Luteal phase intense cramping pain

Hi, I know this thread is a couple of years old but just wanted to say I’ve searched the internet so long to find out any information that could explain the intense symptoms I get every month. So I’m so grateful to hear your experiences. My pains/cramps start pretty much 2 days after ovulation and radiate around my pelvis and lower back. They wake me up several times in the night and are worse when I’m hungry. I also get a lot of stomach gas and suffer from migraines just after ovulation and just before my period. I’ve noticed my cramps change around 8 days after ovulation - they become duller and more like period pains. Nonetheless, I’m in pain for pretty much two weeks out of every month and it’s depressing.
I have also been trying to conceive, without luck for a long time now. I wonder if my symptoms are preventing me from having a successful pregnancy. Has anyone else managed to conceive with such pains? And, if so, did you have the same pains in your successful cycle?

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?

I have an update:
About half a year after I wrote the above, -I got an MRI scan which showed that I actually have endometriosis, they just couldn’t see it on ultrasound scans…

Hello all,

I’m grateful for this thread as it helps to not feel alone with these symptoms. I’m so sorry for everyone who is experiencing ongoing pain with no answers.

A small update from me, which might help someone… I was referred to a vascular surgeon and investigated for pelvic congestion syndrome, which simply put is varicose veins in the abdomen. It was found to have large, ballooned veins which have now been treated. I was told this is common (especially in women who have experienced pregnancy) and a significant contributor to pelvic pain. I encourage everyone to investigate this path.
Unfortunately my pelvic congestion syndrome isn’t the main contributing cause to my pain, but it’s still hopefully to eliminate an issue and continue the search.

I know this post and your reply is a couple of years old, but I had to respond when I read your story and the others. In fact, I burst into tears.
I have been experiencing almost identical symptoms for nearly 7 years now. Every month directly after ovulation, I experience these uterine contractions (that’s what I call them, as they’re worse than just “cramps” and I can feel a bearing down. They are triggered predominantly by lying down and similarly to you, they wake me up hourly, almost like clockwork, at night for approx 7 nights. They’re also triggered by sometimes standing up after having sat down for an extended period, and orgasms.
Doctors dismissed me over and over and finally I pushed for a laparoscopy, they found “minor endo” and ablated it, and absolutely nothing changed. I am told the only course of action would be hormonal birth control (which I stopped taking a couple of years ago for various reasons and do not wish to repeat the experience)- obviously that is not treating the cause, only covering up the symptoms.
Whatever this is, it has devastated my life.

I cannot express how shocked I am to find this thread after years of googling. Would love an update if you have one and are up to sharing. Otherwise, I wish you and everyone on this thread well.
We need more research, more support, and more doctors listening.

I have almost exactly the same as everyone else...

For me, it's exactly 7 days before my period starts, start getting intense, knife-stabbing-like pain in my lower right abdomen. It radiates into my back, it wakes me from a dead sleep, I feel like I'm going to throw up, it becomes the only thing I can think about. The older I get the worse it gets. Pain killers don't help. When the main flare (15 - 45 minutes) passes, there's a dull, bruised-feeling echo that can be helped with heat. It lasts for 4 - 6 days, it's every several hours, and I turn into a zombie from sleep deprivation over those days. On a really bad day recently, it was every 1 - 2 hours all day and night. My notes from that day read "Late in the day, bad pain. Overnight, sometimes just an hour between bad flares. Bad echoes. No relief."

Like many of you it took me a little while to put the pieces together. A tracking app helped a lot because I used to feel the pain at work or something and I would go in and mark my period as started (I would sometimes get small twinges to start the day and put in a menstrual cup in preparation so the lack of bleeding wasn't strange until I'd get home and clean the cup), and then later be confused when it hadn't. Through this, eventually I saw the 7 day out pattern. After that, a while longer before I put it together with digestive issues. I finally realized that the pain would resolve fairly quickly after a bowel movement, but as to why there was pain the first place, still a complete mystery.

I began to suspect endometriosis and finally some desperate googling got me to the website of Pacific Endometriosis. I can't link it because I just joined to add onto this thread, but if you google "Pacific Endometriosis bowel disease" you will find a very helpful article about this. I almost started crying reading a medical professional describe what I was going through. The way many of you have described your pain I suspect it's something similar.

I still haven't been able to find any way to treat it, unfortunately, though I do have a doctor who is willing to do a surgical procedure to look for and remove growth on my bowel if it's there. But having an idea of what is causing the pain helped me a lot.

@kellystreet hi! I wasn’t sure if this reply was targeted at my comment, but if so your experience sounds really similar to my own. In particular that taking birth control (which I assume contained progesterone) actually triggered your symptoms. This is exactly what happened to me. Plus the digestive issues can be related to progesterone which can cause constipation, bloating, etc.

As for a solution, I have been going a bit off script with the oversight of a doctor. In particular a reproductive endocrinologist said this treatment plan, while unorthodox, sounded very safe and viable. His other option was to put me into early menopause which I didn’t want to try. Ok so for the treatment I learned that mifepristone (which is highly regulated in the US for political reasons and almost impossible to get prescribed for this purpose although it is very safe according to many clinical trials) is a progesterone antagonist. It is also in trials as a birth control in Europe. I have been taking mifepristone at around 50 mg every week (been trialing different dose regimens) and haven’t had cramps in almost three months! I am getting my bloodwork done every 3 months to check for any liver toxicity (highly unlikely given how low this dose is) and uterine ultrasounds every 6 months (to ensure the reduction in progesterone isn’t causing unopposed estrogen which can lead to endometrial hyperplasia and possibly then cancer).

Interestingly this medication is also prescribed for people with cushings disease at much higher doses but ultimately is very expensive and normally prescribed through a specialty pharmacy. So while I did find a solution it’s not an easy one only because the meds are hard to get but not because the treatment is actually difficult or invasive in any way. I hope this helps in some way!

@lacycat hi has mifepristone helped get rid of all your symptoms? I have the EXACT same symptoms as you as per your post back in August 2024. I have seen a gyno and a gastro specialist, i have had a DIE scan and additional scans and an endoscopy and colonoscopy and noone seems to understand my pain or symptoms it is very frustrating. I am think of now seeing an endocrinologist based on your post. Thank you for sharing. I am really struggling to deal with this pain every single month.