Even if you haven’t heard of mittelschmerz, you may have experienced it. Derived from the German words for “middle “and “pain,” it refers to the pain many women experience during ovulation, which falls about mid-cycle. Here’s what you should know about ovulation pain.

What Causes Ovulation Pain?

Many women never experience pain or discomfort during ovulation, while some experience it occasionally and others monthly. As an egg ripens in the ovary, the follicular fluid around it increases before the egg, fluid and some blood are released. What makes this painful for some women is unclear, but it is thought that the fluid or blood may cause irritation in the abdominal cavity.

What Are the Symptoms of Mittelschmerz?

For most women, ovulation occurs about two weeks before menstruation begins. At that time, some women experience:

- Localized pain on one side of the abdomen, based on which ovary is releasing an egg that month

- An ache that can vary in intensity from a slight twinge or two over the course of a few minutes to more severe pain that can last several hours

- Nausea if the pain is severe

- A small amount of discharge or blood

How Is It Diagnosed?

If you experience pain or discomfort localized to one side of your abdomen about two weeks prior to your period, it’s likely due to ovulation. However, if the pain is severe, you experience a heavy discharge or significant bleeding mid-cycle, the pain lasts longer than a day or you are concerned for any reason, talk to your women’s health provider who may want to perform an abdominal and pelvic exam or order tests to rule out other causes, such as endometriosis or an ovarian cyst.

What Can I Do for Ovulation Pain?

Since pain during ovulation tends to be short-lived, over-the-counter pain medications, such as ibuprofen (Motrin) or acetaminophen (Tylenol), usually provide relief. Many women also find a heating pad or a warm bath soothing. The only way to prevent the pain is to take a combined estrogen and progesterone birth control pill, which prevents ovulation.

Pain during ovulation is generally nothing to worry about, but you know your body best. If you are concerned about any pain or symptoms, give us a call and we will work with you to find the cause and solution.

‍