II. Definitions

  1. Ovulatory Pain (Mittelschmerz or Midcycle Pain)
    1. Unilateral acute pelvic between Menstrual Cycles, in the time around release of ovum from ovarian follicle

III. Epidemiology

  1. Prevalence: Up to 40% of reproductive age women

IV. Pathophysiology

  1. Luteinizing Hormone (LH) surge leads to increased ovarian perifollicular Smooth Muscle contractility (Prostaglandin mediated)

V. Symptoms

  1. Unilateral Pelvic Pain or lower abdominal quadrant pain, more often on the right side
  2. Radiation may occur to the low back
  3. Onset mid-Menstrual Cycle
  4. Duration 3 to 12 hours (longer with prior ovarian surgery)
  5. Variable severity (mild to severe)

VI. Differential Diagnosis

VII. Management

  1. Symptomatic Analgesic use (esp. NSAIDs)
  2. Oral Contraceptives

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