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Recurring Abdominal Pain

The timing of your pain may be specific enough to identify your diagnosis.

Mid-Menstrual Cycle Pain(Mittelschmerz)

Two weeks prior to the onset of bleeding each month, one of your ovaries releases a maturing egg. This normal event is "ovulation," and it can be painful. Pain caused by ovulation has a medical name, "Mittelschmerz." Mittelschmerz is not harmful, and it can be treated with over-the-counter pain medicines if symptoms linger for more than a few minutes. It is common for Mittelschmerz pain to last for several hours.

Endometriosis

Another condition that can cycle with a monthly pattern is endometriosis. For most women this condition is worst during the days immediately prior to the menses. It can cause pain that is more prolonged than is Mittelschmerz.

The type of tissue that makes up the uterus lining is "endometrial tissue." Some women have small collections of endometrial tissue that are located outside of the uterus. This condition is called "endometriosis." Endometrial tissue in any location can respond to hormone changes by releasing small amounts of blood. Blood that is outside of the uterus can be irritating, resulting in pain. Endometriosis may be responsive to treatment with non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) or naproxen (Aleve.) It can also be treated with hormonal medicines or destruction of the extra tissue during laparoscopic (camera guided) surgery.

Your doctor is likely to reassure you and recommend over-the-counter NSAID medicines if the timing of your symptoms suggests Mittelschmerz. If your pain episodes are severe or if they continue for more than a few hours, your doctor might advise that you have a camera guided inspection of your pelvic organs (laparoscopic surgery) to check for endometriosis.

Please call your doctor today to arrange an evaluation.


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