Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Mittelschmerz (pronounced MITT-ul-shmurz) is a German word that means middle pain.
Mittelschmerz is also referred to as painful ovulation. This pain occurs during ovulation
- the midpoint between menstrual periods, about 2 weeks before a period may begin. The discomfort can appear on either side of the lower abdomen depending on which ovary is producing the ovum (egg). Pain can be on one side of the abdomen one month and switch to the opposite side during the following cycle. About 20% of women experience this type of midcycle pain. Most of the time, it is a mild annoyance. In rare instances, it can be unbearable.
Painful Ovulation Causes
Just before the egg is released by the ovary, it stretches the membrane covering the ovary. This stretching results in pressure and pain. The fluid and blood released when the egg is released from the ovary may cause discomfort. Blood is very irritating to the tissues lining the abdominal cavity and could be responsible for the midcycle pain. The amount of pain varies tremendously from person to person. Most women do not have any discomfort. Others feel a mild pressure or twinge lasting a few hours. For a rare few, the pain is intense and can last for days. In severe cases, the pain may be mistaken for appendicitis.