What is Mittelschmerz?

Mittelschmerz certainly sounds like a strange word. It is derived from a German word which translates to 'middle pain'. ⁣This 'middle pain' is pain which women can experience in the middle of their menstrual cycle and is associated with ovulation.⁣ 

Pain associated with ovulation

Generally, around the middle of your cycle, you release a mature egg from a follicle in your ovary in conjunction with an LH (luteinizing hormone) surge. This is termed ovulation. Once an egg is released from your ovary, your fallopian tube will contract in efforts to help the egg meet sperm in preparation for fertilization. ⁣This process involves an increase of prostaglandins which can drive up inflammation and pain.

During this time, most women notice a change in the texture of their cervical fluid which becomes more slippery (fertile egg white fluid). If you are tracking your body temperature you may also notice a dip, and then a rise of about 0.5 degrees. In some women, ovulation can also be accompanied by spotting. ⁣

Any discomfort associated with ovulation should not be long-lasting. You may notice lower abdominal pain on one side, depending on which ovary is releasing the egg. It can feel like a sharp twinge, or range to more noticeable symptoms like bloating, nausea and intense pain.⁣ Some women only ever feel mittelschmerz on one side. 

Charting your cycles

We know that not all women ovulate in the middle of their menstrual cycle, but mittelschmerz is specifically linked to ovulation. If you notice similar sensations cyclically, take note of the timing of the pain or sensations and see if there is a recurring pattern. The easiest way to do this is to track your cycles, and on the day you feel mittelschmerz, list down the noticeable symptoms. For instance, you can write ‘right-sided pain’ or ‘left-sided pain’, when you feel it, and then note when your period starts (usually 14 days after ovulation). After a few cycles of doing this, you will be able to distinguish between ovulation and any other type of pain you feel. 

If the pain does not coinciding with ovulation, it may coincide with the premenstrual phase and be a symptom of PMS. 

Natural methods to relieve Mittelschmerz pain

1. Heat
   Applying a heat pack on your abdomen, taking a hot bath with Epsom salts, and using a moxa stick over your abdomen can all help with increased circulation and ease cramping. Note: do not burn yourself.
   
   
2. Massage and essential oils
   Abdominal, buttock, and lower back massage can be very helpful. Especially if you are finding that there are specific pressure points in these areas. Rub relaxing essential oils like lavender, ylang-ylang, and peppermint. Try laying on a foam roller, or even a golf ball or tennis ball to get into the pressure points in your lower back and buttocks.
   
   
3. Yoga
   Gentle yoga poses can help stretch the abdominal area to relieve pain.
   
   
4. Breathing exercises
   Deep diaphragm breathing into the abdominal cavity also helps a lot with pain relief and relaxation.
   
   
5. Anti-inflammatory herbs
   Drinking ginger and turmeric tea during this time can help with inflammation. Happy Turmeric can also assist with bringing down inflammation and pain. Read more about turmeric here. 
   
   
6. Supplements
   Happy Hormones can be used to support a healthy female reproductive system and reduce symptoms associated with premenstrual tension. Magnesium can be great for relaxing muscles where there is spasm or pain. Read more about magnesium here – you can use it orally, in a bath, or topically.

Any pain which is abnormal for you – regardless of when you experience it – should be assessed and the following should be ruled out:

• Sexually transmitted infections
• Endometriosis
• Appendicitis
• Ruptured cyst/s
• Pelvic inflammatory disease
• Ectopic pregnancy

On the other hand, some women do not feel any sensations at all during ovulation. 

Summary

Mittelschmerz is pain associated with ovulation. The intensity of the discomfort can vary across women. It is important to differentiate whether the pain that is felt is mittelschmerz, premenstrual pain, or something unrelated.

There are numerous natural methods on how to ease mittelschmerz pain and discomfort. Our naturopaths will be very happy to help you get to the bottom of any pain or discomfort you may be experiencing in relation to your menstrual cycle. Get in touch with us today or take our FREE assessment to begin your journey to better hormonal and overall health!

References

Nathan R. Brott, Jacqueline K. Le. Mittelschmerz. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan.2020 Jul 10.
https://pubmed.ncbi.nlm.nih.gov/31747229/

B Olartecoechea, M García Manero, P Royo, M Aubà. [Treatment for endometriosis]. Rev Med Univ Navarra. Jul-Sep 2009;53(3):12-4.
https://pubmed.ncbi.nlm.nih.gov/19994769/