What Does Mittelschmerz Feel Like?

Do you experience pain or cramps between periods? If you do, you may be experiencing mittelschmerz.

Mittelschmerz (German for "middle pain") is pelvic pain and cramping that occurs during ovulation in some women. It typically refers to the discomfort some women feel around the time that an egg is released from the ovary.

This article discusses everything you need to know about mittelschmerz, from how long it lasts to how to find relief.

What Causes Mittelscmerz?

Approximately 40% of women experience some sort of twinge, discomfort, or pain with ovulation.
Though experts don't know exactly what causes mittelschmerz, they have a few theories.

Ovulation normally occurs about two weeks after the first day of menstruation. During these two weeks, hormonal changes occur that stimulate your ovary to release an egg. Each of your eggs develops inside their own compartment known as a follicle.

The ovary swells and stretches as several follicles are being prepared to release their egg, which may cause some discomfort. Hormones cause smooth muscle contractions around the ovaries, fallopian tubes, and uterus, which may cause additional pain.

At the time of egg release or ovulation, this dominant follicle breaks open and releases an egg along with some fluid or blood. This is referred to as free fluid, and it can be an irritant to the lining of your abdomen and pelvis, which contains pain fibers.

Mittelschmerz Symptoms

Mittelschmerz symptoms can last from a few minutes to a few days. Symptoms include lower abdominal pain that:

• Occurs only on one side
• May switch sides from cycle to cycle
• Feels like a dull ache or sudden sharp pain
• Begins midway through the menstrual cycle

Other symptoms that sometimes occur with mittelschmerz include nausea, low back pain, and/or light bleeding or spotting.

What To Do About Mittelschmerz

Fortunately, you have several options to ease the pain and symptoms of mittelschmerz. Your options include:

• Apply Heat: Take a warm bath or use a heating pad to help relieve the discomfort.
• Use NSAIDs: Anti-inflammatory drugs such as ibuprofen or naproxen sodium may help relieve pain. Remember not to take these medications on an empty stomach.
• Apply Pressure: Gentle pressure or a massage of your abdomen may help relieve constipation and gassy distention.
• Try an Anti-Gas Tablet: You may find taking a medication containing simethicone will help gas pass through your intestines. This can help relieve some of the discomforts from your distended bowels.
• Take a Magnesium Supplement: Magnesium has many health benefits including being a gentle laxative that can be taken the week before ovulation.

Prevention

It is common to have an occasional cycle with significant ovulatory discomfort. However, if you have significant mittelschmerz every month, you may want to consider hormonal contraception.

The birth control pill, contraceptive patch, or contraceptive ring all work by suppressing your ovulation.

When to Call Your Healthcare Provider

Sometimes mid-cycle pain can be a sign of a more significant problem with your ovary or possibly a pelvic infection. Certain signs and symptoms indicate a need to call your practitioner for diagnosis and treatment. These symptoms include:

• If you have a fever because you may have an infection that is unrelated to mittelschmerz
• Severe or increasing pain that lasts longer than 24 hours
• Heavy bleeding during ovulation
• Bad smelling vaginal discharge
• Pain not relieved by the tips mentioned above

Seek emergency care if any of the following occur:

• Increasing pain
• Abdominal pain with pain in one or both shoulder blades
• Vomiting blood
• Bloody stools
• Feeling faint or dizzy
• A high fever
• Difficult or painful urination
• Problems breathing
• Swelling or bloating of the abdomen

As always, be sure to discuss any pain or other period problems you may have with your healthcare provider.