Some women experience pain on one side of the lower abdomen midway through their menstrual cycles. This cyclic pelvic pain is known as mittelschmerz.
Mittelschmerz is one-sided, lower abdominal pain associated with ovulation. German for "middle pain," mittelschmerz occurs midway through a menstrual cycle — about 14 days before your next menstrual period.
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, your doctor may prescribe an oral contraceptive to 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:
Mittelschmerz pain occurs on the side of the ovary that's releasing an egg (ovulating). The pain may switch sides every other month, or you may feel pain on the same side for several months.
Keep track of your menstrual cycle for several months and note when you feel lower abdominal pain. If it occurs midcycle and goes away without treatment, it's most likely mittelschmerz.
Mittelschmerz rarely requires 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.
Mittelschmerz occurs during ovulation, when the follicle ruptures and releases its egg. Some women have mittelschmerz every month; others have it only occasionally.
The exact cause of mittelschmerz is unknown, but possible reasons for the pain include these:
Pain at any other point in your menstrual cycle isn't mittelschmerz. It may be normal menstrual cramping (dysmenorrhea) if it occurs during your period, or it may be from other abdominal or pelvic problems. If you have severe pain, see your doctor.
Mittelschmerz has no clear risk factors. But it may be more likely to happen between the ages of 15 and 25.
Mittelschmerz doesn't lead to other health conditions, also called complications. The pain goes away on its own, or with medicine or home remedies.
Mittelschmerz can't be prevented. It's linked with natural changes in the body that happen during the menstrual cycle.
To diagnose mittelschmerz, your doctor will start by asking you questions to get a clear idea of your medical history, especially regarding your menstrual periods. Your doctor may also perform a physical exam, including a pelvic exam, to check for signs of an underlying condition that could be contributing to the pain.
During a pelvic exam, a doctor inserts one or two gloved fingers inside the vagina. Pressing down on the abdomen at the same time, the doctor can check the uterus, ovaries and other organs.
Possible treatments for mittelschmerz include:
To ease mittelschmerz discomfort that lasts more than a few minutes, try some home remedies. Because heat increases blood flow, relaxes tense muscles and eases cramping, you might want to:
In most cases, you won't need to see a doctor for mittelschmerz. However, if your pain is especially troublesome, you may make an appointment to confirm a diagnosis of mittelschmerz or to explore treatment options.
You may want to write a list that includes:
Preparing a list of questions for your doctor will help you make the most of your time together. For mittelschmerz, some basic questions to ask include:
Don't hesitate to ask other questions, as well.
Your doctor is likely to ask you a number of questions, such as: