What do cramps around ovulation mean?
Mittelschmerz refers to the lower abdominal pain associated with ovulation midway through the menstrual cycle. The exact cause of ovulation pain is not known but there are several theories used to explain why the pain occurs.
What is it?
Mittelschmerz originates from a German term which means “middle pain.” It refers to the lower abdominal pain that is associated with ovulation, which occurs midway through the menstrual cycle. It is a common sensation experienced by many women.
What does Mittelschmerz feel like?
The intensity of pain varies from person to person. While it may only be mild for most women, it can be severe for others. For some women, this feels like a dull, cramping pain on one side of the lower abdomen whereas, in others, a sudden, transient sharp pain is felt. The side of which the pain occurs usually corresponds to the side from which the egg is released. Since the side of the pain is same as the side of the follicular rupture, it can be an indicator used to determine the time of ovulation.
What might cause it?
The exact cause is unknown but several theories have been used to explain the pathophysiology behind mittelschmerz. Researchers have found that mittelschmerz could be due to:
- the release of follicular contents to the abdominal cavity
- the muscular cramps in the uterus, fallopian tubes or the large bowels
- Irritation of the peritoneum by the blood and fluid that is released by the rupture of follicles during ovulation
- Increased pressure within the follicle or the ovary
When should you see a doctor for ovulation pain?
Mittelschmerz usually causes only mild discomfort in most women and therefore rarely requires the need to visit a doctor. However, sometimes this pain is so severe it could warrant medical attention. Consult a medical professional if this pain is associated with nausea or vomiting as it could indicate something more serious such as appendicitis.
How ovulation pain diagnosed and what is the treatment?
There is no specific test available to diagnose ovulation pain. Your doctor will diagnose it by excluding other conditions that may present similarly. They may order tests to exclude conditions like appendicitis or an and ectopic pregnancy. Once this is done, your doctor will question you regarding your menstrual cycle and will ask you to keep track of your cycles to make sure that this pain occurs during the middle of your cycle when ovulation is expected.
The treatment of mittelschmerz generally aims to control the pain or prevent ovulation. Pain relief can be achieved with over the counter drugs such as Acetaminophen and Ibuprofen. If the pain is difficult to control, then the next step would be to prevent ovulation. This can be brought about by the use of birth control pills.
What other conditions might be confused with ovulation pain?
There are two common chronic conditions that may be confused with ovulation pain. They are endometriosis and acute appendicitis. Endometriosis is a condition where endometrial-like tissue grows outside the uterus. This condition causes severe pelvic pain which is aggravated during ovulation and menstruation. Endometriosis is also associated with painful periods and painful intercourse.
Acute appendicitis is another condition that may mimic ovulation pain. If you have lower right sided abdominal pains associated with nausea and vomiting, seek urgent medical attention.