Doctor's Notes on Painful Ovulation (Mittelschmerz)
Painful ovulation (also termed Mittelschmerz) is discomfort or pain that appears on either side of the lower abdomen in the midpoint of a woman’s menstrual cycle, about two weeks before a period begins. Some women do not experience any painful ovulations. The signs and symptoms of painful ovulation are that pain occurs on one side of the lower abdomen (pain can occur one side or the other, depending upon which ovary is ovulating), pain occurs during ovulation, pain can occur every month and may last anywhere from a few hours to 2-3 days. For most women, the pain is a mild annoyance but in rare instances, it can be severe. The pain quality and intensity vary from person to person; some will feel mild pressure, some feel twinges of pain, in a few women, pains can be intense and long-lasting.
During ovulation an egg is released by the ovary and during that time, it stretches the membrane covering the ovary. This stretching results in symptoms of pressure and/or pain and may contribute to the cause of painful ovulation. In addition, the fluid from the follicle and the blood released from the follicle when the egg is released may also contribute to the cause of painful ovulation.
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.