Endometriosis and Ovulation Pain: Why Does It Happen?

by Mar 16, 2020

1 out of every 5 women experiences ovulation pain. Most of the time, ovulation pain isn’t something to worry about — but sometimes, ovulation pain can be a sign of an underlying medical condition. One medical condition that can cause ovulation pain is endometriosis. Endometriosis ovulation pain can spread to the leg or thigh and may be more severe than “ordinary” ovulation pain.

woman experience pain in a belly

This month is Endometriosis Awareness Month. Today, we’ll be talking about endometriosis ovulation pain, including:

  • How endometriosis ovulation pain differs from “regular” ovulation pain
  • Why endometriosis causes ovulation pain
  • How to cope with endometriosis ovulation pain

Read on to learn more about endometriosis ovulation pain. This article may be able to help you decide if you are suffering from ovulation pain due to endometriosis.


Is My Ovulation Pain Due to Endometriosis?

Many women experience ovulation pain as a normal sign of ovulation. However, sometimes pain occurring during ovulation is due to endometriosis.

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Endometriosis is a disorder that causes uterine tissue to grow abnormally outside the uterus. So, how can you tell when ovulation pain is actually endometriosis ovulation pain?

Normal ovulation pain can be identified according to the following criteria:

  • Ovulation pain causes lower abdominal pain, just above the hip bone
  • Pain typically occurs on one side (the side releasing the egg)
  • Pain occurs about two weeks before your next cycle is supposed to start
  • The pain lasts from a few minutes up to 48 hours

Signs that your ovulation pain may not be normal and may actually be endometriosis ovulation pain include:

  • Intense or prolonged pelvic pain lasting longer than 48 hours
  • Pain that is so severe it causes vomiting or diarrhea
  • Ovulation pain due to ovarian cysts called endometriomas or “chocolate cysts”
  • Abnormal bleeding during ovulation

Other signs of endometriosis that may occur alongside ovulation pain include:

  • Pelvic pain ranging from mild to disabling throughout the menstrual cycle
  • Pain during sexual intercourse
  • Urinary urgency and/or pain during urination
  • Chronic fatigue
  • Constipation and/or shooting rectal pain

woman on a bed


Why Does Endometriosis Cause Ovulation Pain?

Ovulation pain can occur in women with or without endometriosis — so why do women with endometriosis commonly experience ovulation pain?

Most of the pain due to endometriosis, including endometriosis ovulation pain, occurs due to uterine tissue growing outside the uterus. This tissue may bind to the pelvic cavity, creating scars or adhesions between organs that frequently lead to pain during ovulation, sexual intercourse, urination and/or bowel movements.

Endometrial tissue can infiltrate deeply into surrounding organs. Endometriosis may also remain confined to the peritoneal lining of your abdomen. However, the depth of your endometriosis does not predict the severity of the pain you experience. Women with early stages of endometriosis can still experience severe ovulation pain — and women with late-stage endometriosis may have no symptoms at all! The only way to know for sure if you have endometriosis is to visit your doctor for testing and treatment.


How to Deal with Endometriosis Ovulation Pain

If you suspect your ovulation pain may be due to endometriosis, you should make an appointment with your OB/GYN. Your doctor will be able to evaluate your symptoms to tell you if you could have endometriosis. They may also order imaging, such as an ultrasound or MRI. However, the only definitive way to diagnose endometriosis is through laparoscopic surgery. This surgery is minimally invasive and offers physicians the opportunity to treat endometriosis at the same time that they diagnose the condition.

Endometriosis cannot be cured, but it can be treated in a number of ways. One way to treat endometriosis is by using birth control pills. The hormones in the pills can stop you from ovulating to prevent endometriosis ovulation pain. They may also make your periods shorter, lighter and less painful. Your doctor can also treat endometriosis during your diagnostic laparoscopy by either removing (excising) the endometriosis or burning (ablating).

There are also things you can do at home to help you cope better with endometriosis ovulation pain. For example, you might try:

  • Using a microwaveable heating pad, hot water bottle or self-heating patches purchased from a drugstore
  • Taking warm baths with soothing Epsom salts or essential oils to help you relax
  • Trying a TENS machine, which uses electrical impulses to block the nerves from sending pain signals to your brain

Taking over-the-counter pain medication such as Advil, Aleve or Tylenol for endometriosis ovulation.

check icon Medically Reviewed by Dr Roohi Jeelani, MD, FACOG and Lauren Grimm, MA

Dr Roohi Jeelani is Director of Research and Education at Vios Fertility Institute in Chicago, Illinois. Dr Jeelani earned her medical degree from Ross University School of Medicine in Portsmouth, Dominica. She then completed a residency in Obstetrics and Gynecology and a fellowship in Reproductive Endocrinology and Infertility at Wayne State University, Detroit Medical Center, where she was awarded a Women’s Reproductive Health NIH K12 Research Grant. She is board certified in Obstetrics and Gynecology. Dr Jeelani has authored numerous articles and abstracts in peer-reviewed journals, and presented her research at national and international scientific meetings. A Fellow of the American College of Obstetrics and Gynecology, Dr Jeelani is a member of the American Medical Association, the American Society of Reproductive Medicine, and the American Association of Gynecologic Laparoscopists.

Lauren Grimm is Research Coordinator at Vios Fertility Institute in Chicago, Illinois. Lauren earned her bachelor’s degree from Loyola University Chicago, where she also completed her masters in Medical Sciences. Lauren has worked alongside Dr. Jeelani for the last 3 years, authoring a number of abstracts and articles in peer-reviewed journals, and presented her research at national and international scientific conferences. Lauren will be continuing her education this fall at Rush University Medical College in Chicago, IL as an MD candidate.

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