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Ovulation pain is normal and usually happens because when the egg is released by the ovary, which usually occurs 14 days after menstruation, a little fluid that protects the egg and blood is also released, which can cause irritation in the abdominal cavity, leading to the appearance of colic. This type of colic gets better soon after the egg is released or as soon as the body absorbs the fluid or blood.
However, if the pain is very severe, lasts for several days, or is accompanied by other symptoms such as fever, nausea, or a smelly vaginal discharge, it could be a sign of a disease such as endometriosis, ectopic pregnancy, appendicitis or sexually transmitted infection, for example, and should always be evaluated by the gynecologist.
Ovulation pain can occur in any woman of childbearing age and usually does not require treatment, but some measures can help alleviate discomfort such as using a hot water bottle or taking a hot bath, for example. However, in some cases, the doctor may recommend the use of anti-inflammatories, treatment with a contraceptive pill or even surgery.
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Ovulation pain happens about 14 days before menstruation, which is when the egg is released from the ovary, and can cause mild to moderate cramping on the left or right side, depending on the ovary where it is occurring ovulation, and although it is rare, it can also occur on both sides at the same time.
This cramping can be accompanied by small hooks, cramps or stronger pulling, which can be mistaken for gas, and usually lasts up to 24 hours.
In addition, ovulation pain may be accompanied by minor vaginal bleeding, and some women may also experience nausea, especially if the pain is severe.
Ovulation pain is caused by the release of the egg by the ovary into the fallopian tubes, which contract so that the egg moves and reaches the sperm to be fertilized. However, when the egg is released, a small amount of fluid and blood are also released causing irritation to the regions around the ovary, causing pain in the abdominal cavity.
This type of pain is common to occur around ovulation, however, if the pain is very intense or lasts longer than 1 day, it may be a sign of a medical condition such as:
Ovulation pain can occur due to endometriosis, a condition where tissue from the endometrium, which is the inner layer of the uterus, implants in other organs in a woman's body, such as the ovaries and fallopian tubes, causing inflammation, abdominal pain and intense colic, due to adherence of the ovary to other structures such as uterus and tubes.See other symptoms of endometriosis and how to treat it.
Endometrioma, also called endometrioid cyst or chocolate cyst, is a type of benign ovarian cyst in which the endometrium implants within or on the surface of one or both ovaries. This condition causes blood and fluid to accumulate inside the ovary causing severe abdominal cramping that can occur at any stage of the menstrual cycle, including during ovulation. Check out other endometrioma symptoms.
3. Polycystic ovary syndrome
Polycystic ovary syndrome is characterized by the formation of small cysts in the ovaries due to the production of a greater than normal amount of testosterone by the body, which can cause intense cramping that can occur during the period of ovulation or at any other time in the menstrual cycle.
This syndrome can also cause irregular menstruation, difficulty conceiving or infertility, as well as hair growth on the face and body and baldness. Learn more about the symptoms of polycystic ovary syndrome and how to identify it.
4. Dermoid Cyst
The dermoid cyst, also called teratoma, is a benign cyst that can be present in one or both ovaries from birth, as it is formed from embryonic cells and, therefore, may contain hair, skin, teeth, keratin, sebum and, more rarely, cartilage.
Although this type of cyst usually does not cause pain and is discovered during imaging tests, when the cyst is very large it can cause ovulation pain due to inflammation that the cyst causes and intense cramping. See other symptoms of dermoid cyst.
Cystoadenoma is a type of benign ovarian cyst characterized by the growth of epithelial tissue on the outer surface of the ovary and that can cause abdominal pain, cramping outside the menstrual period, including during ovulation.
In addition, this type of cyst can cause changes in menstruation such as prolonged absence of menstruation or abnormal bleeding and even intestinal changes such as constipation or diarrhea and even urinary changes such as urine retention, for example.
6. Sexually transmitted infection
Sexually transmitted infections, transmitted through unprotected sex with a partner infected with gonorrhea, chlamydia or HPV, are another cause of ovulation pain as they can cause inflammation and scarring around the ovaries and fallopian tubes that lead to the development of colic and may be accompanied by the production of a strong-smelling discharge, fever, or a burning sensation when urinating.
These sexually transmitted infections require urgent medical attention and drug treatment. Learn more about sexually transmitted infections.
Ovulation pain can also happen after a cesarean section or appendix surgery, due to the formation of scar tissue around the ovaries, fallopian tubes and uterus, causing adhesion between these structures, which leads to the appearance of of pain and colic.
8. Ectopic pregnancy
Ectopic pregnancy is characterized by the implantation of the embryo in another location outside the uterus, being more common in the fallopian tubes, but it can also happen in the ovary, cervix or abdominal cavity, for example, and cause pelvic pain intense only on one side of the belly, and may be another cause of ovulation pain.
Ectopic pregnancy should be treated immediately by the gynecologist through medication or surgery to remove the embryo. Learn more about ectopic pregnancy, types and treatment.
Ovulation pain can also occur due to appendicitis which consists of inflammation of the appendix, a structure present in the intestine that when inflamed causes intense pain on the right side of the belly and may be accompanied by loss of appetite, nausea, vomiting and fever, and requires urgent medical attention. Learn how to identify appendicitis.
What to do to relieve pain
Usually, ovulation pain lasts for a maximum of 24 hours, and no treatment is required. However, you can use a hot water bottle on your belly or take a hot bath to help relieve discomfort.
In some cases, if the colic is severe, the gynecologist may indicate the use of anti-inflammatory drugs such as mefenamic acid, naproxen or ibuprofen. In addition, for women who frequently experience ovulation pain, the doctor may recommend treatment with the birth control pill.
When to go to the doctor
Although pain at ovulation is a normal condition, if the pain is very strong or causes concern in the woman, it is advisable to consult the gynecologist for an evaluation and check if another disease may be causing the intense cramping.
Also, seek medical help as soon as possible if ovulation pain is accompanied by other symptoms such as:
- Pain or burning sensation when urinating;
- Strong-smelling discharge;
- Yellowish, grayish, or yellowish-green discharge;
- Redness or burning of the skin near the site of pain;
- Nausea or vomiting;
- Loss of appetite;
- Vaginal bleeding;
- Absence of menstruation;
- Pain that lasts more than 1 day;
- Pain that does not improve with the use of anti-inflammatories.
In these cases, to determine the cause of ovulation pain, the gynecologist must perform a physical examination, evaluate the woman's medical history, perform a vaginal mucus exam and request blood and imaging tests such as pelvic ultrasound, resonance MRI or computed tomography and start the most appropriate treatment that can be done with the use of medicines such as the contraceptive pill or antibiotics, and in some cases, conventional surgery or laparoscopy.