What Do Ovulation Cramps Both Sides Mean?

The pattern of ovulation pain or cramps varies in females depending on individual factors. Some women find it a minor ache, but it can be intense and frustrating for other women. Similarly, some women experience ovulation cramps on both sides, while some women experience it on only one side.

In this article, we will explore the causes, symptoms, and management of pain after ovulation. We will also cover some health conditions that cause ovary cramping, similar to ovulation.

Why Does Ovulation Cramping Occur?

Ovulation is the process when ovaries release a mature egg, ready for fertilization. This process typically occurs in the middle of the menstrual cycle.

Ovaries contain numerous follicles, and each follicle contains an immature egg. At the start of each menstrual cycle, about 11 to 20 follicles start to mature [2]. During ovulation, one of the mature ovarian follicles bursts to release the egg, which may cause temporary pain or discomfort.

Since ovaries are present on both sides of the pelvis and only one ovary releases an egg per menstrual cycle, women usually experience ovulation pain or cramping on one side.

Causes of Ovulation Cramping

Following changes during ovulation can contribute to ovulation cramping:

• Peak Follicle Growth: Just before ovulation, the follicles in the ovaries reach their maximum growth, which can stretch the ovaries and cause pain [3].
• Rupture of the Follicle: After getting a signal from the body in the form of a luteinizing hormone (LH) surge, one of many mature follicles bursts and releases the egg inside the ovaries. This bursting of follicles and egg release can cause pain.
• Fluid Release: In addition to egg, follicles also contain a number of enzymes and other fluids to support the egg maturation process. When a follicle bursts during ovulation, the release of these fluids in the ovarian space can stimulate irritation and may lead to cramping. Fluid and blood released during ovulation can irritate the lining of the abdomen, leading to cramping after ovulation [4].
• Hormonal Changes: Ovulation is the time of abrupt hormonal changes in the body. The LH levels rise suddenly, and there is a sudden drop in estrogen levels just before ovulation [5]. These hormonal changes might also contribute to cramping or discomfort.

Symptoms of Ovulation Cramping

You can distinguish ovulation cramping from other causes of pain in the abdominal area by the following characteristics:

• Cramping on One Side: Ovulation pain typically occurs on one side, depending on which ovary is releasing the egg. Some women may experience aching after ovulation in alternating sides in different cycles. For example, one month they may feel ovulation pain left side, and the next, it might be the ovulation pain right side.
• Cramping on Both Sides: In rare cases, women may experience ovulation cramps on both sides. It is rare but possible that both ovaries release an egg in the same cycle. This condition is called hyperovulation, and it can cause ovulation cramps both sides.
• Spotting During Ovulation: Some women report cramping and spotting during ovulation. Light bleeding can occur during ovulation because of sudden hormonal shifts, like a rise in LH or a drop in estrogen. These hormonal fluctuations can lead to shedding of the uterine lining on a very small scale and result in light bleeding.

Ovulation Pain on the Right or Left Side

Ovulation pain can be confusing for many women to understand as it doesn't occur in the same ovary each cycle. In which ovary you will experience pain depends on which ovary ovulation is going to occur.

Sometimes, you may find ovulation and pain on right side for a few consecutive months before experiencing pain in the left ovary. This ovulation pain only one side or cramps on one side indicates that ovulation is repeatedly occurring in the right ovary. However, you can experience mittelschmerz pain on both sides which may refer to hyperovulation or release of two eggs, one from each ovary.

A visual representation, such as an ovulation pain diagram, can help pinpoint the area of discomfort and distinguish it from other abdominal pains.

Pain After Ovulation

Some women may continue to feel ovary pain post ovulation, which is usually mild and temporary. This may be due to residual irritation or hormonal changes.

However, this pain usually doesn't persist for that long. For example, cramps after 4 days of ovulation are less common and may be related to early pregnancy, hormonal fluctuations, or other underlying conditions.

How to Manage Ovulation Pain?

Some effective ways to manage ovulation pain include:

1. Natural Remedies

There can be a very long list of natural remedies to manage ovulation pain, but some commonly used ones include heat therapy, hydration, and rest. Applying a heating pad to the lower abdomen can help alleviate cramps. Studies show that drinking plenty of water can reduce the intensity of menstrual pain [6]. Thus, it might also help with ovulation pain. Rest also helps relieve stress and improve pain management.

2. Medications

Over-the-counter pain relievers such as ibuprofen or acetaminophen and prescription mittelschmerz medication are often effective for managing mittelschmerz. In severe cases, you may require hormonal contraceptives to suppress ovulation and prevent pain.

3. Consult a Doctor

If cramping when ovulating is severe, persists for several days, or is accompanied by other symptoms such as heavy bleeding, fever, or nausea, it is essential to consult a healthcare professional. Such symptoms often hint at problems associated with the uterus. The doctor will evaluate your condition and prescribe a management plan to improve your condition.

Differentiating Ovulation Pain from Other Conditions

Pain in the lower abdomen might not always be due to ovulation. Some other health conditions that may cause similar or more intense pain in the lower abdomen include:

1. Appendicitis

Pain in the right lower abdomen can sometimes be mistaken for appendicitis. Unlike ovulation pain right side, appendicitis pain is usually accompanied by fever, nausea, and loss of appetite [7]. Thus, by carefully observing all the symptoms, you can differentiate appendicitis pain from ovulation pain.

2. Endometriosis

Endometriosis is a condition in women where uterine-like cells start to grow in other areas of the reproductive tract [8]. Women with endometriosis may experience endometriosis ovulation pain, which is more severe and prolonged than typical ovulation cramping.

3. Ovarian Cysts

Ovarian cysts are very common and can cause pain similar to ovary cramping. However, in the case of a larger or ruptured cyst, pain is often more intense and persistent.

Other Signs of Ovulation

Ovulation cramping can be discomforting, but it also helps you detect your ovulation days. Ovulation is the time when you are at your peak fertility; thus, detecting ovulation and planning unprotected sex in that duration can significantly improve your chances of getting pregnant [9].

Here are some other signs of ovulation that can help you detect your ovulation days:

• Cervical Mucus Changes: Cervical mucus around ovulation days becomes clear, stretchy, and similar to egg whites. This helps in the easy swim of sperm cells from the vagina to inside the uterus.
• Increased Basal Body Temperature: Your resting body temperature, also called the basal body temperature, increases slightly after ovulation. Monitoring your basal body temperature can help you track your ovulation days.
• Breast Tenderness: Hormonal changes during the ovulation phase of the menstrual cycle can lead to increased sensitivity and tenderness in the breast tissues. You may also find the area around the nipple becoming dark around ovulation days, which is a characteristic sign of ovulation.
• Light Spotting: Some women also experience light blood spotting after ovulation. These blood spottings are very small and significantly different from period blood. It is also easy to differentiate ovulation blood from period blood since it occurs about 2 weeks before the expected period date.

Conclusion

Ovulation cramping, or mittelschmerz, is a common symptom of ovulation that many women experience. This pain is usually mild and manageable, but understanding the causes and symptoms can help distinguish normal ovulation pain from other medical conditions.

Cramping one side, ovulation cramps both sides, cramps after sex during ovulation, or pain after ovulation are some characteristic signs of ovulation. However, if you experience severe or persistent pain in the pelvis or lower abdomen, we recommend you consult your doctor to find out the underlying cause.

If you are planning to conceive, detecting ovulation pain and other ovulation symptoms can help you significantly increase your chances of conception.

FAQs

1. How long after ovulation pain is the egg released?

The egg is usually released very close to the time ovulation pain begins, often within hours. Tracking this pain can be helpful for those trying to conceive, as it indicates the peak fertility time of a woman.

1. Does cramping during ovulation mean pregnancy?

Cramping during ovulation is not an indication of pregnancy since it takes time for fertilization of the egg released during ovulation and implantation of the fertilized egg. This means pregnancy occurs after around 10 days of ovulation.

Resources Used

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3. Ovulation Pain. (2024, May 1). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/9134-ovulation-pain-mittelschmerz 
4. Mittelschmerz - Symptoms and causes. (n.d.). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/mittelschmerz/symptoms-causes/syc-20375122 
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6. Torkan, B., Mousavi, M., Dehghani, S., Hajipour, L., Sadeghi, N., Rad, M. Z., & Montazeri, A. (2021). The role of water intake in the severity of pain and menstrual distress among females suffering from primary dysmenorrhea: a semi-experimental study. BMC Women S Health, 21(1). https://doi.org/10.1186/s12905-021-01184-w 
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8. Chauhan, S., More, A., Chauhan, V., & Kathane, A. (2022). Endometriosis: A Review of Clinical Diagnosis, Treatment, and Pathogenesis. Cureus. https://doi.org/10.7759/cureus.28864 
9. Healthdirect Australia. (n.d.-b). Ovulation and fertility. Pregnancy Birth and Baby. https://www.pregnancybirthbaby.org.au/ovulation-and-fertility