Mittelschmerzmiddle pain

Done by: Mohammed Qazzaz

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.

Definition

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, oral contraceptive stop ovulation and prevent midcycle pain.

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:

On one side of your lower abdomenDull and cramp-likeSharp and suddenAccompanied by mild vaginal bleeding or dischargeRarely, severe

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, but women 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.

For the patient:

When to see a doctor

In the vast majority of cases, mittelschmerz requires no medical intervention. However, contact your doctor if a new pelvic pain becomes severe, if it's accompanied by nausea or fever, or if it persists — any of which could indicate you have a condition more serious than mittelschmerz, such as appendicitis, pelvic inflammatory disease or even an ectopic pregnancy.

During your menstrual cycle, the female sex hormone estrogen causes the uterine lining to thicken every month to create a nourishing environment for a fertilized egg. Soon afterward, a follicle — a tiny sac in the ovary that contains a single egg — ruptures and releases its egg (ovulation).

How this happen

If the egg becomes fertilized on its way to uterus by contact with a sperm, the egg implants in the lining of the uterus. However, most often the unfertilized egg passes through uterus and out of your body. Shortly thereafter, your uterus releases this lining and the 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:

•Just before an egg is released with ovulation, follicle growth stretches the surface of your ovary, causing pain.

•Blood or fluid released from the ruptured follicle irritates the lining of your abdomen (peritoneum), leading to pain.

Pain at any other point in menstrual cycle isn't mittelschmerz. It may be normal menstrual cramping (dysmenorrhea) if it occurs during the 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.

UPPER ABDOMINAL PAIN SYNDROMES

Biliary diseaseAcute pancreatitisDyspepsiaHiatus herniaPneumoniaMyocardial infarctionSplenic abscess or infarction

What could be the others causes?

LOWER ABDOMINAL PAIN SYNDROMES

AppendicitisDiverticular diseaseKidney stonesBladder distensionPelvic pain

DIFFUSE ABDOMINAL PAIN SYNDROMES

Mesenteric ischemia and infarctionRuptured aneurysmPeritonitisIntestinal obstruction

ABDOMINAL PAIN IN FEMALES

- Pelvic inflammatory disease- Adnexal pathology- Endometriosis- Ectopic pregnancy- Endometritis- Leiomyomas

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:Soaking in a hot bathUsing a heating pad on the side of your abdomen where the pain occurs

Reference: mayo clinic web site