Ruptured ovarian (Graafian) follicle (Mittelschmerz)

Question 1

Typical clinical features

Answer 1

Onset of pain in mid cycle

Deep pain in one or other iliac fossa (RIF > LIF) (average 5 h)

Often described as a ‘horse-kick pain’

Pain tends to move centrally

Heavy feeling in pelvis

Question 2

Management

Answer 2

Explanation and reassurance

Simple analgesics: aspirin or paracetamol (acetaminophen)

‘Hot water bottle’ comfort if pain severe