Mittelschmerz Overview
Learn About Mittelschmerz
Mittelschmerz is one-sided, lower abdominal pain that affects some women. It occurs at or around the time when an egg is released from the ovaries (ovulation).
Ovulation pain; Midcycle pain
One in five women have pain around the time of ovulation. This is called mittelschmerz. The pain may occur just before, during, or after ovulation.
This pain can be explained in several ways. Just before the ovulation, the growth of the follicle where the egg develops may stretch the surface of the ovary. This can cause pain. At the time of ovulation, fluid or blood is released from the ruptured egg follicle. This may irritate the lining of the abdomen.
Mittelschmerz may be felt on one side of the body during one month and then switch to the other side during the next month. It may also occur on the same side for many months in a row.
Symptoms may include lower-abdominal pain that:
- Occurs only on one side.
- Goes on for minutes to a few hours. It can last up to 24 to 48 hours.
- Feels like a sharp, cramping pain unlike other pain.
- Is severe (rare).
- May switch sides from month to month.
- Begins midway through the menstrual cycle.
Most of the time, treatment is not needed. Pain relievers may be needed if the pain is intense or lasts a long time. In patients with Mittelschmerz-related symptoms that interfere with their normal activities, the use of an oral contraceptive may be used to control symptoms.
Paul Yong practices in Vancouver, Canada. Mr. Yong is rated as an Elite expert by MediFind in the treatment of Mittelschmerz. His top areas of expertise are Endometriosis, Mittelschmerz, Vulvodynia, Hysterectomy, and Oophorectomy.
Spectrum Health Primary Care Partners
Joya Johnson is an Obstetrics and Gynecologist in Grand Rapids, Michigan. Dr. Johnson is rated as an Advanced provider by MediFind in the treatment of Mittelschmerz. Her top areas of expertise are Vaginal Bleeding Between Periods, Mittelschmerz, Vaginal Bleeding in Pregnancy, Intrauterine Device Insertion, and Hormone Replacement Therapy (HRT). Dr. Johnson is currently accepting new patients.
Legacy Clinics LLC
Melissa Pendergrass is an Obstetrics and Gynecologist in Portland, Oregon. Dr. Pendergrass is rated as an Advanced provider by MediFind in the treatment of Mittelschmerz. Her top areas of expertise are Endometriosis, Pelvic Congestion Syndrome, Hydrocele, Mittelschmerz, and Intrauterine Device Insertion. Dr. Pendergrass is currently accepting new patients.
Mittelschmerz can be painful, but it is not harmful. It is not a sign of disease. It may help women to be aware of the time in the menstrual cycle when the egg is released. It is important for you to discuss any pain you are having with your health care provider. There are other conditions that can cause similar pain that are much more serious and require treatment.
Most of the time, there are no complications.
Contact your provider if:
- Ovulation pain seems to change.
- Pain lasts longer than usual.
- Pain occurs with vaginal bleeding.
Birth control pills can be taken to prevent ovulation. This can help reduce pain that is linked to ovulation.
Summary: Uterine fibroids and endometriosis are two frequent diseases among women of reproductive age. They can be responsible for chronic and/or menstrual pelvic pain and abnormal uterine bleeding. The first-line management of these conditions relies on medical treatment. Hormonal treatment with contraceptive pill can be effective, although up to 30% of patients do not respond to this line of treatment. I...
Summary: The menstrual cycle is a term to describe the sequence of events that occur in body as it prepares for the possibility of pregnancy each month. The average length of a menstrual cycle is 28 days. However a cycle can range in length from 21 days to about 35 days and still normal. The menstrual cycle is the time from the first day of your menstrual period until the first day of your next menstrual p...
Published Date: May 22, 2025
Published By: LaQuita Martinez, MD, Department of Obstetrics and Gynecology, Emory Johns Creek Hospital, Alpharetta, GA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Persaud TVN, Torchia MG. First week of human development. In: Persaud TVN, Torchia MG, eds. The Developing Human. 12th ed. Philadelphia, PA: Elsevier; 2025:chap 2.
Rivlin K, Davis AR. Contraception and abortion. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 13.
Yazdani A. Pelvic pain. In: Cameron P, Little M, Mitra B, Deasy C, eds. Textbook of Adult Emergency Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 19.1.