What is the Mittelschmerz?
Mittelschmerz is the term for all complaints that occur in the middle of the female cycle. In most cases, the cause is hormone fluctuations during ovulation exactly halfway through the cycle. The term “Mittelschmerz” can have several meanings and includes both abdominal pain itself and symptoms associated with ovulation, such as a pulling in the breast or mild hot flushes.
Causes
The causes of Mittelschmerz are the changes in the female sex hormones shortly before ovulation. More precisely, these are the two hormones estrogen and LH (luteinizing hormone). The estrogen in particular is responsible for many complaints during the female cycle.
Its concentration increases until ovulation in order to prepare the uterus perfectly for a possible pregnancy. This means that it is responsible for building up the mucous membrane in the uterus. This is intended to create optimal implantation conditions for the fertilized egg after ovulation.
However, estrogen not only acts on target structures in the uterus, but also causes changes in the female breast. There it represents a growth stimulus for the tissue. As a result, the volume of the breast increases and the affected woman can perceive this as stretching pain.
However, the classical middle pain is the pain in the lower abdomen, which is caused by ovulation itself. It is triggered by the hormone LH and causes a small tear in the tissue of the ovary. Only in this way can the mature egg be released.
This naturally induced wound can cause pain. Typically, however, it is reported as non-specific lower abdominal pain by many women. If the egg has cracked, the middle pain usually subsides quickly.
In fact, it is mainly the tension over the rapidly growing egg on the tissue that causes pain. When the pressure is relieved, the discomfort subsides. This topic might also be of interest to you: Chest pain during ovulation
Does it occur before, with or after ovulation?
Mittelschmerz can occur two days before to two days after ovulation. This period is the sensitive phase for hormone fluctuations. Strictly speaking, this means that during these cycle days the increase in hormones is the strongest and reaches its maximum.
If a woman is very sensitive to the hormone fluctuations, she may have symptoms up to two days before ovulation. If a woman is not sensitive to hormone fluctuations, she has no complaints at all. Experience shows that only a few women have significant moderate pain.
The duration is limited to a few days after ovulation. Strictly speaking, the discomfort after ovulation usually decreases rapidly. Persistent or very severe pain always requires clarification by a gynaecologist.
However, it is normal for a woman to feel less efficient or perhaps have slight discomfort about 14 days after her last menstruation. However, she should not be restricted in her ability to work. It is not possible to say exactly when the Mittelschmerz occurs in a woman, because it does not have to occur at all.
However, it is characteristic of moderate pain that it occurs about 14 days after the last menstrual period. Depending on how sensitively a woman reacts to the hormone fluctuations, she may feel the middle pain one day sooner or later. For a self-diagnosis at home, it is therefore suitable to enter the days of menstruation in a calendar.
If the symptoms appear about two weeks later, this fits well with moderate pain. Mittelschmerzen should only last for a few days and should not drastically reduce performance. If symptomatic treatment with warmth or home remedies such as tea helps, middle pains are still within the range.
If it lasts longer than 3 days or if the symptoms can only be relieved with painkillers, a specialist should be consulted. Exactly the same applies to complaints that recur every cycle. Here too, the gynecologist should be informed – whether at the next routine examination or at an individually arranged appointment out of the ordinary.
