Mittelschmerz is German for "middle" and "pain." It is also known as ‘ovulation pain’ or 'mid-cycle pain.’
Mittelschmerz is a one-sided lower abdominal pain, but can switch to the other side the next month or stay on the same side for several months in a row. Mittelschmerz may occur just before, during, or after ovulation in about 20% of women and can it lasts from a few seconds or minutes to several hours. Rarely does it last 24-48 hours. Longer pain does not usually come from ovulation itself but from bleeding or fluid irritating the peritoneum, the lining of the abdomen or from endometriosis.
Mittelschmerz is due either to swelling and stretching of the surface of the ovary in the area of the follicle, leakage of the follicular fluid or blood, or it comes from enzymes that dissolve the outer wall of the ovary surrounding the follicle to let the egg escape. With ovulation induction the ovaries can swell and pain at that time may be related to post-ovulation ovarian enlargement. This can best be determined by ultrasound.
Some women with endometriosis can also experience pain well before ovulation. Mittelschmerz is too nonspecific to be a reliable enough indicator of ovulation which can better be assessed with the bbt curve, ultrasound, OPKs, or an elevated postovulatory blood progesterone level.
Review of Symptoms of Mittelschmerz:
- One-sided lower abdominal pain
- Pain onset is shortly before, during, or right after ovulation
- Recurrent or with similar pain in past
- Duration is typically seconds or minutes to a few hours, but may extend as long as 24 to 48 hours
- It is usually sharp, cramping, distinctive pain
- Rarely pain can be severe
- Pain may switch sides from month to month or from one episode to another
ATTENTION: Pain in your right lower abdominal area can also indicate other more severe problems such as appedicitis (infection of your appendix). If you have this severe pain, especially if it is accompanied by fever, you should immediately call your doctor or go to an emergency room.