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Is Mittelschmerz A Sign Of Pregnancy?

Mittelschmerz refers to one-sided pain in the lower abdominal area of a woman associated with ovulation. The word is German for middle area pain, as the pain takes place midway during a menstrual cycle i.e. approximately 14 days before the commence of your upcoming menstrual cycle. In most of the cases, Mittelschmerz does not require any medical attention. In case you experience minor discomfort, your doctor may recommend you a few home remedies combined with over-the-counter type of pain relievers to manage your condition. In contrast, if you have troublesome ovulation pain, your doctor may recommend you an oral contraceptive to prevent your mid cycle pain and ovulation.

Is Mittelschmerz A Sign Of Pregnancy?

Is Mittelschmerz A Sign Of Pregnancy?

If you experience ovulation pain/cramping, also known as Mittelschmerz, you only feel a twinge or pinch only at a particular side of your lower abdominal area and it takes place before two weeks of your menstruation. Moreover, the pain lasts only from few minutes to up to few hours, while it involves a sharp pain. On the other side, if you experience pain or cramp due to pregnancy i.e. an implantation pain/cramping, you experience a dull pain. In addition, in case of implantation cramp, you often feel it in your lower abdominal area and your lower back area. In addition, implantation cramps last for 1 day to 3 days as compared to ovulation cramps. Thus, if your cramp continues for many days, while you do not experience any cramp one week before your menstruation, you may be conceiving.

Symptoms Of Mittelschmerz

You may feel Mittelschmerz on a particular side of your body in one month and later on, it switches to other side in the upcoming month. Even it may take place on same side of your abdomen for three to months consistently in one row. However, major symptoms, based on which you may identify your condition include-

  • Pain in your lower abdominal area only on a particular side
  • Lasts for a few minutes to up to many hours and in some cases, may last for 24 hours to 48 hours
  • You may feel a sharp and cramping type of pain
  • Commences during the midway via your menstrual cycle

Causes Of Mittelschmerz

Mittelschmerz takes place at the time of ovulation i.e. whenever follicles rupture and release eggs. A few women even experience the problem monthly, while others feel it occasionally. Until now, the exact cause of ovulation cramping pain is unknown among gynecologists. However, possible reasons associated with the pain include-

  • Once your body releases egg due to ovulation, growth of follicle stretches the ovary surface to cause pain.
  • Release of fluid or blood from ruptured form of follicle causes irritation in your abdominal lining i.e. peritoneum, which results in pain.


Even though implantation cramp does not take place prior to one week of your menstruation or you may experience mild cramp, it may be because of any other reason. Accordingly, we should that neither Mittelschmerz nor implantation pain assures that you are conceiving; however, both of them may indicate a sign of your pregnancy.


  1. American College of Obstetricians and Gynecologists. (2019). Mittelschmerz. Retrieved from https://www.acog.org/womens-health/faqs/mittelschmerz
  2. West, C. P., & Schlaff, W. D. (2018). Ectopic pregnancy: presentation, diagnosis, and management. Clinical obstetrics and gynecology, 61(2), 243-250.
  3. Stanford Children’s Health. (n.d.). Mittelschmerz (Painful Ovulation). Retrieved from https://www.stanfordchildrens.org/en/topic/default?id=mittelschmerz-painful-ovulation-90-P01938
  4. Dermish, A., Turok, D. K., & Lederle, L. (2013). Evidence-based management of suspected ectopic pregnancy. Emergency medicine practice, 15(10), 1-14.
  5. Bulletti, C., Flamigni, C., & Giacomucci, E. (2010). Reproductive failure due to spontaneous abortion and recurrent miscarriage. Human reproduction update, 9(3), 229-240.

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Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:August 1, 2023

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