Ovulation goes unnoticed for most women, but in some it is manifested by sometimes severe pain. Completely benign, they do not harm fertility. Explanations from Dr Odile Bagot, obstetrician gynecologist.
We often talk about period pain but less about the pain during ovulation experienced by some women. This discomfort occurs about 14 days before the onset of menstruation, when a mature egg is expelled from one of the two ovaries.
As a reminder, the menstrual cycle is divided into three phases: the follicular phase, ovulation and the luteal phase. During the follicular phase, follicle-stimulating hormone (FSH) is secreted in large quantities, it promotes the maturation of several ovarian follicles. At the same time, estrogen is released causing the massive production of luteinizing hormone (LH). When the LH reaches its peak, one of the follicles (the largest) ruptures and it releases an oocyte which is immediately sucked by one of the two tubes and will gradually descend to the uterus. This is ovulation. Then comes the luteal phase during which the oocyte, if it has been fertilized by a sperm, will settle in the uterine lining. This is the start of a pregnancy. If the oocyte has not been fertilized by a sperm, the sudden drop in hormones causes the endometrium, the tissue that lines the inside of the uterus, to detach. These are the rules.
On a 28-day cycle, the first day is marked by the onset of menstruation. Ovulation occurs around the 14th day. “28, 30, 34 … It doesn't matter how many days a cycle lasts – it differs from one woman to another – ovulation always takes place 14 days before the first day of menstruation and not 14 days after. the start of menstruation as we tend to repeat”, Insists Dr. Bagot.
What are ovulation pain?
The pain appears in the middle of the cycle. Their intensity and characteristics vary from woman to woman. But they are often acute and can last a few hours to a few days. “The pain can only occur on one side, but it is not always and it may not be in the ovary that expelled the egg. A woman with pain may also lose some blood or feel a ganglion in the groin area.”, Explains Dr Bagot.
Women who experience pain during ovulation admit to having it every cycle, but here again the gynecologist specifies that it is not systematic.
What Causes Pain During Ovulation?
We do not know exactly what causes these pains but several hypotheses have been put forward:
- the presence of follicular fluid in the peritoneum. At the time of ovulation, the production of luteinizing hormone (LH) is at its highest, which increases the pressure of the fluid in the follicle. This eventually bursts to release the oocyte inside. “When the follicle ruptures, fluid can flow abnormally behind the uterus causing pain”, Points out the specialist.
- polycystic ovaries. “Women with Polycystic Ovary Syndrome (PCOS) often complain of pelvic pain during the second part of their menstrual cycle”. In PCOS, too many immature follicles accumulate in the ovary without any dominant follicles. As a result, the ovary, under pressure, swells and becomes painful.
- the increase in the size of the ovary that expels the oocyte can cause lateral tension in the lower abdomen causing pain.
- rupture of a small blood vessel when the follicle ruptures. This is what can cause slight bleeding.
- endometriosis. This disease causes permanent or occasional pain depending on the location of the lesions. These are often cycle-related and intensify especially around the time of ovulation or menstruation.
Painful ovulation in some women also marks the onset of premenstrual syndrome (PMS), which is characterized by a set of symptoms present during the luteal phase and which disappear with the onset of menstruation. It manifests itself by pain in the lower abdomen, sensitive and swollen breasts, fatigue, headaches, irritability, slight depression …
How to relieve them?
Treatment of ovulation pain involves taking simple analgesics, paracetamol in first intention. “I recommend that women who have pain when they ovulate prevent severe pain by taking paracetamol as soon as possible, that is, when the discomfort begins to be felt in the middle of the cycle and not when the pain begins. are already there because the medication will not relieve them effectively”, Advises Dr Bagot.
We do not exceed 3 g (or 3000 mg) of paracetamol per day, i.e. three 1 g tablets to be distributed throughout the day.
Other effective treatment: hormonal contraception because it prevents ovulation. “Women on birth control pills never complain of mid-cycle pain since they don't ovulate!”, Notes the gynecologist.
Pain During Ovulation: When Should You Be Worried?
Ovulatory pain is generally not disabling because it is moderate and temporary. On the other hand, if the pain is sharp, sudden and does not pass over the hours, it is better to consult a doctor urgently because this could be a sign of an ectopic pregnancy, a twist or a rupture of the skin. 'an ovarian cyst. These three gynecological complications require rapid management.
Even though it causes some discomfort, painful ovulation is a sign that you are ovulating normally. For those who want to get pregnant, this is also a good way to find out when you are most likely to conceive! Also, a transparent vaginal discharge similar to egg white, viscous and stringy during the pre-ovulatory and ovulatory period is a sign that the cervical mucus (secreted by the cervix) is ready to pass the sperm through for fertilize the egg. You know what you have left to do…
Sources:
To read also on aufeminin
Menstrual cycle: how is it going?
Painful periods: how to relieve them?
Better understand premenstrual syndrome
The best apps to track your menstrual cycle