40% Of Women Experience Mittelschmerz. Are You One Of Them?

The cramps in your midsection make you feel anything but alluring, and your lower back pain forces you to move your hips in less of a carefree swish and more of a geriatric shuffle. Suddenly ovulation doesn’t seem so sexy. 

So what’s going on here? It’s likely that the pain you’re experiencing in the middle of your cycle is what’s known as mittelschmerz – German for “middle pain.” It’s commonly referred to as ovulation pain, and it’s basically just that: pain you experience during the ovulation phase of your cycle. 

What Is Mittelschmerz? 

Let’s start with the basics: What is ovulation? The ovulation phase – sometimes called the fertile window – is the part of a woman’s menstrual cycle when one of the ovaries is ready to release an egg. Ovulation itself takes place when the follicle in which the egg has been growing breaks open, and the egg is released. 

During your fertile window, you’re likely feeling like your sexiest, most confident self. You can thank your hormone levels for that – your estrogen and testosterone levels are at their peak, giving way to heightened energy and increased libido. Ovulation – as in, the actual release of the egg – typically takes place two weeks before the start of the next menstrual cycle, meaning two weeks before your next period begins. 

While the several days leading up to the release of the egg are often marked by feelings of carefree bubbliness, things can get dicey when ovulation actually takes place. The stretching of the follicle (which can get up to 24mm in diameter, so almost an inch across) to release the egg, as well as the actual rupturing of the follicle, can be painful. The rising level of luteinizing hormone, which peaks to trigger ovulation, also increases ovarian muscle contractility, causing pain. This pain – called mittelschmerz – can range in severity from minor discomfort for a couple of hours to “cancel all plans because I can barely walk” for up to 24 hours. Mittelschmerz is not uncommon, and roughly 40% of women of childbearing age experience it.

Similar to period cramps, ovulation pain occurs in the pelvic area and can extend to the abdomen and the lower back. The pain occurs on the side of the body where the egg is released – for instance, if your right ovary is releasing the egg that month, you’ll have pain on your right side. It’s normal for the ovaries to “switch off” on egg releasing duty month to month, which is why during some cycles you may experience pain on one side, and the next month it’s on the other (or not at all). 

Can I Make Mittelschmerz Go Away?

Here’s the bad news: There’s not really much you can do to prevent ovulation pain. That’s because, unlike period cramps that can potentially point to a larger problem in regards to your hormones, mittelschmerz likely isn’t a sign that something is actually wrong. In this case, part of your body (the egg follicle) is rupturing, and hey, it’s easy to see why that might hurt.

Some doctors recommend birth control for patients with extreme mittelschmerz, but that’s only a “solution” because it stops ovulation altogether. The pill’s negative side effects are a discussion for another time, but getting on birth control simply to prevent ovulation pain seems akin to putting a cast on a paper cut – it’s way too extreme and does more harm to your body than good. 

Although mittelschmerz pain is unfortunately a phenomenon that some of us just have to go through, resist the urge to simply grit your teeth and tough it out. Instead, lean into the experience and try to learn from it. When you realize that ovulation pain is your body’s way of telling you something – in this case, it’s telling you Ready or not, here comes your egg – you might see your ovulation pain in a whole new light. Case in point, you can view mittelschmerz pain as a way to know what day you’re ovulating, instead of just having a general idea based on the days of your cycle. Since mittelschmerz pain has been shown to coincide with peak luteinizing hormone (LH) levels – a telltale sign that you are indeed ovulating – you can potentially use this knowledge for family planning. 

While ovulation pain may not be preventable, there are some ways to make the pain more manageable. For starters, make heat your friend. Applying a heating pad to your pelvic area can provide some soothing relief for tensed-up muscles. A warm bath has a similar effect. Even though your energy levels might actually be high on the day you have mittelschmerz (it’s your ovulation phase, after all), try to take it easy with your workout and do some light stretching instead. This may provide some mild relief during the acute stage of the pain and can help greatly during the days following ovulation since you won’t be holding onto all that tension that may have built up in your body from “guarding” the painful area. And knowing that the pain will be relatively brief – generally a few hours to up to a day – can provide some peace of mind as well. 

Closing Thoughts 

One of the best ways to embrace your femininity is to treat your body with understanding and kindness during all phases of your cycle. So even though mittelschmerz may not give you all the glowy goddess vibes you expect during ovulation, see it as a chance to listen to your body. Learning why you feel the way you do during each phase of your menstrual cycle is incredibly empowering. 

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