Physical examination was unremarkable: there was no palpable adenopathy; breath sounds were clear to auscultation bilaterally in all lung fields; there were no appreciable murmurs, rubs, or gallops; there was no organomegaly or tenderness on abdominal examination; there were no appreciable rashes on examination of the skin; and there were no sensory ...
1 Each follicle contains an immature egg (ovum) but only one follicle usually survives to maturity. It is supposed that ovulation pain is caused by the expanding follicle stretching the membrane of the ovary.  Ruptured follicle - when the egg is mature, it bursts from the follicle. This may cause slight bleeding.
Many women never experience painful ovulation. Some women, however, have mid-cycle pain every month and can determine by the pain that they are ovulating. As an egg develops in the ovary, it is surrounded by follicular fluid. During ovulation, the egg and the fluid, as well as some blood, are released from the ovary. While the exact cause of mittelschmerz is unknown, it is believed that the fluid or blood may irritate the lining of the abdominal cavity, causing pain.