Is Ovulation Pain a Reliable Sign of Fertility?

About 1 in 5 women experience ovulation pain and it is not always a way to assume it's associated with exactly when ovulation occurs. Ovulation pain can happen at many points throughout ovulation and can be a sign that environmental factors like heavy metals, phthalates or underlying health conditions are influencing your fertility. Heavy metal testing and toxicity is a very complex issue. This can often increase the length of your preconception preparation by many months. Which is why it is good to get tested.

Sometimes, ovulation pain is referred to as mittelschmerz, a German word that means “middle pain.”

What does ovulation pain feel like?

Women feel ovulation pain (mittelschmerz)  differently and it can:

  • Occur on one side of the abdomen
  • Alternate sides from cycle to cycle
  • Be a dull ache that persists for a few minutes to a few hours
  • Be sudden, sharp, and last for only a moment
  • Be mild, or severe and be mistaken for appendicitis

What causes ovulation pain?

There are several hypotheses for what actually causes ovulation pain/mittelschmerz

  • Swelling of ovarian follicles prior to ovulation: early in your cycle, multiple follicles begin maturing, with one of them eventually becoming dominant. Because follicles mature on both sides of the ovaries before dominant follicle selection, this may explain why ovulation pain is occasionally experienced on both sides of the abdomen.
  • Ovarian wall rupture: at the time of ovulation, the egg breaks through the walls of the ovaries. This may cause pain for some women.
  • Fallopian tube activity: After ovulation, the fallopian tubes contract to help the egg travel toward the uterus. This contraction may cause cramping.
  • Muscle contractions: At the time of ovulation, smooth muscles in the ovaries and its surrounding ligaments go through contractions in response to increased levels of prostaglandins

Is mittelschmerz a reliable way to detect your fertile window on its own?

Not really. Even if the mittelschmerz pain is associated with ovulation, the evidence is mixed that ovulation pain happens at the precise moment of ovulation. The pain might happen before, during, or after ovulation, and there is no easy way to know how the pain you experience correlates to ovulation.

But even if you knew for sure that your mittelschmerz pain happened at the precise moment that the egg bursts out of the follicle, it wouldn’t be very helpful in knowing when to have sex to get pregnant. That’s because the best time to have sex is in the days leading up to ovulation, not the day of ovulation itself.  Once the egg is released, it has a short lifespan of 12 – 24 hours maximum. Chances of pregnancy are much higher when sperm is already waiting in the fallopian tubes at the time of ovulation.

That doesn’t mean you should ignore ovulation pain if you happen to experience it. But it should be considered one among many fertility signs. The most accurate predictions are made when looking at the overall picture given by multiple different fertility signs such as temperature and cervical mucus. 

What Causes Problems With Ovulation and Pain

If you are having trouble conceiving and do not have regular periods each month, you may experience problems with ovulation. Ovulation problems are one of the most common causes of infertility and are influenced by over 120 modifiable factors.

What's important to know is environmental toxins like phthalates, cause problems with ovulation. Phthalates are endocrine disruptors, which means they bind to hormonal receptors and interfere with the function of reproductive hormones like estrogen and testosterone.

Higher levels of phthalates have been associated with the disruption in menstruation, ovulation pain and dysfunction, as well as increased risk of endometriosis. Studies have shown that higher levels of phthalates in both men and women trying to conceive are associated with longer times to conception and eventual diagnosis of unexplained infertility (inability to conceive for one year). Studies have shown that phthalate exposure has been associated with poor egg quality and poor sperm quality.

How can I confirm I have environmental toxins?

One of the most reliable ways to determine whether environmental toxins may be causing your symptoms is to keep a diary of symptoms. Common symptoms of toxicity include ovulation pain, irregular ovulation, Premature Ovarian Failure, failed IVF cycles, poor egg or sperm quality, recurrent miscarriage and many more.

In addition, several tests are available to help confirm an environmental toxin diagnosis.  At BUMP we offer a full range of environmental lab testing so you can access the most up to date testing resources.

If a couple has been trying to conceive for more than one year without success despite there being no other reason for infertility and/or has had multiple miscarriages, my recommendation is for testing and if we do find heavy metals, I will recommend chelation therapy as a part of natural fertility treatment.

There are a few different ways of testing for heavy metals, and although you can buy inexpensive urine test kits online, these are only semi-accurate and can distort the result.

Other detective work may include:

  • Stool analysis – Which will confirm whether the gut is functioning optimally
  • Liver function testing - to determine ALT and the ability to remove heavy metals
  • Genetic testing – To help establish whether genetic defects (MTHFR) may be contributing

How can Narelle help?

Navigating unexplained infertility alone can be both isolating and confusing, particularly when undertaking IVF. Working with a Naturopath can provide you with the necessary support to pinpoint the issue and work on correcting it.

For more information on managing environmental toxins or if you think you are experiencing symptoms of unexplained infertility, decide to take action to work with us so we can tailor a treatment plan to your own unique needs and ensure the most successful outcome.

To book a FREE 10-minute fertility chat click here

** research references available on request.


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