Post-Birth Control: Ovarian Pain and Irregular Cycles

After stopping birth control pills, there is a persistent cramping sensation in the abdomen following ovulation?

Hello doctor, I started taking birth control pills in April 2018.
Before taking the pills, my menstrual cycle was quite regular, approximately 25 to 26 days.
I took the last pill of my last pack on January 19, 2020, and my period started on January 23, 2020.
On January 30 and 31, I had sexual intercourse with external ejaculation.
On February 1, I began to experience a sharp pain in the lower abdomen, slightly to the left, occurring about twice a day, sometimes on the right side.
I am wondering if this could be ovulation pain? This discomfort has continued until today, February 17, with intermittent sharp and stabbing sensations, about twice a day, sometimes more noticeable than others.
I am unsure what this could be.
Yesterday, February 16, I used a pregnancy test, which showed negative results.
I urinated a little over an hour before the test and had also consumed water; I am unsure if this could affect the accuracy.
Since I just stopped taking the birth control pills, will my next period be irregular?

JJU, 20~29 year old female. Ask Date: 2020/02/17

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, ovulation pain typically does not last this long.
If you are still experiencing discomfort, it is advisable to see a doctor.
After stopping birth control, menstrual cycles can sometimes become irregular, but this is not always the case; just monitor your symptoms.
Wishing you good health.

Reply Date: 2020/02/17

More Info

After discontinuing birth control pills, many women experience various changes in their menstrual cycles and may also encounter ovarian pain. This is a common occurrence, and understanding the underlying mechanisms can help alleviate concerns.

Firstly, when you stop taking birth control pills, your body begins to readjust to its natural hormonal cycle. Birth control pills work by suppressing ovulation and stabilizing hormone levels, which can lead to a more predictable menstrual cycle while on the pill. However, once you stop, your ovaries may take some time to resume their normal function, which can result in irregular cycles and symptoms like ovarian pain.

The pain you are experiencing, described as a sharp or pulling sensation in the lower abdomen, could indeed be related to ovulation. This phenomenon is often referred to as "mittelschmerz," which is German for "middle pain." It occurs when an ovary releases an egg, and it can happen around the midpoint of your menstrual cycle. The pain can vary in intensity and duration, and it is not uncommon for it to be felt on either side of the abdomen, depending on which ovary is releasing the egg.

Regarding your concern about the accuracy of the pregnancy test, it is generally recommended to take the test with the first morning urine, as it is more concentrated and can provide a more accurate result. However, testing a few days after a missed period is usually the best time to ensure accuracy. If you tested negative and are still experiencing symptoms, it may be worthwhile to wait a few days and test again or consult with a healthcare provider for further evaluation.

As for your menstrual cycle after stopping the pill, it is common for the first few cycles to be irregular. Some women may experience heavier or lighter periods, and the timing of ovulation may vary. It can take a few months for your body to establish a regular cycle again. If your cycles remain irregular after a few months or if you experience severe pain, it is advisable to consult a healthcare professional for further assessment.

In terms of treatment for the pain, over-the-counter pain relievers like ibuprofen or acetaminophen can be effective. If the pain persists or worsens, or if you experience additional symptoms such as heavy bleeding, fever, or severe discomfort, it is important to seek medical attention. A healthcare provider may perform a pelvic exam or imaging studies, such as an ultrasound, to rule out any underlying conditions such as ovarian cysts or endometriosis.

In summary, post-birth control, it is normal to experience some irregularities in your menstrual cycle and potential ovarian pain as your body readjusts. Monitoring your symptoms and maintaining open communication with your healthcare provider will help ensure that any concerns are addressed promptly. If you have any further questions or if your symptoms change, do not hesitate to reach out to a healthcare professional for guidance.

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