Ovulation Pain

One-sided lower abdominal twinges or cramping around mid-cycle, lasting minutes to a couple of days — known as mittelschmerz, it is a normal sign of ovulation rather than a problem. It becomes worth investigating when pain is severe, prolonged, or accompanied by other symptoms.

Evidence synthesis: Mittelschmerz is attributed to follicular swelling and peritoneal irritation from follicular fluid at ovulation; its benign, self-limiting nature is well established in gynaecology literature. For inflammatory pelvic pain broadly, omega-3 fatty acids have randomised trial support in dysmenorrhoea (reduced pain scores and NSAID use), with mechanisms relevant to ovulation pain, though no trials target mittelschmerz specifically. NSAIDs are first-line pharmacologically. Red flags — pain lasting over 48 hours, severe intensity, or accompanied by fever, vomiting, or abnormal bleeding — warrant evaluation for ovarian cysts, endometriosis, or pelvic infection rather than self-management.