Luteal phase intense cramping pain

@freyaaya Welcome to Mayo Clinic Connect. While this thread has posts from a few years ago there are recent posts so hopefully you will get some informative and supportive responses to your post and queries.

I'm menopausal and so while I do recall lower back pain a few days before my period started and discomfort around ovulation I wonder now if the depressive episodes I experienced were around these times. No one much talked about this in the 1970's and 1980's. I do know a few women who are in their 30's and experience much the same as you especially with changes in their mood.

I wanted to ask if anyone here has experienced anything similar, or if you’ve ever found answers for something like this.

For about two years now, I’ve been having cyclic pain on my left side that always starts a few days after ovulation and disappears a day or two before my period begins. The pattern is very consistent - always left sided, always during luteal phase.

The pain seems to start deep in my left hip area (around the iliac/ASIS region) and radiates through my groin, vulvar area, the inner and front of my thigh, and all the way down to my knee and foot. It’s a mix of sharp, aching, and cramping pain. The pain flares consistently thought out the day, usually lasting 2–7 days each cycle. It improves briefly with Advil/Tylenol, then returns

I had a specialized endometriosis transvaginal ultrasound at SUGO (Hamilton) and it came back clear:

“No evidence of deep or ovarian endometriosis or endometriosis-associated adhesions. No bowel or ovarian endometriosis were identified.”

(For context: they didn’t ask me to do a bowel clean-out I hadn’t had a BM for ~24 hours before the scan. The ultrasound took around 20-25 mins.)

But given how strongly it’s tied to post ovulation and the luteal phase, and how localized it is to one side, I can’t help wondering if it could be deep or nerve-related endometriosis, or maybe something else that’s hormonally triggered in the luteal phase.
It’s so specific and cyclical that I feel like there has to be an explanation.

Has anyone else had similar one-sided, post-ovulation pain — especially with normal imaging results (Endo TVUS).
If so, did you ever find out what it was, or are you still trying to figure it out too?

I’m just frustrated and overwhelmed as I have no idea what else to do.
I’d really appreciate hearing about anyone’s experiences or thoughts — even if you’re still in the “trying to make sense of it” stage like I am. 💛

Thank you 🫶🏽

Hi @ashi1998! Two years is a long time to be dealing with this pain -- how frustrating (and exhausting!).
I merged your question into this existing conversation about intense luteal phase pain. You might find some great information here from others who are experiencing something similar.
Has your doctor offered next steps? If not, have you thought about getting a second opinion?

@klp Thank you! My GP told me to just make sure I’m taking fibres and having good bowel movements as my left ovary can be in close proximity to my bowel.. I am going to ask for a referral for an MRI with DIE protocol, pelvis/hip with attention to sciatic notch + lumbosacral plexus. Hopefully I get a tech and radiologist experienced in pelvic and/or Endo taking and interpreting the images!

@marthamartha may I ask if you had to put any special instructions on your MRI for them to see it on the images?

@ssarahbons did this procedure help long term? I’m supposed to have this done but don’t know if it’s the culprit of my pain after ovulation.