Mittelschmerz Pain Between Periods

Ovulation Pain at Midcycle

Woman laying on bed holding stomach in pain
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Have you ever experienced severe mid-cycle pain? Do pain and cramping seem to occur during ovulation? What you are experiencing may be mittelschmerz.

Mittelschmerz is a German word which translated literally means "middle pain." Other words you may hear include ovulation pain, mid-cycle pain, menstrual middle pain, or cramps.

Overview

Ovulation usually occurs about two weeks after the first day of your last period.

Mittelschmerz occurs during ovulation when an egg is released by the ovaries. For some women, this causes severe pain and cramps on one side of the lower abdomen. Although the pain may feel like something serious is wrong, Mittelschmerz is rarely serious.

Causes

The cause of the pain isn't exactly known. The egg grows within a follicle in the ovary, surrounded by follicular fluid. As with a cyst or any swelling, this stretches the surface of the ovary. It needs to rupture to be released. When this happens, the fluid and some blood is released, which may further irritate the lining of the abdomen.

About one in five women note that they have pain around the time that they ovulate. Why some women have it and others don't isn't known. While some have it every month, others have it only on occasion.

Signs and Symptoms

The typical pain is on one side of your lower abdomen. Beyond that, the symptoms are highly variable.

  • It can be a sudden, sharp pain or it may be a dull, cramp-like pain.
  • It can range in severity from a mild twinge to severe discomfort.
  • The pain can be momentary or continued. Mittelschmerz lasts for six to eight hours in most women; however, occasionally it can last as long as 24 to 48 hours.

Occasionally, in addition to mid-cycle pain and cramping, some women may experience nausea, and/or light menstrual spotting.

Diagnosis

You probably won't need to see your doctor for mild mittelschmerz pain. By noting that it has been about two weeks since the start of your last period, you can suspect that the pain is due to ovulation. You might keep a menstrual diary and note when you experience the pain.

Other possible causes of the pain could be endometriosis or an ovarian cyst. Signs that this is something more serious than ovulation pain and you should see a doctor or seek emergency care include:

Treatment

Typical self-care for mittelschmerz includes:

  • Rest.
  • Drink at least eight glasses of water a day.
  • Use a heating pad (try making a homemade tube sock heating pad), or take warm baths to ease the pain.
  • Use an over-the-counter remedy such as acetaminophen or naproxen sodium.
  • Check your temperature several times a day to be sure you are not developing an infection.
  • Call your doctor if the pain is severe and these self-help tips do not ease your mid-cycle pain.

If you experience mid-cycle ovulation pain that lasts longer than two to three days, experience heavy bleeding, or have any unusual vaginal discharge, call your healthcare provider.

If you commonly experience painful ovulation, you might discuss with your doctor whether birth control pills that prevent ovulation is a solution.

Sources:

Mittelschmerz. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/mittelschmerz/basics/definition/con-20025507.

Mittelschermz. MedlinePlus. http://www.nlm.nih.gov/medlineplus/ency/article/001503.htm.

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