Mittelschmerz

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Mittelschmerz
Classification and external resources
ICD-10N94
ICD-9625.2
DiseasesDB8310
MedlinePlus001503
 
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Mittelschmerz
Classification and external resources
ICD-10N94
ICD-9625.2
DiseasesDB8310
MedlinePlus001503

Mittelschmerz (German: "middle pain") is a medical term for "ovulation pain" or "midcycle pain". About 20% of women experience mittelschmerz, some every cycle, some intermittently.

Symptoms and diagnosis[edit]

Mittelschmerz is characterized by lower abdominal and pelvic pain that occurs roughly midway through a woman's menstrual cycle. The pain can appear suddenly and usually subsides within hours, although it may sometimes last two or three days.[1] In some cases it can last up to the following cycle. In some women, the mittelschmerz is localized enough so that they can tell which of their two ovaries provided the egg in a given month.[citation needed] Because ovulation occurs on a random ovary each cycle, the pain may switch sides or stay on the same side from one cycle to another.

Diagnosis of mittelschmerz is generally made if a woman is mid-cycle and a pelvic examination shows no abnormalities. If the pain is prolonged and/or severe, other diagnostic procedures such as an abdominal ultrasound may be performed to rule out other causes of abdominal pain.

The pain of mittelschmerz is sometimes mistaken for appendicitis and is one of the differential diagnoses for appendicitis in women of child-bearing age.

Treatment[edit]

The pain is not harmful and does not signify the presence of disease. No treatment is usually necessary. Pain relievers (analgesics) may be needed in cases of prolonged or intense pain.[2]

Hormonal forms of contraception can be taken to prevent ovulation[2]—and therefore ovulatory pain—but otherwise there is no known prevention.

Causes[edit]

Mittelschmerz is believed to have a variety of causes:

Usefulness[edit]

Women charting with some form of fertility awareness may find mittelschmerz to be a helpful secondary sign in detecting ovulation. Because normal sperm life is up to five days, however, mittelschmerz alone does not provide sufficient advance warning to avoid pregnancy. Because other causes of minor abdominal pain are common, mittelschmerz alone also cannot be used to confirm the beginning of the post-ovulatory infertile period.[1][3]

Other ovulation symptoms[edit]

Women may notice other physical symptoms associated with their mittelschmerz, during or near ovulation. The most common sign is the appearance of fertile cervical mucus in the days leading up to ovulation. Cervical mucus is one of the primary signs used by various fertility awareness methods. Other symptoms are sometimes called secondary fertility signs to distinguish from the three primary signs.[3]

References[edit]

  1. ^ a b c d Kippley, John; Sheila Kippley (1996). The Art of Natural Family Planning (4th ed.). Cincinnati, OH: The Couple to Couple League. pp. 83–84. ISBN 0-926412-13-2. 
  2. ^ a b http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002472/
  3. ^ a b c d e f g h Weschler, Toni (2002). Taking Charge of Your Fertility (Revised ed.). New York: HarperCollins. pp. 65–68, 228. ISBN 0-06-093764-5. 
  4. ^ Michael H. Ross, Wojciech Pawlina (2006). Histology: A Text and Atlas (5th ed.). Hagerstown, MD: Lippincott Williams & Wilkins. p. 788. ISBN 978-0-7817-7221-1.