1 What is Mittelschmerz?

A lower abdominal pain associated with ovulation which is usually one-sided is called Mittelschmerz (“middle pain” in German) and occurs midway, about 14 days before your next menstrual period, through a menstrual cycle.

There is no need for medical attention but over the counter medicines can be taken to ease the pain in your abdomen.

Your doctor may prescribe an oral contraceptive to stop the ovulation and prevent the mid-cycle pain if your mittelschmerz is troublesome.

2 Symptoms

Pain is the main symptom of mittelschmerz.

Mostly a few minutes to a few hours will the pain lasts but it will continue for about 1 to 2 days.

The pain that you may feel can be:

  • on just one side of the lower abdomen where you can feel dull and cramp-like,
  • sharp and mild,
  • accompanied by vaginal bleeding or discharge,

Some severe mittelschmerz , the pain occurs at the side of the ovary that is releasing the egg (ovulating).

You may feel the pain on the same side for several months or may switch sides every month. In order for you to track down your menstrual cycle, write it down on a notebook, whenever you feel lower abdominal pain for several months.

It is mostly a mittelschmerz if it occurs mid-cycle and goes away without any treatment.

If a new pelvic pain becomes severe and is accompanied by fever or nausea or any condition that suggests it is more serious than mittelschmerz such as pelvic inflammatory, appendicitis or ectopic pregnancy, visit your doctor right away.

3 Causes

There is no known cause of mittelschmerz.

During ovulation when the follicle ruptures and releases its egg, mittelschmerz occurs. Some women have mittelschmerz occasionally but some have it every month.  

Some of the pains may include:

  • follicle growth stretches the surface of your ovary just before an egg is released with ovulation causing pain,
  • fluid or blood released from the ruptured follicle irritates the peritoneum which is the lining of your abdomen causing pain,
  • if it occurs during your period, chances are it is dysmenorrhea or other pelvic and abdominal problems.

The release of an egg from one of the ovaries is called transcript ovulation and occurs midway through your menstrual cycle but the exact timing may vary.

In ovulation the endometrium or the lining of the uterus thickens. The pituitary gland in the brain stimulates one of the ovaries to release an egg. The egg is then released and finger-like structures called fimbriae sweep the egg into the neighboring fallopian tube where the eggs travelled, propelled in part by contractions. The egg may be fertilized by a sperm in a fallopian tube, and it will unite to form a one-celled entity called a zygote. The zygote travels down the fallopian tube towards the uterus and divides rapidly forming a cluster of cells resembling a tiny raspberry. Pregnancy begins when the zygote reaches the uterus and it implants in the lining of the uterus, but if the egg is not fertilized it is just absorbed by the body before it reaches the uterus.Menstruation is formed when the lining in the uterus sheds through the vagina about two weeks later.

4 Making a Diagnosis

You might want to see your doctor if your pain is consistent or to confirm a diagnosis of Mittelschmerz.

Bring a notebook. Write down the detailed descriptions of your symptoms, the dates of the last two menstrual periods began, if you have or any members of your family have medical conditions. You can also write down the supplements, vitamins and medications that you are taking.

You can ask your doctor these kinds of questions:

  • What is the cause of my symptoms?
  • Are there possible causes for my symptoms?
  • Will they change over time? What tests do I need?
  • What treatments do I need?
  • Are there any home remedies?
  • What websites do you recommend?  

Your doctor will likely ask you some questions such as:

  • What symptoms are you experiencing?
  • How many days apart are your menstrual periods?
  • How long do they last?
  • How would you describe your symptoms?
  • Where exactly is your pain?
  • How long are you experiencing your symptoms? Is it constant?
  • On a scale of 1 to 10, hoe severe is it?
  • Do you have any other symptoms?

5 Treatment

The possible treatments for mittelschmerz are:

  • Pain relivers for the relief of pain such as aspirin, ibuprofen (Avdil, Mortin IB), acetaminophen (Tylenol) and naproxen sodium (Aleve),
  • Birth control pills or oral contraceptives that prevents ovulation.

6 Prevention

Preventing ovulation, which can be done with birth control pills, is the only way to effectively prevent mittelschmerz.

7 Alternative and Homeopathic Remedies

You can do some alternative remedies for mittelschmerz at home such as putting a heating pad in the area where the pain is or soaking in a hot bath.

8 Risks and Complications

There are no complications associated with mittelschmerz.