By Kelly Winder

When some women ovulate, they experience a sensation commonly referred to as ovulation pain, which is also known as mittelschmerz. The sensation is usually a sudden twang, pop or twinge in the lower abdomen, which coincides with the ovulatory stage of their menstrual cycle. But some women would describe ovulation as being painful. Because ovulation pain is common these days, it might come as a shock to hear that ovulation pain is actually not normal. Yes, many women feel ovulation and it isn’t a big deal. But acute, severe, stabbing or debilitating pain is not normal. Ovulation pain is a red flag that you have an underlying health issue that should be addressed. In fact, some of the underlying causes can result in fertility problems that can prevent you from getting pregnant. The pain could be the result of any number of problems — all of which should be investigated by a professional. Read on to find out more about what could be the underlying problem in this case.


Ovulation pain is often the sign of cysts on the ovaries. Cysts can form, or can burst, during the ovulation period. Women with PCOS (polycystic ovarian syndrome) often experience ovulation pain due to multiple ovarian cysts. Cystic ovaries are the result of a hormonal imbalance, usually related to insulin resistance. Cutting out sugar and grains (which cause inflammation in the body) can be highly beneficial.




Endometriosis is an inflammatory disease which affects the ovaries and fallopian tubes. It can also cause pain during the ovulatory period. Other symptoms include: pain during intercourse, migraines, constipation, headaches, dizziness and more.

Prior Surgery

If you have had surgery — for example, a c-section or having your appendix out — adhesions and scar tissue can cause ovulation pain, by restricting the ovaries and surrounding structures. Ovaries can adhere to the bowel and other organs, causing you pain when you ovulate.


This could be caused by medical procedures. Bacteria can be introduced into the pelvic cavity through catheters, surgery and even childbirth. This can cause inflammation and infection, resulting in ovulation pain.

Sexually Transmitted Infections

Another reason for ovulation pain is sexually transmitted infections (STI’s). One example is chlamydia, which can cause inflammation in the tubes, scarring and pelvic inflammatory disease. Chlamydia can also cause a condition known as a hydrosalpinx, where the fallopian tubes are blocked with pus. This causes inflammation and pain. Even if you have had children, there are still issues that you might not be fully aware of. If it’s a condition that might eventually lead to infertility, are you comfortable gambling with that?


Ovulation Pain Is Normal?

Doctor Orr says that you should not let anyone tell you that pain during ovulation is normal. “Many GPs don’t know that much about gynecology. Remember that it’s not their field of expertise, they are general practitioners. Always get a referral to see a specialist”.

“But I have had a scan and it came up fine.” – Unfortunately scans don’t pick up everything – especially scar tissue, adhesions and endometriosis. Doctor Orr says, “I need to point out that scans do not always pick up pelvic pathology. They will not pick up endometriosis, so if you have had a scan and think that you have been checked for endometriosis – you haven’t. The only way to assess the pelvic cavity properly is through laparoscopy. It is the gold standard of investigations for gynaecological conditions. I always get so worried when I see comments where people have pain and think they are okay because they have had a scan. Just to repeat: scans cannot pick up endometriosis and other crucial pathology and pain of any kind is not normal.”