The German word middle pain means “middle pain”. It refers to the lower abdominal pain that some women experience during ovulation, during which an egg is released from their ovaries. Mid-perimenstrual pain is not a serious condition, but it can be uncomfortable and interfere with daily activities. It usually occurs about 14 days before the next menstrual period, and lasts from a few minutes to a few hours. We will discuss the causes, symptoms, diagnosis, treatment, and prevention of mittelschmerz in this blog post.
Causes
Several factors may contribute to mittelschmerz, but the exact cause is unknown:
-
As the egg matures and breaks through the follicle, the ovarian surface or fallopian tube stretches
-
A ruptured follicle releases blood or fluid that irritates the abdominal lining (peritoneum)
-
An egg is moved towards the uterus by contraction of the uterus or fallopian tube
The pain may switch sides from month to month depending on which ovary is ovulating, or it may remain on one side for several months.
Symptoms
Mittelschmerz is characterized by a sharp, cramp-like pain in the lower abdomen, usually on one side.
-
Bleeding or spotting in the vaginal area
-
Discharge from the vaginal canal
-
Vomiting or nausea
-
Dizziness or headache
-
Chills or fever
It is possible for women to experience mild or no pain, while others may experience severe pain that requires medication or medical care. Pain severity and duration can vary from person to person and from cycle to cycle. Stress, physical activity, sexual activity, or certain foods and drinks can also trigger or worsen the pain.
Diagnosis
The diagnosis of middle pain is usually based on a patient's history and physical examination. The doctor will also inquire about the menstrual cycle, the nature and timing of the pain, as well as any other symptoms. For signs of infection, inflammation, or other problems that could cause similar pain, the doctor may also perform a pelvic exam.
Tests may be ordered to rule out other causes of lower abdominal pain, such as appendicitis, ectopic pregnancy, ovarian cysts, or pelvic inflammatory disease:
-
Pregnancy tests, infection tests, and hormone tests
-
Checking for kidney stones or urinary tract infections with urine tests
-
Using ultrasound to visualize the ovaries, uterus, and fallopian tubes
-
Through a small incision and a camera, a laparoscopy examines the pelvic organs and peritoneum
Treatment
Usually, middle pain resolves on its own without any complications, but the following measures may help relieve pain and discomfort:
-
Acetaminophen, naproxen, or ibuprofen are over-the-counter pain relievers
-
The lower abdomen or the back can be heated with a heating pad or a hot water bottle
-
Bathing or showering in warm water
-
Relaxing and resting
-
Maintaining a healthy weight by drinking plenty of fluids
-
Caffeine, alcohol, tobacco, and spicy foods should be avoided
It may be necessary to prescribe stronger painkillers or antibiotics if the pain persists or is accompanied by other symptoms, such as fever, nausea, vomiting, or abnormal bleeding. To prevent mittelschmerz, the doctor may also recommend birth control pills or other hormonal methods.
Prevention
In spite of the fact that mittelschmerz is a natural part of the menstrual cycle, there are certain steps that may reduce the risk or severity of the pain.
-
Recording the menstrual cycle and ovulation pain to identify the pattern and triggers
-
Preparing painkillers and heating pads ahead of time
-
Preventing infections of the pelvic organs by practicing good hygiene and using condoms
-
Supporting hormonal balance and reproductive health by eating a balanced diet and taking supplements, such as vitamin B6, magnesium, or omega-3 fatty acids
-
Regular and moderate exercise improves blood circulation and muscle tone
-
Reducing tension and inflammation in the body by managing stress and anxiety
