What You Should Know About Mittelschmerz, aka Annoying Ovulation Pain
By Korin Miller | Originally Published November 29 on Self | Featuring Dr. Sherry Ross
Sometimes your menstrual cycle can feel like a terrible à la carte menu. Your period is the main course, but you might also wind up with random sides like cramps, hormonal highs-and-lows, breast changes, and even mid-cycle pain. If you’re someone who experiences that middle-of-your-menstrual-cycle ovulation pain, also known as mittelschmerz (“middle pain” in German), you know exactly what we’re talking about.
Some people out there are blissfully unaware of when they’re ovulating. How nice for them. But others may get a painful heads-up in the form of mittelschmerz, which can show up in a few different ways. Some people feel a sharp or dull pain that lasts for hours on one side of the body, Christine Greves, M.D., a board-certified ob/gyn at the Winnie Palmer Hospital for Women and Babies, tells SELF. Others experience a quick cramping sensation that goes away as suddenly as it appears, Jessica Shepherd, M.D., an assistant professor of clinical obstetrics and gynecology and director of minimally invasive gynecology at the University of Illinois College of Medicine, tells SELF.
Either way, “it’s not fun,” Dr. Greves says. “It’s a strange feeling.”
Although experts haven’t determined its exact cause, mittelschmerz is tied to the process of ovulation.
Ovulation happens when hormonal fluctuations prompt one of your ovaries to produce a cyst-like structure known as a follicle, which ruptures to release an egg, according to the Mayo Clinic. If you have an average 28-day menstrual cycle, this typically happens around day 12 to 14, when your levels of estrogen peak, women’s health expert Jennifer Wider, M.D., tells SELF. Of course, the length of your cycle can vary, and so can the day you actually ovulate.
Ovulation pain may occur because that follicular growth stretches your ovary before the egg’s release, according to the Mayo Clinic. It might also happen when the cyst actually ruptures, letting loose the egg along with some cystic fluid or blood, which can irritate the lining of your abdomen.
Some months you may have a lot of cystic fluid while other times it might be minimal, which can help explain why you might have mittelschmerz one month and not the next, Sherry A. Ross, M.D., a women’s health expert and author of She-ology: The Definitive Guide to Women’s Intimate Health. Period, tells SELF. Still, “there’s no good data to say why some women get it and some don’t,” Dr. Greves says.
Luckily, if you experience mittelschmerz, there are a couple of ways you can relieve the pain.
Taking some anti-inflammatory medication to help reduce pain and inflammation may help, Dr. Wider says. And if you consistently experience mittelschmerz that painkillers can’t handle, going on the pill, the patch, or NuvaRing may be a good option for you. These combined hormonal contraceptives typically work by suppressing ovulation, explains Dr. Shepherd. Unfortunately, other forms of contraception, like IUDs, may not help with this specific pain since they don’t always stop your body from ovulating, Dr. Greves says.
If you’re experiencing ovulation pain every month and it’s gone from “huh, that’s an annoying but cool sign I’m ovulating” to “I hate my ovaries with every fiber of my being,” Dr. Greves says it’s important to talk to your doctor. Mittelschmerz may not get as much buzz as regular old period cramps, but it doesn’t mean you just have to put up with it.
One last thing: Sudden and extreme pelvic pain can be a sign of many different things.
So if you’re suddenly experiencing severe pelvic pain you’ve never felt before, or a sharp pain that doesn’t seem to get better with time (or even starts getting worse), it’s time to call a doctor, says Dr. Shepherd. It could be a sign of a non-follicular ovarian cyst rupture, ectopic pregnancy (when implantation of a fertilized egg happens outside of the uterus), or pelvic inflammatory disease, an infection of the reproductive organs that’s usually caused by untreated sexually transmitted infections.
If the pain goes away and comes back next month (or the next month) around the same time, it may just be ovulation pain. Either way, any sudden severe pain is important to flag for your doctor.