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Alternative Names Return to topOvulation pain; Midcycle pain
Definition Return to top
Mittelschmerz is one-sided, lower abdominal pain that occurs in women at or around the time of an egg is released from the ovaries (ovulation).
Causes Return to top
About 20% of women experience mittelschmerz, or pain associated with ovulation. The pain may occur just before, during, or after ovulation.
There are several explanations for the cause of this pain. Just prior to ovulation, follicle growth may stretch the surface of the ovary, causing pain. At the time of ovulation, fluid or blood is released from the ruptured egg follicle and may cause irritation of the abdominal lining. Mittelschmerz may be felt on one side one month, then switch to the opposite side the next month, or it may be felt on the same side for several months in succession.
The pain is not harmful and does not signify the presence of disease. In fact, women who feel this pain may be at an advantage when planning or trying to avoid pregnancy. A woman is most likely to become pregnant just before ovulation, on the day of ovulation, or immediately after ovulation. However, birth control methods that rely solely on predicting ovulation are far from completely reliable.
Symptoms Return to top
Lower-abdominal pain that is:
Exams and Tests Return to top
A pelvic examination shows no abnormalities. Other diagnostic procedures (such as an abdominal ultrasound) may be performed to rule out other causes of ovarian pain if ovulatory pain is prolonged.
Treatment Return to top
No treatment is usually necessary. Pain relievers (analgesics) may be needed in cases of prolonged or intense pain.
Outlook (Prognosis) Return to top
The outcome is expected to be excellent.
Possible Complications Return to top
There are usually no complications.
When to Contact a Medical Professional Return to top
Call for an appointment with your health care provider if ovulation pain seems to change, lasts longer than usual, or occurs with vaginal bleeding.
Prevention Return to top
Hormonal forms of contraception can be taken to prevent ovulation -- and therefore ovulatory pain -- but otherwise there is no known prevention.
References Return to top
Rebar RW, Erickson GF. Menstrual cycle and fertility. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 256.
Williams R, Elam G. Gynecology. In: Rakel RE, ed. Textbook of Family Medicine. 7th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 36.Update Date: 4/12/2009 Updated by: Linda Vorvick, MD, Family Physician, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.