II. Definitions
- Ovulatory Pain (Mittelschmerz or Midcycle Pain)
- Unilateral acute pelvic between Menstrual Cycles, in the time around release of ovum from ovarian follicle
III. Epidemiology
- Prevalence: Up to 40% of reproductive age women
IV. Pathophysiology
- Luteinizing Hormone (LH) surge leads to increased ovarian perifollicular Smooth Muscle contractility (Prostaglandin mediated)
V. Symptoms
- Unilateral Pelvic Pain or lower abdominal quadrant pain, more often on the right side
- Radiation may occur to the low back
- Onset mid-Menstrual Cycle
- Duration 3 to 12 hours (longer with prior ovarian surgery)
- Variable severity (mild to severe)
VI. Differential Diagnosis
VII. Management
- Symptomatic Analgesic use (esp. NSAIDs)
- Oral Contraceptives
VIII. References
- O'Herlihy (1980) Br Med J 280(6219):986 +PMID: 7417773 [PubMed]
- Brott (2023) Mittelschmerz, StatPearls, Treasure Island