Mittelschmerz

Mittelschmerz
Other namesOvulation pain, mid-cycle pain
Approximate location of abdominal pain based on potential causes
SpecialtyGynecology
SymptomsOne sided lower abdominal pain, spotting
Usual onsetMid menstrual cycle
DurationMinutes to days
CausesRelated to ovulation but mechanism unclear
Diagnostic methodAfter ruling out other potential causes
Differential diagnosisAppendicitis, endometriosis, ovarian cyst, ectopic pregnancy, sexually transmitted infections
PreventionBirth control pills
TreatmentParacetamol, ibuprofen
PrognosisNone serious
Frequency40% of women

Mittelschmerz (German: [ˈmɪtl̩ʃmɛʁt͡s] ) is a term for pain due to ovulation. It occurs mid-cycle (between days 7 and 24) and can last minutes to up to several days. The pain affects one side of the lower abdomen and may be dull or sharp in nature. Other symptoms may include spotting. Often it occurs monthly and may alternate sides.

The underlying mechanism is unclear but may involve irritation due to release of blood and fluid from the follicle or high blood levels of luteinizing hormone causing contraction of smooth muscle. Diagnosis involves ruling out other potential causes such as appendicitis, endometriosis, ovarian cysts, ectopic pregnancy, and sexually transmitted infections.

Treatment may involve paracetamol or ibuprofen. Birth control pills may be used for prevention. It is not serious, though may reoccur. Mittelschmerz affects about 20 to 40% of women. The term is from the German for "middle pain". Its presence has been used to manage fertility.