As you know, the menstrual cycle is the main assistant in assessing the state of women’s health. By its duration, the presence or absence of pain during menstruation, the appearance of bleeding can be judged on whether there is any gynecological problem or a woman is healthy. One of the characteristics of the menstrual cycle are pain during ovulation, however, this condition is observed only in 20% of women of reproductive age.
We will understand the term ovulation
The duration of the menstrual cycle is determined from the first day of the previous month to the first day of the next. Its duration is different and normally is 21 – 35 days. The ideal menstrual cycle is a cycle lasting 28 days, which corresponds to the full lunar cycle. The menstrual cycle consists of several phases:
The follicular phase is caused by the action of estrogens, under the influence of which the dominant follicle is defined in the ovary, in which the future egg cell matures. This phase continues on average 12 to 18 days, depending on the length of the cycle. At 28 days, it is 14 days. By the end of the follicular phase, the dominant follicle has reached its maximum development, is tense and is preparing to burst.
The shortest phase of the menstrual cycle, its duration is 12 – 36 hours. In this phase, the level of estrogen falls, with the result that the main follicle bursts and a mature egg comes out of it, ready for fertilization. What is characteristic is that in the ovulatory phase, the level of both estrogen and progesterone is quite low (estrogens are not synthesized anymore, since the dominant follicle and egg have already matured, and progesterone is not yet produced in sufficient quantities by the action of luteinizing hormone due to the unformed yellow body in place of the main follicle).
Progesterone synthesis increases, under the action of which proliferative processes take place in the uterine mucosa, preparing it for implantation of a fertilized egg. In the case of not accomplished fertilization, by the end of the luteal phase, the level of progesterone decreases, (the yellow body of menstruation dies off) and the functional layer of the endometrium is rejected, which is called menstruation.
So, ovulation is nothing like the process of release of a mature egg from the dominant follicle at the time of its rupture. A painful ovulation is called ovulatory syndrome or Mittelschmerz syndrome.
Signs of ovulation
Ovulation (from the Latin word egg) has characteristic signs, and every woman experiencing the discomfort or pain associated with it can almost accurately determine its beginning:
Pain in the right side or in the left
Pain arises from a certain side depending on which ovary “works” in a given menstrual cycle (right-side pain is most often observed, which is associated with better blood supply to the right ovary and its innervation, as well as with the immediate proximity of the appendix).
As a rule, the pain is insignificant and can give only mild discomfort. In some cases, women describe pain as cutting, piercing, or cramping. Such a feeling does not last long, from an hour to a day or two. The intensity of the pain depends on:
- a temper of character – the emotional representatives of the weaker sex feel pain brighter
- the presence of gynecological diseases increases pain
- threshold of pain sensitivity – the higher it is, the less pain a woman experiences during ovulation.
Thus, ovulation itself is short-lived, and pain in the lower abdomen after ovulation can last one to two days. Since in each menstrual cycle only one ovary participates in ovulation, they function alternately, that is, the pain can be in one month on the right and in the other on the left.
In rare cases, when both ovaries are involved in the work, 2 eggs mature at the same time, which, if they are successfully fertilized, leads to multiple pregnancies. In such a situation, the woman feels pain from both sides or diffuse aching pain in the lower abdomen.
Libido, or sexual desire during the period of ovulation increases slightly, which is laid by nature itself (after all, ovulation is the most favorable moment for conception, and therefore, for the continuation of the species).
On the eve of ovulation, at the time of its accomplishment and in a couple of days, the nature of vaginal secretions changes. They become more liquid, stretch and look like egg white. These changes in secretions are necessary to create favorable conditions for the penetration of spermatozoa into the uterus to fertilize a mature egg. The fluid consistency of the secretions in the somewhat enlarged cervical canal facilitates the advancement of zhivchikov in the uterus.
Change the color of selections
During the period of ovulation and some time after it, the color of the discharge may also change. They acquire a pinkish tint or a few drops of blood are found on the linen (see spotting in the middle of the cycle). This is due to a small detachment of the endometrium (estrogens are no longer produced, and progesterone has not yet begun to be synthesized).
Pain in the mammary glands
Perhaps the appearance of pain or sensitivity of the breast during ovulation (see pain in the mammary glands), which is associated with the initial preparation of the mammary glands for pregnancy and lactation. Such pains (mastodynia) are short-lived and cease by the time of formation of the yellow body.
There are several causes of ovulation pain. Before starting to exit the follicle, it must mature and increase in size significantly.
- Large dimensions of the follicle stretch the ovarian capsule, which explains the occurrence of pain before ovulation.
- After the dominant follicle has reached the “necessary condition”, it bursts, and the finished egg leaves it in the abdominal cavity.
- At the time of the rupture of the follicle, in addition to the egg, some quantity of fluid is poured into the abdominal cavity, which irritates the parietal peritoneum. In addition, the capsule of the ovary, in which small blood vessels burst, is damaged, as a result of which even a small amount of blood gets into the abdominal cavity, which also irritates the peritoneum.
- Such pulling pains after ovulation can disturb a woman for 12 to 48 hours. But then the blood and follicular fluid in the stomach are absorbed and the pain syndrome disappears.
- And since at the time of the appearance of the egg in the abdominal cavity, the fallopian tubes begin to peristaltize (contract) more strongly in order to have time to seize the viable egg cell and ensure that it meets with the sperm cell, the pain can be supported by this process.
- An indirect sign of a possible future pregnancy is pain in the middle of the cycle.
But in some cases, pain at the time of ovulation is more pronounced, which is caused not only by the threshold of pain sensitivity, but also by the presence of certain gynecological diseases, for example:
- adhesive pelvic disease, which may be due to chronic inflammation, the presence of surgical intervention in history or endometriosis
- adhesions do not allow the tubes to quietly contract and overtighten the ovary, and in some cases cause the capsule to seal, all this increases the severity of pain.
Types of ovulation
There are several types of ovulation:
Premature ovulation is the maturation and release of an egg from the follicle not in the middle of the cycle, but much earlier and may be due to several factors:
- excessive sexual activity (see the causes of pain during sexual intercourse);
- increased physical exertion or weight lifting;
- stress and strong emotional experiences;
- various diseases, including gynecological;
- hormonal disorders and endocrine pathology.
The etiology of late ovulation includes various hormonal problems, including menstrual disorders.
In connection with the described types of ovulation, pain, respectively, occurs not as usual, in the middle of the cycle, but much earlier or, conversely, later, which may be a cause for concern for the woman (see also symptoms of premenstrual syndrome). Therefore, an indirect sign of a possible future pregnancy is pain in the middle of the cycle.
Speaking of ovulation, one cannot but touch upon the problem of its absence or anovulation. Normally, anovulation occurs in pregnant women and in premenopausal and menopausal age. And, of course, ovulation can not be when taking hormonal contraceptive pills.
If a woman of reproductive age does not have ovulation for several cycles in a row (2 or more), she should start to sound the alarm, because there is no ovulation – no egg – there is no way to get pregnant.
As a rule, the cause of anovulation are hormonal disruptions in the body, which, with appropriate treatment, are stopped and the woman has a chance to become a mother. To clarify the date of ovulation, you can use tests for ovulation or undergo an ultrasound, where the doctor will see the ripe follicle and the egg from it (of course, ultrasound is performed repeatedly during the period of the intended ovulation).
How to facilitate
As if a woman was not sure that the pain that appeared in the right or left lower half of the abdomen is associated with ovulation, you should not self-medicate, but rather go to a doctor. After all, any pathology, not only gynecological, can cause pain, which coincidentally coincides with the middle of the cycle.
The specialist will exclude other causes of pain during the examination and will recommend optimal treatment (see also how to reduce pain during menstruation).
- If ovulatory syndrome bothers a woman in each menstrual cycle, it is recommended to relax as much as possible on the days of ovulation, eliminate stressful situations and follow a certain diet.
- In clinical nutrition, they limit foods and foods that increase the load on the gastrointestinal tract, increase intestinal motility, which exacerbates pain, cause flatulence, and excite the central nervous system. This is primarily spicy and fatty dishes, legumes and white cabbage, chocolate, coffee and strong tea.
- Helps relieve pains warm bath with aromatic oils or medicinal herbs. heat sinks to the lower abdomen, which reduces the contraction of the uterus and tubes and relieves pain, but only if acute infectious and surgical diseases are excluded.
- Among painkillers, nonsteroidal anti-inflammatory drugs are used as a method of choice. They block the synthesis of prostaglandins, relieve pain and inflammation (ibuprofen, indomethacin, naproxen, ketoprofen).
- Also effective in receiving antispasmodics (no-shpy, spazgana, spazmalgona).
With persistent ovulatory syndrome, the gynecologist may advise taking oral contraceptives (for and against taking them), which, by blocking ovulation, prevent pain. But, if a woman wants to become pregnant, their admission is excluded, and the use of a heating pad on the lower abdomen and taking any medication on the days of ovulation is not acceptable, as this may affect the quality of the egg.
In some cases, you may experience very intense pain in the middle of the cycle. Severe pain in the ovary or in the right / left side of the groin may be a sign of an emergency:
Each of these conditions requires emergency medical care, and in most cases even surgery, so the delay only aggravates the situation and in the literal sense, as Peter I said, death is like. You should not wait for a very pronounced pain, trying to ease it yourself, you must immediately call an ambulance.
When to sound the alarm
It is necessary to consult a doctor as soon as possible for very pronounced pains in the lower abdomen and / or the following symptoms:
- the pain lasts more than two days (“a week hurts during ovulation” – a clear sign of the disease);
- temperature has risen and lasts more than an hour;
- nausea / vomiting;
- there was bloody discharge from the genital tract, regardless of their intensity;
- when taking drugs that stimulate ovulation;
- history of acute gynecological diseases, operations, endometriosis;
- sudden fainting;
- progressive deterioration.