• About one in five women experience pain during ovulation that can last from a few minutes to 48 hours.
• Ovulation pain is usually harmless, but can sometimes indicate various medical conditions such as endometriosis.
• See your GP (doctor) if your ovulation pain lasts longer than three days or is associated with other unusual menstrual symptoms, such as heavy bleeding.

What is ovulation?

Ovulation is part of the female menstrual cycle. An egg is released from an ovary and moves along a fallopian tube towards your uterus.

When does ovulation happen?

Ovulation usually happens once each month, around two weeks before your next period.

Ovulation does not happen if you are:

• on the contraception pill
• pregnant
• postmenopausal.

Some women do not ovulate regularly. This is common when you first start getting your periods. It can also happen during perimenopause (the lead-up to menopause). Hormone conditions can also affect ovulation (e.g. polycystic ovary syndrome (PCOS)).

Up to 40% of women experience pain and discomfort during ovulation. The pain can last from a few minutes to 48 hours.

Women may experience different symptoms of ovulation pain, including uncomfortable pressure, twinges, sharp pains, cramps or strong pain in the lower abdomen.

We don’t know exactly what causes ovulation pain, but it may be caused by:

• the surface of the ovary swelling before the egg is released
• the egg being released from a mature follicle (the sac containing an egg).

In most cases, ovulation pain is harmless. But severe pain in the lower abdomen might mean you have other health conditions (e.g. endometriosis, appendicitis or pelvic inflammatory disease).

Your GP (doctor) may ask about your medical history and do a physical examination to find the cause of your pain. They might also do some tests. For example:

• blood tests
• swabs from the cervix for sexually transmitted infections (STIs) and other bacteria
• an abdominal ultrasound
• a vaginal ultrasound (preferably at the time the pain is occurring)
• exploratory surgery (a laparoscopy or ‘keyhole’ surgery).

Managing ovulation pain

There are many practical ways to manage ovulation pain.

For example, you can:

• relax by having a warm bath, or rest in bed with a heat pack or hot water bottle
• use pain relief or period pain medication (e.g. anti-inflammatories) – ask your GP (doctor) or pharmacist for recommendations
• take the contraceptive pill or other forms of hormonal contraception, as they stop ovulation.

When to see your doctor

See your GP (doctor) if your ovulation pain lasts longer than three days or if it is associated with symptoms such as heavy bleeding or vaginal discharge.