Mittelschmerz

Question 1

what is it?

Answer 1

Mittelschmerz literally translates to ‘middle pain’ and refers to abdominal pain associated with ovulation.

Question 2

why does it happen

Answer 2

One explanation is that is occurs due to a leakage of follicular fluid containing prostaglandins at the time of ovulation, which causes the pain.

Another explanation is that the growth of the follicle stretches the surface of the ovary, causing pain.

Question 3

why does it happen

Answer 3

One explanation is that is occurs due to a leakage of follicular fluid containing prostaglandins at the time of ovulation, which causes the pain.

Another explanation is that the growth of the follicle stretches the surface of the ovary, causing pain.

Question 4

what is the presentation?

Answer 4

Sudden onset of pain in either iliac fossa which then manifests as a generalised pelvic pain.

Typically, the pain is not severe and varies in duration, lasting from minutes to hours.

It is self-limiting and resolves within 24 hours of onset.

Pain may switch side from month to month, depending on the site of ovulation

Question 5

Ix

Answer 5

There is no specific test to confirm Mittelschmerz and it diagnosed clinically, after taking a full history and examination to exclude other conditions
No abnormal signs on abdominal or pelvic examination.

Question 6

Ix

Answer 6

clinical

Question 7

mx

Answer 7

none - simple analgesia