Menstrual Cycle & Disorders

What Is Ovulation Pain (Mittelschmerz)?

What Is Ovulation Pain (Mittelschmerz)?
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Updated on March 11, 2025
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Ovulation pain, also known as mittelschmerz, is discomfort in the lower belly during ovulation, when the ovaries release an egg.

 Mittelschmerz comes from the German word meaning "middle pain" because it happens in the middle of the menstrual cycle, around 14 days before a period starts.
Although ovulation pain isn't dangerous and doesn't need treatment, it's easy to confuse it with more serious conditions like appendicitis, which can lead to unnecessary tests and treatments.

 Usually, though, the pain is manageable with over-the-counter pain relievers and goes away within a few hours.

Signs and Symptoms of Ovulation Pain (Mittelschmerz)

Pain from ovulation is usually felt on one side of the lower belly — the side where the ovary is releasing the egg.

 Ovulation pain can feel like a mild ache or a sudden sharp pain. It can last for minutes, hours, or less often, for more than a day.
Other mittelschmerz symptoms are:

Illustrative graphic titled Ovulation Pain (Mittelschmerz) Signs and Symptoms shows Nausea, Clear Vaginal Discharge, Low Back Pain, Lower Belly Pain on One Side and Light Vaginal Bleeding. Everyday Health logo
Ovulation pain (mittelschmerz) may be associated with any or all of these symptoms. Ovulation pain can last for minutes, hours, or more than a day.Everyday Health

Causes and Risk Factors of Ovulation Pain (Mittelschmerz)

Mittelschmerz may be caused by the ovulation process.

 During ovulation, the follicle inside the ovary that houses an egg stretches and then breaks open.

 Both the stretching and the rupturing of the follicle can be painful.
Pain during ovulation is normal for more than 40 percent of women.

 But other medical conditions that cause similar pain could be more serious, including:

How Is Ovulation Pain (Mittelschmerz) Diagnosed?

The timing, location of the pain, medical history of you and your family, and medications you take can help with the diagnosis.

 If the pain happens 14 days before a menstrual period, lasts for a few hours, and feels like a dull ache, it may be mittelschmerz.
Part of the diagnosis involves ruling out other causes of pelvic pain.

 The healthcare provider will start by asking questions about symptoms, medical history, and menstrual cycle. During a pelvic exam, the doctor will look for other conditions that cause this type of pain, like endometriosis or an ovarian cyst.
If the doctor still can't find a cause for the pain, other tests may be done to confirm the cause, such as:

Treatment and Medication Options for Ovulation Pain (Mittelschmerz)

Mittelschmerz doesn't usually need treatment, because the pain goes away within a few minutes or hours.

 It may help to hold a heating pad on the painful area or take a warm bath. Over-the-counter pain relievers and at-home treatments can calm the pain until it subsides.

Medication Options

An over-the-counter pain reliever like acetaminophen (Tylenol) or a nonsteroidal anti-inflammatory drug (NSAID) can help with ovarian pain.



NSAIDs include:
  • Aspirin
  • Ibuprofen (Advil, Motrin)
  • Naproxen (Aleve)
If ovulation pain is severe or bothersome, the doctor may prescribe hormonal birth control pills to stop ovulation.

 Stopping ovulation should prevent ovulation pain. You will not be able to get pregnant while taking birth control pills.

Complementary and Integrative Therapies 

In addition to over-the-counter pain relievers, the following complementary therapies may help to relieve ovulation pain, including:

Home Remedies

If you find your ovulation pain to be generally light, applying heat may help.

 Heat can relax muscles and increase blood flow, which reduces cramping.

Try the following for heat remedies:

  • Heating pads
  • Hot baths or showers

Prevention of Ovulation Pain (Mittelschmerz)

Ovulation pain isn't preventable, because it's a normal part of ovulation for some women.

 Usually, the pain doesn't last long. If mittelschmerz is very bothersome, the only way to prevent it is to stop ovulation through hormonal birth control methods like the pill.
Certain foods increase inflammation in the body, and may worsen ovarian pain.

Other foods lower inflammation and may reduce pain. These foods may help with pain related to the menstrual cycle:

  • Vegetables: Spinach, broccoli, sweet potatoes, Brussels sprouts
  • Fruits: Berries, oranges, apples
  • Legumes: Beans, peas, lentils
  • Whole grains: Brown rice, oatmeal
Eat fewer foods like these, which increase inflammation:

  • Animal proteins, like red meat, chicken, and eggs
  • Dairy products
  • Refined grains, like white bread and white rice
  • Fried foods
Furthermore, to lessen pain related to the menstrual cycle, it may help to reduce or avoid caffeine and alcohol.


How Long Does Ovulation Pain (Mittelschmerz) Last?

Ovulation pain isn't serious and it should go away on its own within a few minutes or hours.

 But if this pain is bothersome or it occurs on a regular basis, talk to a healthcare provider about ways to prevent or manage it.

Complications of Ovulation Pain (Mittelschmerz)

Mittelschmerz doesn't cause any complications, although ovarian pain from a condition like endometriosis or an ectopic pregnancy can lead to problems.

 Ovarian pain itself should go away within a few hours, or days at most.

How Many People Have Ovulation Pain (Mittelschmerz)?

Mittelschmerz affects more than 40 percent of women during their reproductive years (the years between when their periods start and end).

 Many have ovarian pain during every menstrual cycle, starting a few years after they get their first period.

Disparities and Inequities in Ovulation Pain (Mittelschmerz)

There is currently no research to show that mittelschmerz affects any race more than another. But not everyone who needs treatment may have access to it. To prevent ovulation pain, hormonal birth control is needed to stop ovulation. But racial and ethnic disparities in access to hormonal birth control do exist.

White women are more likely to be prescribed hormonal medications than are Black or Latinx women.

 One reason is bias among healthcare providers. Another is that studies on hormonal therapy for treating menstrual cycle problems disproportionately include more white participants than participants of color. And, for various reasons, including beliefs about treatment, certain racial and ethnic groups may be less likely to follow the treatment plan for ovarian pain that their doctor prescribes.

Conditions Related to Ovulation Pain (Mittelschmerz)

Several other conditions that cause ovarian or lower belly pain may be mistaken for mittelschmerz, including:

  • Appendicitis Inflammation of the appendix, an organ in the lower belly
  • Ectopic pregnancy When a fertilized egg implants and starts to grow outside of the uterus, often in a fallopian tube
  • Endometriosis Tissue similar to the lining of the uterus that grows in other parts of the abdomen and causes pain
  • Ovarian cyst A fluid-filled sac that forms in the ovary
  • Ovarian torsion When an ovary twists around
  • Pelvic inflammatory disease (PID) An infection of the reproductive organs
  • Scar tissue Scarring from a C-section or other abdominal surgery that causes organs in the belly to stick together (adhesions)

The Takeaway

  • Ovulation pain affects around 40 percent of women who are of reproductive age.
  • It may be caused by the follicle stretching and then rupturing to release the egg.
  • The pain is most often felt in the lower belly on the same side as the follicle.
  • Mittelschmerz usually lasts only a few hours and is manageable with over-the-counter pain relievers and a heating pad.

Common Questions & Answers

What is mittelschmerz caused by?
Ovulation pain happens when the follicle that holds the egg stretches and then bursts open in the middle of the menstrual cycle.
The pain from ovulation happens because of the stretching and breaking open of the egg follicle.
An over-the-counter pain reliever like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) may help. Holding a heating pad over the painful area or taking a warm bath is another way to ease discomfort.
Ovulation pain shouldn't have any effect on a person’s ability to get pregnant.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Mittelschmerz. Mayo Clinic. February 13, 2024.
  2. Brott NR et al. Mittelschmerz. National Library of Medicine. February 13, 2024.
  3. Ovulation Pain. Cleveland Clinic. February 9, 2023.
  4. Ovulation Pain. NHS. January 30, 2023.
  5. Mid-Menstrual Cycle Pain (Mittelschmerz). Harvard Medical School. February 10, 2024.
  6. Complementary & Alternative Therapies. Royal Women's Hospital.
  7. Using Food Against Menstrual Pain. Physicians Committee for Responsible Medicine.
  8. Dysmenorrhea. Cleveland Clinic. May 22, 2023.
  9. General Approaches to Medical Management of Menstrual Suppression Author: American College of Obstetricians and Gynecologists’ Committee on Clinical Consensus–Gynecology. American College of Obstetricians and Gynecologists. September 2022.
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Kara Smythe, MD

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Kara Smythe, MD, has been working in sexual and reproductive health for over 10 years. Dr. Smythe is a board-certified fellow of the American College of Obstetricians and Gynecologists, and her interests include improving maternal health, ensuring access to contraception, and promoting sexual health.

She graduated magna cum laude from Florida International University with a bachelor's degree in biology and earned her medical degree from St. George’s University in Grenada. She completed her residency in obstetrics and gynecology at the SUNY Downstate Medical Center in Brooklyn, New York. She worked in Maine for six years, where she had the privilege of caring for an underserved population.

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