Ovary

Ovulatory Pain

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Ovulatory Pain, Mittelschmerz, Ovulation Pain, Midcycle Pain

  • See Also
  1. Acute Pelvic Pain
  2. Premenstrual Syndrome
  • Definitions
  1. Ovulatory Pain (Mittelschmerz or Midcycle Pain)
    1. Unilateral acute pelvic between Menstrual Cycles, in the time around release of ovum from ovarian follicle
  • Epidemiology
  1. Prevalence: Up to 40% of reproductive age women
  • Pathophysiology
  1. Luteinizing Hormone (LH) surge leads to increased ovarian perifollicular Smooth Muscle contractility (Prostaglandin mediated)
  • Symptoms
  1. Unilateral Pelvic Pain or lower abdominal quadrant pain, more often on the right side
  2. Radiation may occur to the low back
  3. Onset mid-Menstrual Cycle
  4. Duration 3 to 12 hours (longer with prior ovarian surgery)
  5. Variable severity (mild to severe)
  • Differential Diagnosis
  1. See Acute Pelvic Pain Causes
  2. Acute Appendicitis
  • Management
  1. Symptomatic Analgesic use (esp. NSAIDs)
  2. Oral Contraceptives
  • References
  1. O'Herlihy (1980) Br Med J 280(6219):986 +PMID: 7417773 [PubMed]
    1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1601114/
  2. Brott (2023) Mittelschmerz, StatPearls, Treasure Island
    1. https://www.ncbi.nlm.nih.gov/books/NBK549822/