Mittelschmerz Syndrome: Symptoms, Causes And Treatment
It is estimated that 20% of women suffer from discomfort associated with ovulation in the middle of the menstrual cycle. The pain is sharp, but annoying, accompanied by expulsion of blood and slowing of the intestines.
This problem is called Mittelschmerz syndrome and, although in most cases it usually lasts less than two days and is not dangerous, it can be an indication that something is wrong with the ovaries.
Below we will delve into this syndrome, what its main symptoms are, what causes it, treatment, prevention and when to worry.
Mittelschmerz syndrome, also called intermenstrual pain, is unilateral pain in the lower abdomen associated with ovulation. The word “Mittelschmerz” comes from German and means “pain in the middle”, referring to the fact that occurs in the middle of menstrual periods, about two weeks after the previous one and two weeks before the next one
Gynecologists consider that this syndrome occurs in 20% of women and usually manifests itself with pelvic pain and cramps that occur during ovulation. These discomforts are directly associated with the ovary releasing one of its eggs, a phenomenon that occurs approximately halfway through the menstrual cycle.
Although in most cases the pain is not severe enough to require medical help, if it occurs every month and is very intense it may be indicative of a hormonal, infectious or abdominal problem.
Symptoms
Typically, Mittelschmerz syndrome It manifests itself in the form of abdominal discomfort that can last from minutes to hours, with 6 to 8 hours being normal, although in some cases it can last one or two days. It is not usually serious nor does it involve excessively intense pain, although it is annoying. A woman may suspect that she has this syndrome if she develops abdominal pain about 14 days after the start of her menstrual cycle.
The pain usually occurs on one side of the lower abdomen, being dull and cramp-like. It can appear acutely and suddenly, in addition to being accompanied by mild vaginal bleeding and nausea.
Pain appears on the side of the ovary that is releasing the egg during that specific menstrual cycle, and you may change sides every month or there may be several months in a row in which the painful side is the same.
Causes
Although the exact causes of Mittelschmerz syndrome are not known for sure, it is clear that it is related to ovulation. Normally, ovulation occurs two weeks after the first day of menstruation.
It is during those 14 days in which a series of changes at the hormonal level that stimulate the ovary to release its eggs Each of these eggs develops within its own compartment, called a follicle. As the follicle grows, it stretches the surface of the ovary, causing pain.
When the ovary is stimulated, its follicles swell, preparing to release the egg they harbor inside, a phenomenon which can cause certain discomfort. Only one of these follicles, the one we could call the dominant one, will end up releasing her egg and depositing it in the fallopian tube
It is in this process that some bleeding may occur because the ovarian follicle ruptures, spilling some blood and fluid into the pelvis. These fluids irritate the lining of the abdomen and pelvis, areas that are sensitive to pain. In addition, this liquid can slow down the activity of the intestines, causing gas to be retained and abdominal discomfort to occur.
As we said, Mittelschmerz syndrome occurs in the middle of the menstrual cycle, therefore, Any pain that occurs at another time in the cycle cannot be considered intermenstrual pain
These discomforts may be normal menstrual pain, that is, dysmenorrhea, or it may be caused by other abdominal or pelvic problems not associated with the cycle, such as an infection, indigestion or drug poisoning. In all these cases it is best to consult a gynecologist.
Mittelschmerz syndrome has a relatively short duration. In many cases it can last a maximum of 8 hours, although its discomfort can hinder the daily life of the affected woman. Fortunately, there are several economical, homemade and effective ways to reduce the pain of this intermenstrual syndrome.
One of the most common remedies is to apply heat to the abdomen, either using a bandage soaked in hot water or a heating pad. Another, also from around the house, is to apply gentle pressure or a massage on the abdomen, relieving the distention caused by the accumulation of gases caused by the slowing down of intestinal activity. It is recommended to drink plenty of water.
The other most effective and fastest way is the use of drugs. On the one hand, we have the use of anti-inflammatories, such as ibuprofen or naproxen sodium, which can reduce pain although they must be consumed on a full stomach. On the other hand we have the consumption of pills for the expulsion of gas that contain simethicone and, also, the use of infusions that help evacuate flatulence, reducing intestinal pain by making the intestines not so distended.
Prevention
Normal menstruation is not a pathology nor a problem that must be treated. It is a natural part of life for any woman who has healthy ovaries and associated structures. Before pathologizing and eradicating the normal discomforts associated with this process It is preferable to learn strategies to be able to cope with them and manage occasional pain of this process. It is not healthy to take medication every month if the pain is relatively mild and you can continue leading a normal life.
However, any woman is free to decide if she prefers to briefly suffer the symptoms of this syndrome or prefers to avoid them, especially if they are very intense and prevent her from leading a normal life. The main preventive options for Mittelschmerz syndrome involve the use of hormonal contraceptives, patches and contraceptive rings These treatments suppress ovulation and, with it, the irritation and pain associated with follicle rupture.
These measures must be recommended and monitored by a gynecologist since, like any other treatment, they involve side effects. It must be assessed whether the advantages of stopping suffering from Mittelschmerz syndrome outweigh the possible disadvantages associated with the mechanism of action or hormonal alterations of contraceptive drugs and interventions. Any decision evaluated by the doctor must be made with the primary objective of guaranteeing the well-being and good health of the person affected by the syndrome.
When to worry?
As we mentioned, Mittelschmerz syndrome is a relatively common and mild problem. However, if the discomfort is very significant and occurs very frequently in each menstrual cycle, it may be an indication that something is not right. Sometimes it can indicate that the ovaries have a disease or that there is an infection in the pelvic floor Among the symptoms that can warn us that something is not right we have:
If one or more of these symptoms occur, you should see a doctor urgently The symptoms presented here are not due to a normal Mittelschmerz syndrome, but to a much more aggravated one accompanied by other medical problems. Bloody stools and vomiting are especially serious, since they may be indicative of internal bleeding.
