Definition

What is mittelschmerz?

Mittelschmerz is one-sided, lower abdominal pain associated with ovulation. German for “middle pain,” mittelschmerz occurs midway through a menstrual cycle — about 14 days before your next menstrual period.

How common is mittelschmerz?

One in five women have pain around the time of ovulation. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of mittelschmerz?

Mittelschmerz pain usually lasts a few minutes to a few hours, but it may continue for as long as a day or two. Pain from mittelschmerz may be:

  • On one side of your lower abdomen
  • Dull and cramp-like
  • Sharp and sudden
  • Accompanied by mild vaginal bleeding or discharge
  • Rarely, severe

Mittelschmerz pain occurs on the side of the ovary that’s releasing an egg (ovulating). The pain may switch sides every other month, or you may feel pain on the same side for several months.

Keep track of your menstrual cycle for several months and note when you feel lower abdominal pain. If it occurs midcycle and goes away without treatment, it’s most likely mittelschmerz.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

Mittelschmerz rarely requires medical intervention. However, contact your doctor if a new pelvic pain becomes severe, if it’s accompanied by nausea or fever, or if it persists — any of which could indicate you have a condition more serious than mittelschmerz, such as appendicitis, pelvic inflammatory disease or even an ectopic pregnancy.

Causes

What causes mittelschmerz?

Mittelschmerz occurs during ovulation, when the follicle ruptures and releases its egg. Some woman have mittelschmerz every month; others have it only occasionally.

The exact cause of mittelschmerz is unknown, but possible reasons for the pain include these:

  • Just before an egg is released with ovulation, follicle growth stretches the surface of your ovary, causing pain.
  • Blood or fluid released from the ruptured follicle irritates the lining of your abdomen (peritoneum), leading to pain.

Pain at any other point in your menstrual cycle isn’t mittelschmerz. It may be normal menstrual cramping (dysmenorrhea) if it occurs during your period, or it may be from other abdominal or pelvic problems. If you have severe pain, see your doctor.

Risk factors

What increases my risk for mittelschmerz?

Please discuss with your doctor for further information.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is mittelschmerz diagnosed?

Ovulation usually occurs about two weeks after the first day of each menstrual cycle, so the timing of the pain makes mittelschmerz easy to recognize. To help determine if your pain is related to ovulation, your doctor might ask you to keep a record of your menstrual cycles, noting whenever you have pain, as well as where the pain is located.

Your doctor also might perform an abdominal and pelvic examination to help rule out other possible causes of pain, such as endometriosis or a cyst on your ovary. If your pain is severe or if the doctor notices any irregularities on the exam, he or she might order further testing to help determine the cause of your pain.

How is mittelschmerz treated?

Possible treatments for mittelschmerz include:

  • Pain relievers. For the relief of discomfort from mittelschmerz, try an over-the-counter drug such as acetaminophen (Tylenol, others), aspirin, ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve).
  • Birth control pills (oral contraceptives). If mittelschmerz causes you a lot of discomfort or occurs monthly, ask your doctor about taking birth control pills. They prevent ovulation, so you shouldn’t have ovulation pain while on them.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage mittelschmerz?

The following lifestyles and home remedies might help you cope with mittelschmerz:

  • Soak in a hot bath
  • Use a heating pad where the pain is

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: November 22, 2017 | Last Modified: November 22, 2017

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