Ovulation Pain
by Dr Peta Wright
Illustration: Katrin Friedmann
Many women may be aware of a little pain around the time of ovulation especially if they track their cycles, but many more come to see me with pain that occurs mid-cycle and they have no idea why. Pain around ovulation can sometimes feel quite severe and if you are not sure what’s happening this random pain can feel scary. This is another example of how knowledge of what’s happening in your body can actually help. Pain without fear and the accompanying stress hormones is much more manageable. Ovulation pain can be due to a few things happening around this miraculous egg hatching time.
Pressure of a growing follicle – the follicle or (cyst) that contains the egg grows up to 2-3cm before ovulation and the stretching of ovary can be enough to be painful in some women.
Prostaglandin release around the time of ovulation that can also irritate pain nerves. We actually need these prostaglandins to ovulate so they do perform a helpful function.
Ovulation itself. This is the main event of the month when the follicle is stimulated by the brain to release the egg into the pelvis and into the fallopian tube. Think of it like mini ovarian fire works! When the egg pops out of the follicle some of the surrounding fluid and sometimes a little blood can also release into the pelvis, and this may irritate the lining of the pelvis or other organs.
All of this is completely normal and safe and is a sign your body is working just as it should. Occasionally it may be more painful and last for longer or be accompanied by other symptoms and in those cases see your doctor.
The other big thing to remember is that if you have endometriosis, or persistent pain and your pain pathway system and pelvic floor is already upregulated and extra sensitive, you may experience more ovulation pain. This does not mean anything bad is happening but that your body has become wired to feel more pain when there is any stimulus in the pelvis.
Ovulation is your sign that your body is doing what it should so this knowledge itself can be helpful.
Although ovulation pain can affect 1/3 women and is mostly totally normal, for many women, especially women with endometriosis and pelvic pain, it can be debilitating.
My first tip is to breathe, remember that your body is doing what it is meant to. You are safe. This is so important to keep remembering, especially when sensitive pain pathways tell you that you aren’t safe and that something is very wrong.
Start with knowledge, and then activating your para-sympathetic nervous system to bring those stress hormones down. You can do this with deep belly breathing, meditation, mindfulness, repeating a mantra that you are safe.
Doing this, not only reduces stress and fear which increase pain, but can also help to relax pelvic floor muscles that may be in spasm as a result of the ovulation pain trigger.
Heat packs, warm baths, gentle stretches and massage can also help.
Supplements such as Magnesium, Zinc, Curcumin and omega 3 all help to reduce inflammatory prostaglandins and may help with pain.
Sipping ginger tea or trying some ginger root capsules help with inflammation and can relieve pain too and an anti-inflammatory whole food diet focused on more plants and less sugar, gluten, dairy, inflammatory seed oils and grain fed meats may also help to reduce overall inflammation and prostaglandin mediated pain.
Anti-inflammatory medications that reduce prostaglandins like Ibuprofen can also help but high doses can impair ovulation as prostaglandins are needed for ovulation to occur.
Finally, the oral contraceptive pill prevents ovulation and so will generally stop severe ovulation pain – however the pill won’t fix sensitive pain pathways or reduce inflammation. The Mirena IUD may take away periods but generally does not prevent ovulation.
Remember go back to basics, remind yourself of the amazing event happening inside your body, calm your nervous system, relax your pelvic floor, reduce inflammation, and ovulation pain may feel less of a burden.
You are making all your hormones and hatching an egg that is the grand event of your menstrual cycle. You are safe. Your body is incredible. Rest, slow down and be gentle with yourself. Repeat.
