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Symptoms
By Mayo Clinic staffThe main symptom of mittelschmerz is a distinctive, one-sided lower abdominal pain or discomfort. The pain may switch sides every other month or every other time you feel it. It's also possible to feel it on the same side for several months in a row. The pain occurs on the side in which you're ovulating.
The pain usually lasts a few minutes to a few hours, but it may continue for as long as a day or two. Pain from mittelschmerz may be:
- A dull ache that feels like a cramp
- Sharp, sudden pain
- Accompanied by mild vaginal bleeding or discharge
- Rarely, severe
The location and the timing of your pain can help you identify mittelschmerz, especially if you have a history of it. Keep track of your menstrual cycle for several months and note when you experience this pain. If it occurs midcycle and goes away without treatment, it's most likely mittelschmerz.
When to see a doctor
In the vast majority of cases, mittelschmerz requires no medical intervention. However, contact your doctor if a new pelvic pain becomes severe, if it's accompanied by nausea or fever, or if it persists — any of which could indicate you have a condition more serious than mittelschmerz, such as appendicitis, pelvic inflammatory disease or even an ectopic pregnancy.
- Biechman AN, et al. Evaluation and management of ruptured ovarian cyst. http://www.uptodate.com/home/index.html. Accessed April 22, 2009.
- Forcier M. Emergency department evaluation of acute pelvic pain in the adolescent female. Clinical Pediatric Emergency Medicine. 2009;10:20.
- Welt CK, et al. The normal menstrual cycle. http://www.uptodate.com/home/index.html. Accessed April 22, 2009.
- Greydanus DE, et al. Menstrual disorders in adolescent females: Current concepts. Disease-A-Month. 2009;55:45.
- Zurawski JM. Mittelschmerz. In: Hillard PJA, ed. The 5-Minute Obstetrics and Gynecology Consult. Philadelphia, Pa.: Wolters Kluwer/Lippincott Williams & Wilkins; 2008:128.
