Mittelschmertz is a pain in the lower abdomen which occurs at or around the time of ovulation. The pain may last a few minutes to a couple of days. Sometimes it happens just on the ovulating side or may be felt throughout the pelvis. For me, it would happen only when I ovulated on the right.
If the pain happens right before ovulation the cause may be the growing follicle. A follicle is like a fluid-filled sac that pushes against the wall of the ovary and contains the ovum (egg). This growth may stretch the ovarian site resulting in pain.
If the pain happens right after ovulation it may be caused by blood irritating the peritoneum. As Dr. Aviva Romm explains, “Upon rupture of the follicle the cavity that held the ovum collapses, its cells enlarge, and the cavity that has formed becomes blood-filled, forming what is called the corpus hemorrhagicum (bloody body). “Mittleschmerz” is a result of minor bleeding from this site that may cause peritoneal irritation and mild lower abdominal pain of short duration. The blood is soon replaced with yellowish, lipid-rich luteal cells, forming the corpus luteum, hence the name of the luteal phase of the menstrual cycle.” Knowing how to track your cycle and knowing how a particular stage of your cycle may relate to your symptom is extremely useful, both for you and your physician.
Moving from the lower left (primary follicle) in a counter-clockwise motion to corpus albicans shows the stages of the follicular cycle throughout the month.
If you get ovarian pain with or right after menses it may be a Corpus Luteum cyst which is a type of ovarian cyst that may rupture about the time of menstruation.
I’ve also had ovulation pain that irritated my psoas (or maybe my psoas was irritating my ovary?). The ovaries typically lie right over the psoas! That’s why I never let anyone “massage my psoas with their elbow”. You can read more about the psoas/ovarian connection and how it caused my knee pain here.
I teach abdominal massage and pelvic alignment for uterine and ovarian health in my Womb Care Online Course.
