Ovulazione dolorosa
L’ovulazione è la fase del ciclo mestruale nella quale avviene il rilascio dell’ovocita da parte dell’ovaio. Normalmente noi donne non proviamo dolore in questa fase, come avviene invece per le mestruazioni. Nella maggior parte dei casi, gli unici sintomi evidenti sono perdite trasparenti filamentose, aumento della temperatura basale e della libido. A volte, però, si può avere un’ovulazione dolorosa, caratterizzata da dolori al basso ventre e detta in gergo medico “mittelschmerz“, ovvero “dolore di metà ciclo“. In un ciclo mestruale di 28 giorni, infatti, l’ovulazione avviene intorno al 14° giorno, ovvero a metà periodo, dopo circa due settimane dall’inizio delle mestruazioni. L’ovulazione dolorosa colpisce circa il 20% delle donne in età fertile e può essere episodica oppure abituale. Il dolore è dovuto all’aumento di volume del follicolo maturo e raggiunge il culmine nel giorno dell’ovulazione, quando esso si rompe per rilasciare la cellula uovo.
Ovulazione dolorosa sintomi
Di solito l’ovulazione dolorosa è innocua e sopportabile, a differenza di quanto accade durante le mestruazioni in chi soffre di dismenorrea. Si può avvertire una sensazione di tensione all’addome, di solito unilaterale, un dolore al basso ventre sinistro o destro, a seconda dell’ovaio nel quale è maturato il follicolo. In alcuni casi, però, il dolore può essere di forte intensità ed essere quindi sintomo di patologie, come l’endometriosi o la malattia infiammatoria pelvica. In questo caso, è bene rivolgersi al ginecologo, per una corretta diagnosi e cura. Il dolore legato all’ovulazione può comparire improvvisamente e durare solo poche ore, oppure può durare più giorni, fino alla rottura del follicolo. In rari casi, i dolori si possono prolungare fino all’arrivo delle successive mestruazioni. L’ovulazione dolorosa non si manifesta alla stessa maniera in tutte le donne, alcune possono avvertire fitte e crampi più o meno forti, altre solo un senso di pesantezza e tensione. A volte al dolore si accompagnano anche perdite vaginali e spotting, ovvero piccole perdite ematiche al di fuori delle mestruazioni. Infine, alcune donne lamentano nausea, acne, gonfiore vulvare e dei linfonodi.
Ovulazione dolorosa cause
Le cause dell’ovulazione dolorosa non sono certe e cambiano da donna a donna. Le più probabili, però, sono:
- rigonfiamento del follicolo maturo all’interno dell’ovaio, che avviene nella fase follicolare che precede l’ovulazione. Ciò provoca un conseguente rigonfiamento dell’ovaio stesso, che causa dolore;
- rottura della parete ovarica: durante l’ovulazione, il follicolo rilascia l’ovocita rompendo la parete dell’ovaio. Ciò può essere doloroso in alcune donne;
- irritazione addominale, dovuta al liquido follicolare che viene rilasciato nelle ovaie al momento della fuoriuscita dell’ovocita durante l’ovulazione. Il fluido può irritare il peritoneo, ovvero il rivestimento della cavità addominale
- contrazione delle cellule muscolari lisce presenti nell’ovaia e nei suoi legamenti, dovute ad un aumento del livello di prostaglandina F2-alfa e dell’ormone luteinizzante (LH).
- contrazione delle tube di Falloppio: dopo l’ovulazione, le tube di Falloppio nelle quali viene rilasciato l’ovocita possono contrarsi.
In caso di dolori al basso ventre molto forti durante l’ovulazione o al di fuori di essa, le cause possono essere patologie più o meno gravi, come:
- malattia infiammatoria pelvica, un’infezione agli organi sessuali causata da agenti patogeni sessualmente trasmessi, come gonorrea e clamidia, o da batteri normalmente presenti in vagina;
- salpingite, un’infiammazione delle tube di Falloppio in seguito ad un’infezione;
- endometriosi, patologia in cui si ha uno sviluppo anomalo dell’endometrio, il tessuto che riveste l’utero;
- cisti ovarica, un’anomala raccolta di liquido raccolta da una sottile parete all’interno dell’ovaio;
- appendicite, l’infiammazione dell’appendice;
- gravidanza ectopica, ovvero una gravidanza sviluppatasi al di fuori dell’utero, di solito nelle tube di Falloppio;
- diversi problemi gastrointestinali.
Ovulazione dolorosa diagnosi
Nel caso il dolore al basso ventre si manifesti durante i giorni dell’ovulazione, non c’è bisogno di rivolgersi ad un medico per avere una diagnosi. In caso di forti dolori, può essere utile una visita ginecologica, per verificare che si tratti davvero di ovulazione dolorosa. Il medico procederà con un esame pelvico, fisico e mediante ecografia, per verificare che ci sia ovulazione.
Ovulazione dolorosa rimedi
Di solito, i dolori legati all’ovulazione sono sopportabili, a differenza della dismenorrea. Tuttavia, in caso non li si tolleri, è possibile ricorrere ad antidolorifici come l’ibuprofene o il naprossene. Qualora l’ovulazione dolorosa si ripresenti ad ogni ciclo, il ginecologo può scegliere di prescrivere la pillola anticoncezionale o altri contraccettivi ormonali, che bloccano l’ovulazione. Validi rimedi naturali, infine, sono un bagno caldo, una borsa dell’acqua calda da posizionare sull’addome e tisane rilassanti.
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