Pain in the mammary glands

Pain or tenderness of the breasts may occur during ovulation (see pain in the mammary glands), which is associated with the initial preparation of the mammary glands for pregnancy and lactation. Such pain (mastodynia) is short-lived and stops by the time the corpus luteum forms.

What ailments can be suspected?

In addition to the normal manifestations of pain during and after ovulation, it should be noted that they can be a sign of serious internal diseases in the patient’s body. You should pay attention to diseases that may cause acute pain.

Ectopic pregnancy . Accompanied by bloody vaginal discharge, cramping attacks of pain, increased pain during walking and defecation.
Ovarian diseases . Ovarian cyst and torsion of its legs, other ovarian tumors, apoplexy (rupture) of the ovary. In these cases, pain can occur on either side.
Cyst rupture .
Accompanied by cutting and pulling pain. The main visible symptom is bleeding.
Ovarian hypertrophy . Occurs due to hormonal stimulation of reproductive function. It is characterized by swelling of the ovarian stroma with aching pain.
Diseases of the pelvic organs . Mainly inflammatory in nature: cervicitis, endometritis, adnexitis, salpingo-oophoritis.

In addition, pain during ovulation is similar to pain during the following diseases:

peritonitis;
inflammation of the appendages;
appendicitis;
varicose veins of the pelvic area;
call.

Signs of pathologies

Unfortunately, pain during ovulation can be pathological in nature, caused by various diseases , and in this case, consultation with a specialist will be mandatory. An approximate list of symptoms for which this is necessary looks like this:

pain lasts more than three days;
prolonged increase in body temperature, accompanied by chills and other signs of intoxication;
vaginal discharge has an uncharacteristic appearance and an unpleasant odor;
multiple heavy bleedings during this period;
disturbances in the gastrointestinal tract;
irradiation of pain to the bladder area, lower back, area around the navel;
decreased blood pressure with increased heart rate;
increased fatigue against a background of general weakness.

Causes

There are several causes of pain during ovulation. Before it begins to emerge from the follicle, it must mature and significantly increase in size.

The large “dimensions” of the follicle stretch the ovarian capsule, which explains the occurrence of pain before ovulation.
After the dominant follicle has reached the “desired condition,” it bursts and a ready-made egg is released into the abdominal cavity.
At the moment of rupture of the follicle, in addition to the egg, a certain amount of fluid is poured into the abdominal cavity, which irritates the parietal peritoneum. In addition, the ovarian capsule is damaged, in which small blood vessels burst, resulting in even a small amount of blood entering the abdominal cavity, which also irritates the peritoneum.
Such nagging pain after ovulation can bother a woman for 12 to 48 hours. But then the blood and follicular fluid in the abdomen are absorbed and the pain syndrome disappears.
And since at the moment the egg appears in the abdominal cavity, the fallopian tubes begin to peristalt (contract) more strongly in order to have time to capture a viable egg and ensure that it meets the sperm, pain can be maintained by this process.
An indirect sign of a possible future pregnancy is pain in the middle of the cycle.

Causes of pain after ovulation?

Follicle rupture is a microtrauma . This process is accompanied by damage to a certain group of nerve endings and capillaries. In addition, during ovulation, a woman's body prepares for potential fertilization. All these factors become the main causes of pain in the postovulatory period.

also become natural causes of pain after ovulation :

an increase in the level of the hormone progesterone ;
hormonal changes;
ovarian distension;
ovarian follicle rupture;
fallopian tube spasms;
slight endometrial detachment.

ON A NOTE! Nagging pain in the lower abdomen after ovulation may indicate conception has occurred. If breast sensitivity and discomfort in the ovaries persist for more than two days, you should consult a gynecologist.

Types of ovulation

There are several types of ovulation:

premature;
timely;
late.

Premature ovulation is the maturation and release of an egg from the follicle not in the middle of the cycle, but much earlier and can be caused by several factors:

excessively violent sexual intercourse (see causes of pain during sexual intercourse);
increased physical activity or heavy lifting;
stress and strong emotional experiences;
various diseases, including gynecological ones;
hormonal disorders and endocrine pathology.

The etiology of late ovulation includes various hormonal problems, including menstrual irregularities.

In connection with the described types of ovulation, pain, accordingly, does not occur, as is customary, in the middle of the cycle, but much earlier or, on the contrary, later, which can become a cause for concern for a woman (see also symptoms of premenstrual syndrome). Therefore, an indirect sign of a possible future pregnancy is pain in the middle of the cycle.

The main signs of the onset of ovulation

The process of the release of an egg from the follicle is accompanied by some characteristic symptoms, and sometimes discomfort and pain, by which a woman can determine the beginning of the ovulatory phase of menstruation.

Side pain

Pain in the middle of the cycle can occur in the left or right side, depending on which ovary the egg has matured in. Most patients experience pain on the right side, since the right-sided ovary is better supplied with blood and is located next to the appendix.

Often, in the middle of the cycle, the side pain does not hurt much and causes only slight discomfort. Some women note sharp, stabbing or cramping pains, but the duration of these sensations is short: from several hours to several days.

The intensity of pain may depend on several factors:

The emotionality of the woman herself;
Gynecological diseases can increase pain;
The height of the pain threshold (the higher it is, the less pain there will be).

The ovulation period is short, and abdominal pain in the middle of the cycle can last a maximum of several days. And since only one ovary is normally used during one menstrual cycle, pain can occur in different sides every month.

Sometimes eggs mature in two ovaries at the same time. If fertilization is successful, a woman experiences a multiple pregnancy, and during ovulation, the patient may feel diffuse pain in the lower abdomen in the middle of the cycle.

Anovulation

Speaking about ovulation, one cannot help but touch upon the problem of its absence or anovulation. Normally, anovulation is observed in pregnant women and premenopausal and menopausal women. And, of course, ovulation cannot occur while taking hormonal birth control pills.

If a woman of reproductive age does not ovulate for several cycles in a row (2 or more), she should start sounding the alarm, because no ovulation - no egg - no possibility of getting pregnant.

As a rule, the cause of anovulation is hormonal imbalances in the body, which, with appropriate treatment, are stopped and the woman has a chance to become a mother. To clarify the date of ovulation, you can use ovulation tests or undergo an ultrasound, where the doctor will accurately see the mature follicle and the release of the egg from it (of course, ultrasound is performed several times during the period of expected ovulation).

How to relieve pain?

Despite the fact that pain in the right or lower side often occurs precisely during ovulation, self-medication is not recommended. To know for sure that the pain is caused by the release of the egg, you should consult a doctor. Pain can be caused by any disease or pathology that may coincidentally coincide with the middle of the cycle.

The gynecologist will be able to conduct a thorough examination, determine the exact cause of the pain and prescribe the best means to combat it:

If there is constant pain (during each menstruation), a woman is advised to avoid stress, physical activity and adhere to a diet during ovulation;
Therapeutic nutrition involves limiting or eliminating foods that are difficult for the gastrointestinal tract, as well as those that increase peristalsis and gas formation. First of all, you should exclude all fatty and spicy foods, white cabbage, legumes, coffee, strong tea and chocolate.
Warm baths with medicinal herbs or aromatic oils are good for pain relief. If there are no surgical or infectious diseases, a warm compress can be applied to the lower abdomen, which will relax the uterus and relieve pain.
As a pain reliever, it is better to choose non-steroidal anti-inflammatory drugs that relieve pain, inflammation and reduce the production of prostaglandins (Ibuprofen, Ketaprofen).
Antispasmodics (No-shpa, Spazgana) have also proven themselves well.
see how to reduce period pain

In some cases, if there is constant pain during ovulation, the patient is recommended to start taking oral contraceptives, which block ovulation and prevent pain from occurring. However, if a woman wants to get pregnant, such drugs are not taken. In addition, during ovulation, you should not apply a heating pad to your stomach or take medications, as this can impair the quality of the egg.

How to make it easier

No matter how sure a woman is that the pain that appears in the right or left lower abdomen is associated with ovulation, she should not self-medicate, but rather consult a doctor. After all, any pathology, not only gynecological, can cause pain, which accidentally coincides with the middle of the cycle.

During the examination, the specialist will rule out other causes of pain and recommend the optimal treatment (see also how to reduce pain during menstruation).

If ovulatory syndrome bothers a woman every menstrual cycle, she is advised to relax as much as possible on the days of ovulation, eliminate stressful situations and adhere to a certain diet.
In therapeutic nutrition, they limit dishes and products that increase the load on the gastrointestinal tract, increase intestinal motility, which aggravates pain, cause flatulence and excite the central nervous system. These are primarily spicy and fatty foods, legumes and white cabbage, chocolate, coffee and strong tea.
Warm baths with aromatic oils or medicinal herbs help relieve pain. heat descends to the lower abdomen, which reduces contraction of the uterus and tubes and relieves pain, but only if acute infectious and surgical diseases are excluded.
Of the painkillers of choice, non-steroidal anti-inflammatory drugs are the method of choice, which block the synthesis of prostaglandins, relieve pain and inflammation (ibuprofen, indomethacin, naproxen, ketoprofen).
Taking antispasmodics (no-shpa, spazgan, spasmalgon) is also effective.

With constant ovulatory syndrome, the gynecologist may recommend taking oral contraceptives (pros and cons of taking them), which, by blocking ovulation, prevent the occurrence of pain. But, if a woman wants to get pregnant, their use is excluded, and it is also not permissible to use a heating pad on the lower abdomen and take any medications on the days of ovulation, as this may affect the quality of the egg.

Why does pain occur during ovulation?

Painful sensations are mainly caused by monthly physiological processes occurring in the female body during ovulation. Until this day, the cell forms and grows, gradually stretching the walls of both the follicle and the ovary on one side. On the day of ovulation, the cell reaches its maturity, and the follicle is stretched to its maximum and is ready to burst. At this moment, some already feel a tug in the lower abdomen, despite the fact that there may still be several hours left before ovulation.

When the walls of the follicle rupture, the cell and fluid exit into the abdominal cavity. This process is traumatic for the body, so pain is felt during ovulation, especially in the lower abdomen. Sometimes this pain radiates to the right or left side. This is explained by the fact that usually only one ovary is “triggered” during ovulation. This is where we feel the discomfort.

On the day of ovulation, the lower abdomen often hurts due to the rupture of blood vessels at the moment the egg is released. The fluid that comes out of the follicle when it ruptures also provokes pain, since the walls of the abdominal cavity are irritated. The uterus reacts to this with contractions, causing nagging pain in the abdomen.

If during the rupture of the follicle many nearby blood vessels were damaged, the pain will be felt more acutely.

Painful sensations may be of the following nature:

mild discomfort;
tingling of varying duration;
aching pain for one or several days;
nagging pain of varying degrees of intensity;
painful, severe spasm.

Those women whose pain sensitivity is higher or who have adhesions in the pelvic organs react particularly acutely to ovulatory processes.

Normally, any type of pain should be constant during each ovulatory process. But if earlier there were only symptoms, but now they have changed dramatically and become pronounced, this may warn of the presence of problems in the body.

If before ovulation your stomach hurts a lot, like before your period, this may be a symptom of an ectopic pregnancy, the onset of the development of various gynecological diseases of an infectious nature or oncology of the pelvic organs. Then pain will be observed in the postovulatory period.

If during ovulation the right lower abdomen hurts, and this symptom is aching or cutting in nature, and in addition there is an elevated temperature, such symptoms indicate appendicitis. In this case, you cannot hesitate; you should immediately consult a doctor.

If white discharge is noticed and the stomach hurts, this is considered normal. The danger lies in spotting or, which is rare, bleeding during ovulation. This condition requires immediate examination by a gynecologist, since it may indicate diseases such as endometritis (myometrium) or a cyst.

There are other causes of pain, for example, unexpected pregnancy. If ovulation occurred earlier than planned, and there was sexual intercourse before that, there is a possibility of fertilization of the egg. And after 4–5 days, the zygote will reach the uterus and attach to its wall. In this case, the palms often sweat, there is slight discomfort in the abdominal area and an increase in temperature.

When the appendages become inflamed, the ovaries can also ache, which collectively leads to nagging pain from the damaged organ. Additional symptoms may include bloody discharge and increased temperature.

Severe pain

In some cases, very intense pain may appear in the middle of the cycle. Severe pain in the ovary or in the right/left side of the groin may be a sign of an emergency:

ectopic pregnancy
apoplexy of the ovary
torsion of the pedicle of the cyst
appendicitis
cyst rupture
drug-induced ovarian hyperstimulation syndrome
or acute inflammation of the appendages.

Each of the listed conditions requires emergency medical care, and in most cases even surgical intervention, so delay only aggravates the situation and, in the literal sense, as Peter I said, is like death. You should not wait out very severe pain, trying to relieve it yourself; you must immediately call an ambulance.

Localization of pain

If unpleasant sensations are caused by natural physiological reasons, then they are usually present on one side. If the right ovary is pulling, presumably that is where the egg has matured in this cycle.

When the ovaries hurt a week after ovulation, this may be a sign of pregnancy or an inflammatory disease.

One ovary hurts

If the right ovary hurts for several days after ovulation, perhaps it is where the egg has matured. The pain is caused by a rupture of the follicle, it is not severe, the ovary tingles slightly. For the same reason, after ovulation the left ovary tingles.

If pain persists for more than 12 hours, this is a sign of pathology. It is possible that the cyst has ruptured or an inflammatory process has begun, so the pain “tugs” and causes suffering. Prolonged and severe discomfort in the ovary requires immediate medical attention.

When to sound the alarm

You should consult a doctor as soon as possible if you experience severe pain in the lower abdomen and/or the following signs:

the pain continues for more than two days (“it hurts for a week during ovulation” - a clear sign of the disease);
the temperature has risen and lasts for more than an hour;
nausea/vomiting occurred;
bloody discharge from the genital tract appeared, regardless of its intensity;
when taking drugs that stimulate ovulation;
a history of acute gynecological diseases, surgeries, endometriosis;
sudden fainting;
progressive deterioration of the condition.

Causes of pain

If your side hurts during ovulation, this process can be explained by several reasons:

An enlarged follicle stretches the ovarian capsule;
When a follicle ruptures, not only the egg, but also fluid enters the abdominal cavity, which can cause irritation;
Follicle rupture also provokes damage to the follicle capsule and small blood vessels, from which a small amount of blood enters the peritoneum, which also irritates the walls;
Fluid and blood remain in the abdominal cavity for no more than 48 hours, after which they are absorbed into the mucous membrane and the pain goes away;
Pain can also be provoked by increased peristalsis of the fallopian tubes, which should capture the egg and promote its movement to the uterine cavity;
Pain in the lower abdomen in the middle of the cycle in some cases also serves as an indirect sign of pregnancy.

Severe pain during ovulation, in addition to a low pain threshold, may also indicate gynecological diseases:

Adhesions in the pelvis that appeared as a result of an inflammatory process, endometriosis or after surgery;
The adhesive process prevents normal contraction of the fallopian tubes and tightens the ovary, which causes compaction of the capsule and increases pain.