Is Mittelschmerz Causing Your Pelvic Pain Every Month?

When I was about 19-20 years old, I noticed I was having regular pains in my pelvic area that usually occurred two weeks after my period. A friend of mine explained to me that the discomfort was because my ovaries "were moving" and that I was ready to ovulate. It wasn't until I started nursing school that I realized this movement of the ovaries had a name: mittelschmerz.

What exactly is mittelschmerz?

Mittelschmerz or painful ovulation is the pelvic pain some women feel midway between when they're menstruating and when they're ovulating. It's caused when the dominate follicle growing in the ovary ruptures and leaks fluid and blood into the pelvic area. The pain is usually felt on the right or left side of the pelvic area and can be described as twinging or sharp. In my case, the pain varies but is usually a sharp feeling.

Dominant follicle? What's that?

In the two weeks before a woman officially ovulates, her body begins preparing several immature eggs for this task. However, only one egg will receive enough estrogen to become the dominant follicle that will mature and be released from the ovary. The release of this mature egg is called ovulation. As for the other eggs that never fully mature, they simply disintegrate.

Is mittelschmerz causing my pelvic pain?

To determine if your pelvic pain is caused by mittelschmerz, timing is everything. If you are experiencing this sharp pain during the two weeks before you ovulate, odds are this is mittelschmerz. If your pain is occurring in the lower abdominal area near your ovaries, this can indicate mittelschmerz as well. Because ovulation tends to rotate between the right and left ovaries each month, you may notice one month the pain is on one side and next month the pain is on the other side.

How do you treat mittelschmerz?

For me, mittelschmerz has been uncomfortable at times, but never serious enough that I needed to seek treatment. In fact, the pain tends to go away in a few hours and even that can be treated with some over the counter pain medication . I've never had any vaginal bleeding with my mittelschmerz but some women do and this can be taken care of by wearing a pantyliner. If your mittelschmerz is very painful and/or accompanied by other troubling symptoms like nausea, vomiting, and painful urination, speak with your gynecologist about possible treatments like oral contraceptives.

Sources:

Personal experience

Cleveland Clinic website, Mittelschmerz (Painful Ovulation), January 2011

Murray, Sharron Smith and McKinney, Emily Sloan, (2010) Foundations of Maternal-Newborn and Women's Health Nursing (5 ^th ed), Saunders-Elsevier, Maryland Heights, Missouri, pp 62-63 and 905