Mittelschmerz is referred to as pain in the pelvic and lower abdominal region that some women will experience during ovulation. It is derived from the German word which means middle pain (mittelschmerz) occurring in between menstrual cycles. This ovulation pain can either be mild or severe in intensity that can last for a few minutes to a few hours. It will mostly occur on one side of the abdomen or pelvis and on which side the pain occurs depends on the side from where the egg is released from the ovary during that cycle. In a few cases it might be associated with minor bleeding and discharge. Sometimes when the pain is severe it may be accompanied with nausea.
How Painful Is Mittelschmerz?
The intensity of pain experienced will vary from person to person. Some women will have symptoms of mild pressure and discomfort ranging from a few minutes to a few hours. While for others the pain can be severe lasting for many days that can sometimes be mistaken for appendicitis pain.
Causes And Symptoms Of Mittelschmerz
Mittelschmerz is caused by stretching of the membrane covering the ovary that will occur just before the follicular rupture and release of follicle from the ovary. This stretching of the follicle will result in painful pressure over the pelvic region. The fluid and blood that is released from the follicle might cause discomfort and pain. The blood irritating the lining of the abdominal cavity tissues could be a reason for Mittelschmerz.
The symptoms of Mittelschmerz include pain in the pelvic region or lower abdominal area occurring on either side, the pain experienced will be midway between the menstrual cycle i.e. during ovulation, will occur monthly and typically lasts for a few hours to a couple of days.
It is important to differentiate the pain of appendicitis and ectopic pregnancy from Mittelschmerz. Both these conditions are serious and mimic Mittelschmerz but might need emergency treatment. Therefore, it becomes important to confirm the diagnosis and get appropriate treatment. Appendicitis pain will occur on the lower right side midway between the umbilicus and the anterior superior iliac spine of the abdomen along with symptoms of fever and vomiting. In ectopic pregnancy the pain will occur on either side of the abdomen due to the development of pregnancy in the fallopian tube instead of normally developing in the uterus. It can be associated with irregular menses if there is a suspicion of her being pregnant. In either case it is advisable to get immediate attention and care if the ovulation pain exceeds three days. Since there is not test to diagnose Mittelschmerz and it can only be confirmed when other test results come out to be normal and pain is typically presenting during the menses.
Management Of Mittelschmerz Or Ovulation Pain
Mittelschmerz can be relieved by taking NSAIDs such as naproxen, ibuprofen and ketoprofen that are available over the counter. They block the affect of prostaglandins that might lead to pain and abdominal discomfort. They can be taken whenever the pain occurs and for as long as required. These medications can lead to acid reflux and should be taken with antacids. In addition to these pills use of warming pad can help relieve pelvic or abdominal pain. Taking hot bath and showers also relieves stress and pain in the abdomen.
If Mittelschmerz occurs every month and is severe in intensity then some form of birth control pills will be given that will prevent ovulation from taking place and hence no occurrence of pain. The outcome for the condition is good and other than mild discomfort it does not usually lead to major problems. In very rare cases Mittelschmerz can be severe and require medications to ease the pain and associated bleeding or discharge if present. In mild cases where the pain does not last for more than 24 hours rest and warm compresses can ease the Mittelschmerz pain and discomfort.
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