Mittelschmerz is one-sided, lower abdominal pain associated with ovulation. "Mittelschmerz" is a German word that means "middle pain." The condition occurs midway through a menstrual cycle — about 14 days before your next menstrual period.
In most cases, mittelschmerz doesn't require medical attention. For minor mittelschmerz discomfort, over-the-counter pain relievers and home remedies are often effective. If your mittelschmerz pain is troublesome, your doctor may prescribe an oral contraceptive to stop ovulation and prevent midcycle pain.
Female reproductive system
The ovaries, fallopian tubes, uterus, cervix and vagina (vaginal canal) make up the female reproductive system. ...
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:
Mittelschmerz pain occurs on the side of the ovary that's ovulating — releasing an egg — in that menstrual cycle. The pain may switch sides every other month, or you may feel pain on the same side for several months in a row.
Keep track of your menstrual cycle for several months and note when you experience lower abdominal pain. If it occurs midcycle and goes away without treatment, it's most likely mittelschmerz.
When to see a doctor
During your menstrual cycle, the female sex hormone estrogen causes your uterine lining to thicken every month to create a nourishing environment for a fertilized egg. Soon afterward, a follicle — a tiny sac in your ovary that contains a single egg — ruptures and releases its egg (ovulation).
If the egg becomes fertilized on its way to your uterus by contact with a sperm, the egg implants in the lining of the uterus. However, most often the unfertilized egg passes through your uterus and out of your body. Shortly thereafter, your uterus releases this lining and your menstrual flow begins.
Mittelschmerz occurs during ovulation, when the follicle ruptures and releases its egg. It's estimated that 1 in 5 women experience ovulation discomfort. Some have mittelschmerz every month, while others have it only occasionally.
The exact cause of mittelschmerz is unknown, but possible reasons for the pain include these:
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 your pain is severe during the time of ovulation or at any other time during your cycle, see your doctor.
Preparing for your appointment
In most cases, you won't need to see a doctor for mittelschmerz. However, if your pain is especially troublesome, you may make an appointment to confirm a diagnosis of mittelschmerz or to explore treatment options.
What you can do
Your time with your doctor is limited, so preparing a list of questions ahead of time will help you make the most of your time together. List your questions from most important to least important, in case time runs out. For mittelschmerz, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment.
What to expect from your doctor
Treatments and drugs
If you need relief from the discomfort of mittelschmerz, try an over-the-counter pain reliever, such as acetaminophen (Tylenol, others), aspirin, ibuprofen (Advil, Motrin, others) or naproxen (Aleve).
If you experience mittelschmerz nearly every month and it causes you quite a bit of discomfort, talk to your doctor about the option of taking a birth control pill (oral contraceptive). Birth control pills prevent ovulation, which prevents mittelschmerz because the condition can only occur if an ovary releases an egg.
Lifestyle and home remedies
If the discomfort from mittelschmerz lasts more than a few minutes, try some home remedies to gain relief. Because heat increases blood flow, relaxes tense muscles and eases cramping, you might want to try:
Last Updated: 2011-06-11
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