What Is ‘Mittelschmerz’ or Pain during Ovulation?

By (embryologist) and (fertility counselor).
Last Update: 06/25/2015

Ovulation is the most fertile phase of the woman's menstrual cycle. It occurs when an ovary releases a mature egg into the Fallopian tubes, enabling it to be fertilised. The egg remains alive within the tubes for one or two days. If it is not fertilised, it will start shedding. Subsequently, the vaginal bleeding will occur during what is known as "menstruation".

A large number of women suffer from cramps, headache, constipation or diarrhoea during their menstrual period. However, around 20% of women also experience pain during the ovulatory phase, which takes place half-way through the menstrual cycle. This kind of pain is considered as usual and is seldom severe.

Intermenstrual pelvic pain is medically known as Mittelschmerz, a German word that means "middle pain", since it takes place half-way through the female menstrual cycle.

As mentioned before, ovulation is the most fertile moment during women’s menstrual cycle. Thus, it is during this period when pregnancy is most likely to occur.

For this reason, many women desiring to become pregnant rely on calendar-based methods to get the timing right and therefore engage into unprotected sex during this period, favouring this way the union between the sperm and the egg.


Women often experience a pain in the lower abdomen, usually located on a single side, depending on the ovary which has released the egg. Usually, but not always, one egg is released each month.

Pain may last from a few hours to two days. In addition, cramps and/or a slight bleeding or discharge are also symptoms of more severe cases.


There are several explanations for the origin of pain:

  • Just before ovulation, the follicular development may cause a painful muscle strain in the area of the ovary.
  • During ovulation, if the follicle containing the egg ruptures, bleeding is likely to occur. It is believed that this may lead to the irritation of the abdominal lining, causing pain.

Although pelvic pain during ovulation may be severe, it is not considered to be a major problem and has nor is it a sign of illness. Indeed, it may be beneficial for planning a pregnancy or, conversely, avoiding it.

Women are more likely to become pregnant just before, during or immediately after ovulation. The egg survives for about 24 hours in the female reproductive tract, out of the follicle.


Treatment is not needed. However, if the pain is highly severe and lasts for long, painkillers may provide relief.

Another treatment option is the medical prescription of oral contraceptives, which can prevent ovulation and help reduce pain. If the pain is especially intense, you should see your gynaecologist. He or she will conduct a pelvic examination in case it is due to other reasons.

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 Laura Rollán Guilén
Laura Rollán Guilén
Bachelor's Degree in Biology from the University of Valencia (UV). Specialist in Human Assisted Reproduction. Writer of scientific contents. More information about Laura Rollán Guilén
Adapted into english by:
 Sandra Fernández
Sandra Fernández
B.A., M.A.
Fertility Counselor
Bachelor of Arts in Translation and Interpreting (English, Spanish, Catalan, German) from the University of Valencia (UV) and Heriot-Watt University, Riccarton Campus (Edinburgh, UK). Postgraduate Course in Legal Translation from the University of Valencia. Specialist in Medical Translation, with several years of experience in the field of Assisted Reproduction. More information about Sandra Fernández

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