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Medically reviewed by Last updated on Jul 4, 2022.

What is mittelschmerz?

Mittelschmerz is pain or discomfort that may happen to females before, during, or after ovulation. Ovulation is when an ovary in your body releases an egg. Ovulation usually happens once a month, about 2 weeks before your period. Mittelschmerz is not serious, but it can be very uncomfortable. Mittelschmerz pain usually goes away within a few minutes to hours but may last as long as 1 or 2 days.

What causes mittelschmerz?

The cause is not known. Mittelschmerz pain may happen because the ovary stretches before an egg is released. The actual release of the egg may also cause this pain.

What are the signs and symptoms of mittelschmerz?

You may have sharp, aching pain and cramping on one side of your lower abdomen. The pain may be on the right side one month, and on the left side the next month. Other signs may include nausea and spotting of blood or discharge from your vagina.

How is mittelschmerz diagnosed?

Your healthcare provider will examine you and ask about your symptoms and your periods. You may need any of the following:

  • A pelvic exam may be done to find the cause of your pain. Your healthcare provider checks your vagina, cervix, and uterus for problems.
  • An abdominal ultrasound uses sound waves to show pictures of your ovaries, uterus, and the inside of your abdomen on a monitor.

How is mittelschmerz treated?

  • Rest may help decrease the pain.
  • Apply heat on your abdomen for 20 to 30 minutes every 2 hours for as many days as directed. Heat helps decrease pain and muscle spasms. A soak in a warm bath may also help decrease your discomfort.
  • Ask about medicines. Medicines that may decrease or stop mittelschmerz pain include the following:
    • NSAIDs help decrease swelling and pain. This medicine is available without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.
    • Acetaminophen decreases pain. It is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.
    • Oral contraceptives (birth control pills) may be suggested by your healthcare provider if your pain continues. Birth control pills stop you from ovulating, which stops mittelschmerz pain.

When should I contact my healthcare provider?

  • You have a fever.
  • You have a fever and abdominal pain with vomiting or diarrhea.
  • Your pain lasts longer than 24 hours.
  • Your pain is different than it has felt in the past.
  • You have abdominal or pelvic pain after you miss a period.
  • You have pain when you urinate or have a bowel movement.
  • You have vaginal bleeding in between your periods that is heavier than spotting.
  • You have yellow, green, or foul-smelling vaginal discharge.
  • Your abdomen becomes swollen.
  • Your skin has redness or burning at the site of pain.

When should I seek immediate care or call 911?

  • Your pain is so severe that you cannot stand up straight.
  • You use tampons and you get a rash, feel dizzy, or have muscle aches during or after your menstrual period.
  • You feel dizzy or faint.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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Further information

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