ovulation pain and spotting - in depth
Update 12-22-17
Ladies, seven years after I first wrote this and I've gone through many cycles with hundreds if not thousands of you by now and I PROMISE YOU that you cannot cannot cannot tell reliably anything about your cycle based on ovulation pains. I know you think that you can, but a bajillion other people also swore to me (and sometimes swore AT me LOL since people get a little testy over this sometimes) that they could and they were wrong. Please, please, please to infinity and beyond do not rely on ovulation pain to tell you anything reliable about when you ovulated or when to have your attempt(s) for swaying and trying to conceive.
Mid-cycle ovulation pain is surprisingly common, affecting about twenty percent of women regularly and up to half of all women have experienced it at least once. When it becomes severe enough to interfere with life (to the point where at times it is mistaken for appendicitis) it's referred to as mittelschmerz, from the German word for “middle pain.” However, this term has kinda become the basic term for any ovulation pain, even milder cases.
The pain may be caused by many factors. First, the ovary swells as ovulation approaches and 15-20 eggs in each ovary are racing to develop. Then, when the largest egg is released, a twinge or popping sensation may be felt, accompanied by pain as blood and follicular fluid from the ovary is released. This fluid can cause painful irritation of the abdominal wall.
Your individual biology - the amount of space in your abdominal cavity and the amount of fluid you release along with your egg - can determine whether or not you have O pain or not. If you're on blood thinners like aspirin, cranberry, garlic, and fish oil, you may have more severe O pains than you ever have before. If you've taken fertility medication like Clomid and Femara you may also have much worse O pains than normal. Also, many doctors and researchers believe that some women may have tubal and uterine cramping as their muscles spasm to circulate the cervical mucus, bringing sperm to the egg and moving the egg down the Fallopian tubes to the uterus.
If you've experienced a one-sided pain at mid-cycle, that begins as a sharp twinge (egg has broken free of the ovary) and diminishes into a dull ache (Fallopian tube is cramping and blood/follicular fluid is leaking into the abdominal cavity) for the next day or so, that was possibly O pain (but I doubt it LOL because I have not seen any reliable trend where people were able to tell when they ovulated based on O pains and many, many people telling me that they could only to have them be proven wrong). However, some women have mild to severe aching prior to the egg being released (ovaries are tender and swollen from the eggs it is developing) that is actually relieved when the egg breaks free.
The pain doesn't have to be one sided, either. 15-20 eggs form in both ovaries every month and only the best one or two is released, so if you tend to experience achiness prior to ovulation, you very well could feel it on both sides. Post-ovulation, your entire uterus may cramp in order to circulate cervical mucus and bring sperm nearer to the egg. Backache is another symptom that may indicate ovulation.
Occasionally, some women may experience nausea, diarrhea, and/or light spotting (usually a little pink EWCM) at the same time as O pain. The pantheon of ovulatory symptoms last for 6 to 8 hours but can last as long as twenty-four to forty-eight hours, particularly if you have released more than one egg. And for some of us lucky, lucky gals like me personally O pain lasts for up to a week to 10 days. We get it coming and we get it going. O pain seems to be felt more often on the right side regardless of which ovary released an egg, probably because the right side of your body has more blood flowing to it and may have more nerve endings. The pain also may be aggravated OR relieved by intercourse.
Because it's possible to feel ovulation pain before, during, and after ovulation, it cannot be relied upon to help pinpoint ovulation. It's not even reliable to tell whether or not you ovulated. Even women who are very experienced with their cycles (ME!) have been fooled by fake O pains. However, if you experience spotting with ovulation, that may be a better indicator that ovulation has actually occurred than just pain. Unfortunately, some people experience not ovulation spotting but bleeding from the cervix at ovulation since your cervix becomes very soft and easily injured at that point of your cycle. Habitually checking your cervical position and/or pH may exacerbate this.
Painful ovulation, even when severe, does NOT cause or indicate infertility or cancer. However, some medical conditions can cause painful ovulation, such as PCOS or fibroids on the ovaries and these things CAN be signs of a larger issue with your body. Also, if you have pain that lasts for more than two days and ANY abdominal pain that is accompanied by a fever, you should seek medical care. Pain should never be ignored, if you are in any way concerned about anything happening with your body, SEE A DOCTOR!!
To relieve O pains, you can use a heating pad, take a warm bath or shower, or take some Tylenol (taking blood thinning pain relievers like aspirin or ibuprofin will only cause more bleeding from the ovary and may aggravate the pain). Intercourse with female orgasm can help some people, but others find that the actual act of penetrative intercourse is too painful. Please note that taking more than 1-2 aspirins or ibuprofens just prior to ovulation may also cause or contribute LUFS, where your body has a harder time setting the egg free from the ovary and so may make it more difficult to ovulate if you're taking those medications. Stick to Tylenol for O pain if you need medication.
One interesting link I stumbled across tells how to use acupressure to relieve ovulation pains - hey, it can't hurt! How to Relieve Ovulation Pain With Acupressure | LEAFtv
