From the Guidelines
Ovulatory pain, also known as mittelschmerz, is a normal phenomenon that can be managed with over-the-counter pain medications and hormonal birth control methods if necessary. For relief, you can take over-the-counter pain medications like ibuprofen (Advil, Motrin) 200-400mg every 6-8 hours or naproxen (Aleve) 220mg every 8-12 hours as needed when pain begins 1. Applying a heating pad to the lower abdomen can also provide comfort. The pain usually lasts 24-48 hours and resolves on its own without treatment. Some key points to consider when managing ovulatory pain include:
- If you experience regular ovulatory pain, hormonal birth control methods like combined oral contraceptives can prevent ovulation and thus eliminate the pain.
- Consult your healthcare provider if the pain is severe, lasts longer than 3 days, or is accompanied by fever, vomiting, or unusual vaginal discharge, as these could indicate other conditions like endometriosis, ovarian cysts, or pelvic inflammatory disease 1. Ovulatory pain occurs because the growing follicle stretches the ovary's surface before rupturing to release the egg, and the released fluid can irritate the abdominal lining, causing the characteristic one-sided lower abdominal discomfort. It is essential to note that while the provided evidence discusses abnormal uterine bleeding associated with ovulatory dysfunction, the management of ovulatory pain itself is not directly addressed in the studies 1. However, the principles of managing related conditions can be applied to inform the approach to ovulatory pain. In clinical practice, the focus is on alleviating symptoms and preventing complications, which aligns with the use of pain medications and hormonal birth control methods for managing ovulatory pain.
From the Research
Ovulatory Pain
- Ovulatory pain, also known as mittelschmerz, is a common symptom experienced by some women during their menstrual cycle 2.
- The use of over-the-counter analgesic medications, such as ibuprofen and acetaminophen, has been found to be associated with decreased odds of sporadic anovulation in healthy, premenopausal women 2.
- A study published in 2015 found that analgesic use during the follicular phase was associated with higher luteal progesterone levels and a lower probability of sporadic anovulation 2.
Medications Used for Ovarian Stimulation
- Medications such as letrozole, clomiphene citrate, gonadotropins, and pulsatile gonadotropin-releasing hormone (GnRH) are used to stimulate ovarian function in patients with anovulatory infertility or as part of assisted reproductive treatments (ART) 3.
- These medications work by stimulating the ovaries to produce eggs, and their pharmacology is reviewed in detail in the literature 3.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) and Ovulatory Pain
- NSAIDs, such as mefenamic acid and naproxen, are commonly used to treat ovulatory pain and other types of pain 4.
- However, cross-reactivity between chemically unrelated NSAIDs has been rarely described in fixed drug eruption (FDE), a condition characterized by skin lesions 4.
- Clinicians should be aware of the potential for cross-reactivity between NSAIDs and take this into consideration when prescribing medications for ovulatory pain 4.