Mittelschmerz – I’m in Pain When I Ovulate

Woman with her monthly menstrual pains clutching her stomach with her hands as she becomes stressed by the ongoing cramps, torso view of her hands and tummy isolated on white
Woman with her monthly menstrual pains clutching her stomach with her hands as she becomes stressed by the ongoing cramps, torso view of her hands and tummy isolated on white

If you are one of the 20% of women approximated to experience mittelschmerz, you may already be familiar with this strange sounding word. The word itself is German for ‘middle pain’ and refers to pain experienced just before, during, or after ovulation.

The pain can sometimes be light and tolerable, but for some women it can be severe and debilitating. It’s often on just one side (the ovary from which you ovulate) and so the pain may switch sides from month to month, or some women may experience it in just one ovary and hence usually every second month. Doctors say the pain occurs because during ovulation, the follicle where an egg develops may stretch or inflame the surface of the ovary. sometimes,  blood or fluid can be released from a ruptured egg follicle too, which may cause irritation.

I first experienced Mittelschmerz after my miscarriage at 35. My first period after the miscarriage arrived normally and with no ovulation pain. The following month however, was another story.

What started as light pulsing in my left ovary, gradually increased to a heavy throbbing and severe lower abdominal and lower back pain. The ovulation pain got so severe I had problems getting out of bed without assistance, let alone walk at times. The first month I experienced this pain, it lasted for 2-3 days straight. Ultrasound showed what looked like a normal ovary which had just released an egg during ovulation. It was put down to my body ‘regulating’ itself after the miscarriage, and that was that.

The pain got so severe I had problems getting out of bed without assistance, let alone walk at times.

The next month was fine. Hooray! It was a once off, and I could work on trying to move forward emotionally from my miscarriage. Or so I thought….

The following month, there was that pain again. This time, it was even worse. The pain lasted 4 days straight and I couldn’t stop crying from the pain. I felt so sore and so fatigued, and I knew that something felt  ‘off’ from a hormonal perspective. This time I went to my gynecological specialist. He didn’t want to rush me to surgery, which I commend. He suggested painkillers and to wait another 2 months and see if the pain recurred or got worse.

It did. It recurred like clockwork, skipping a month and again returning the month after on my left side. This time It lasted almost 6 days, at which point my specialist suggested that the fact that it was getting worse indicated that there may be a problem with the ovary itself and surgery may have to be considered.

Surgery? I had just lost my baby, and I couldn’t get past the emotion of it let alone deal with this pain and also surgery. I delayed surgery as much as I could, opting to try natural remedies, change my diet and even start yoga….but 4 months later it only got worse. I was bedridden for almost 10 days from the pain. On the other side of things I struggled on a monthly basis knowing that my inability to have sex with my partner during ovulation because of this pain, only meant that my dream of having a baby was being put on hold even longer.

I struggled on a monthly basis knowing that my inability to have sex with my partner during ovulation because of this pain, only meant that my dream of having a baby was being put on hold even longer.

I had had enough. I opted for surgery to see what was going on.

As it turns out, where a normal looking follicle appeared on my ultrasounds, there was actually a hemorrhagic cyst with endometriosis tissue. I didn’t even know I had endometriosis on my ovary – this isn’t something that can be picked up on an ultrasound.

My surgeon removed the cyst and endometriosis tissue and that was that.

That surgery was a blessing. I could function without dreading the middle of the month. I didn’t have to pencil it in my calendar and avoid social events for that week. I didn’t have to lie in bed crying. Once recovered, I finally felt normal again.

Not everyone will have this problem and find a solution the way I did. To those people struggling with this pain out there, I acknowledge how hard it must be at times for you and I truly commend your strength in getting through each month.


This story is a REAL LETTER sent from Diane, 37 yo, Sydney, Australia. Edited by Dear Bub.

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