Many women can tell when they are ovulating due to various symptoms, one of them being ovulation pain. This is usually described as cramping or sharp twinges in the lower abdominal area, either on one or both sides, about two weeks after menstruation. Some women even feel nauseated and experience light spotting along with the pain. The cramping is referred to as mittelschmerz, which is German for "middle pain," and it can last anywhere from six hours to two days. The exact cause is unknown, but some of the possibilities include follicular swelling, the egg's rupture from the ovary, muscle contraction, or medical conditions.
Before ovulation occurs, the follicles that are present in the ovaries begin to swell. Despite the fact that just one to two eggs are released at one time during this process, several follicles grow and swell up, which may explain the pain that some women feel. If this process is in fact the reason for painful ovulation, it might explain why a fraction of females feel the pain on both sides of the abdomen instead of just one.
There is some evidence to support the assumption that ovulation pain is caused by the rupture of the egg from the ovary. Since there are no openings in the ovaries, the egg literally breaks out through the ovarian wall, which may result in pain. Women who agree with this theory may decide that intercourse is best while they feel the pain, since the egg often lives for 24 hours after being released.
Some medical research shows that contractions may be to blame for the ovulation pain that some women feel. For example, just after ovulation, the fallopian tubes are known to contract, which could be painful. Additionally, the luteinizing hormone released just before ovulation can cause contractions in the ovaries, which can result in some discomfort.
While pain during ovulation could be considered normal for some women, certain medical conditions are known to cause this kind of pain, as well. PCOS occurs when painful cysts develop on the ovaries, eventually causing the woman not to ovulate regularly. Ovulation pain could also be a sign of fibroids on the ovaries, which can cause both discomfort and eventual fertility problems. Therefore, sudden pain around ovulation should be discussed with a doctor during an annual exam so that tests can be run to ensure that the discomfort is not related to a medical condition.