Cramps that occur outside of a menstrual period might be a sign that a person is ovulating. Being aware of the symptoms of ovulation may help a person identify when they are most fertile.
Ovulation cramps occur when one of the ovaries releases an egg, which typically happens halfway through a person’s cycle. Doctors sometimes call them “mittelschmerz,” which translates as “middle pain.”
In this article, we explore what ovulation cramps feel like and what they mean for fertility. We also look at other symptoms of ovulation and other causes of mid-cycle cramps.
An ovary typically releases an egg about midway through a person’s menstrual cycle. This is ovulation.
For some people, ovulation creates a sensation of cramping or pain once a month on one side of the abdomen. If a person has these cramps every month, the sensation may switch sides from month to month, depending on which ovary releases the egg.
Ovulation cramping may happen before, during, or shortly after the release of an egg.
Not everyone who menstruates has ovulation cramps. According to the University of Florida, about 1 in 5 people who menstruate have cramping around the time of ovulation.
Some people do not experience the cramping every month or do not have the same amount of discomfort every month.
Ovulation cramping may occur if:
- the follicle where the egg develops stretches the ovary
- the release of blood and other fluid from the ovary irritates surrounding tissue
The sensation of ovulation cramping can range from mild discomfort to intense pain. It may be difficult to identify the cause of the pain, especially if ovulation cramps do not occur every month.
The primary symptom of ovulation cramping is pain on one side of the abdomen, and this typically lasts 3–12 hours. However, a person who has had ovarian surgery may experience the pain until menstruation.
Below are characteristics of ovulation cramping:
- pain or cramping on one side of the abdomen
- pain or cramping that starts midway through the menstrual cycle
- pain or cramping that switches sides, month by month
- pain that is sharp and may be severe
Ovulation pain occurs right before, during, or right after the release of an egg, which is also when a female is most likely to become pregnant. As a result, the sensation may help with recognizing fertility.
However, people who do not want to conceive should not use ovulation cramps to determine when it is safe to have unprotected sex — this method is not accurate, the University of California note, and could result in unintended pregnancy.
Some people who menstruate do not experience any discomfort during ovulation.
A person might also recognize that they are ovulating by the following signs:
- increased cervical mucus
- breast tenderness
- spotting or light bleeding
- increased libido
- increased basal body temperature
Ovulation cramps occur when one ovary releases an egg. If sperm do not fertilize the egg, the menstrual cycle continues: the egg breaks and the uterus sheds its lining.
If sperm do fertilize the egg, the fertilized egg attaches to the lining of the uterus. This attaching is called “implantation.”
Implantation can cause cramping. It can also cause a small amount of bleeding or spotting, which can occur 3–14 days after fertilization. Implantation bleeding is typically brownish and the flow is light.
Beyond implantation bleeding and cramping, early pregnancy can cause:
- a frequent urge to urinate
Various health conditions cause abdominal cramps, which may happen to occur in the middle of the menstrual cycle and resemble ovarian cramping.
Some other causes of abdominal cramping or pain include:
- acute appendicitis, which can present with similar symptoms to ovulation cramps
- endometriosis, which involves uterine lining tissue growing outside the uterus and affects at least 11% of females in the United States ages 15–44
- uterine fibroids, which are noncancerous growths in the walls of the uterus and can cause pain, bleeding, and a feeling of fullness in the abdomen
Ovulation cramps typically go away on their own. To relieve the pain, the following can often help:
- over-the-counter pain medications, such as ibuprofen (Advil)
- a warm compress or bath
- hormonal contraceptives that prevent ovulation
If ovulation cramps go away within a few hours, a person usually does not need medical attention.
A person should contact a healthcare provider if they have cramping and:
- pain that lasts longer than 24 hours
- unusual vaginal bleeding
- painful urination
- have missed a period
Ovulation cramping is often mild and goes away after a few hours. It can let people who want to conceive know that the time might be right.
However, people who do not want to conceive should not rely on ovulation cramps to indicate fertility. This is not an effective way to time unprotected sex.
If the cramping or pain is intense, a warm bath and over-the-counter pain medication may help. Anyone who experiences severe pain or cramps accompanied by vomiting or unusual bleeding should contact a doctor.