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    Mittelschmerz

    Ovulation pain; Midcycle pain

    Mittelschmerz is one-sided, lower abdominal pain in women. It occurs at or around the time of an egg is released from the ovaries (ovulation).

    Causes

    About 1 in 5 women have pain around the time of ovulation. This is called mittelschmerz. The pain may occur just before, during, or after ovulation.

    This pain can be explained in several ways. Just before to ovulation, the growth of the follicle where the egg develops may stretch the surface of the ovary. This can cause pain. At the time of ovulation, fluid or blood is released from the ruptured egg follicle. This may irritate lining of the abdomen.

    Symptoms

    Mittelschmerz may be felt on one side of the body in one month and then switch to the other side in the next month. It may also occur on the same side for many months in a row.

    Symptoms include lower-abdominal pain that:

    • Occurs only on one side
    • Goes on for minutes to a few hours. It can last up to 24-48 hours.
    • Feels like a sharp, cramping pain unlike other pain
    • Severe (rare)
    • May switch sides from month to month
    • Begins midway through the menstrual cycle

    Exams and Tests

    A pelvic exam shows no problems. Other tests (such as an abdominal ultrasound or transvaginal pelvic ultrasound) may be done to look for other causes of ovarian or pelvic pain. These tests may be done if the pain is ongoing.

    Treatment

    Most of the time treatment is not needed. Pain relievers may be needed if the pain is intense or lasts a long time.

    Outlook (Prognosis)

    Mittelschmerz can be painful, but it is not harmful. It is not a sign of disease. It may help women be aware of the time in the menstrual cycle when the egg is released.

    Possible Complications

    Most of the time there are no complications.

    When to Contact a Medical Professional

    Call your health care provider if:

    • Ovulation pain seems to change.
    • Pain lasts longer than usual.
    • Pain occurs with vaginal bleeding.

    Prevention

    Birth control pills can be taken to prevent ovulation. This can help reduce pain that is linked to ovulation.

    References

    Won HR, Abbott J. Optimal management of chronic cyclical pelvic pain: an evidence-based and pragmatic approach. Int J Womens Health. 2010; 2: 263–277.

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      Review Date: 4/25/2013

      Reviewed By: Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.

      The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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      St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
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