Mittelschmerz is a German word that literally means middle pain. Many women experience pain during the middle of their menstrual cycle, about the time of ovulation.

This ovulation pain or mid cycle pain is experienced either regularly or intermittently, and 20% of women experience this pain during their reproductive years.

There is a slight benefit of ovulation pain because women can more accurately able to gauge and pinpoint the time of ovulation to assess pregnancy readiness.

Mittelschmerz or ovulation pain usually has the following symptoms or characteristics:

  • Half way through the menstrual cycle of women, a lower abdominal pain or ache is the main symptom. This pain may come suddenly and usually subsides within a few hours. Some women may experience several days of pain around the time of ovulation. Yet others find that the pain that starts around ovulation continues till the next period.
  • The pain may be localized to the area of one or the other ovary (the one that is active that month) or may be general.
  • Some women experience the kind of pain that can be mistaken for appendix related pain.
  • Some women may experience slight vaginal discharge or bleeding as well as pain.
  • If accompanied by nausea and fever, ovulation pain could be caused by appendicitis, ectopic pregnancy or pelvic inflammatory disease.

So what causes ovulation pain or Mittelschmerz? For the most part, ovulation pain is a harmless thing and does not signify the presence of a disease or medical condition.

It usual requires no treatment except perhaps pain management when it is more severe. In some cases, birth control pill may be prescribed to prevent ovulation. Chief causes of ovulation pain are:

  • The swelling of the follicles before ovulation could cause pain.
  • The rupture of the ovarian walls during ovulation may cause pain (the ovaries have no opening and the egg is required to break through the wall in any case).
  • After the release of the egg, the fallopian tubes contract in a manner that propels the egg along. This may also cause pain.
  • Smooth muscle cell contraction occurs when there are increased levels of prostaglandin F2-alpha due to the surge of luteinizing hormone (LH). This smooth cell contraction as well as the contraction of its ligaments could be the casual factors for ovulation pain in some women.
  • The ruptured follicle produces blood and other fluid at the time of ovulation, which is thought to be responsible for irritating the lining of the abdomen in some women.