Pain in your lower abdomen may be a sign of mittelschmerz.

If you have regular pain in your lower abdomen during the middle of your menstrual cycle, you may be experiencing mittelschmerz – a condition affecting roughly a quarter of all women.

“Mittelschmerz is a German word meaning ‘middle pain’ and is used as a medical term for pelvic and abdominal pain occurring around the time of ovulation, which usually occurs in the middle of the menstrual cycle,” explained Dr. Robert L. Barbieri, Chief of Obstetrics, Gynecology and Reproductive Biology at Brigham and Women’s Hospital. Hmm, who knew?

About 25 percent of women experience mittelschmerz. Some women experience ovulation pain with every cycle, but most notice the symptom in occasional cycles.

“For most women, the symptom of mittelschmerz lasts for hours, but some women experience symptoms for up to two or three days, Dr. Barbieri said.

Mittleschmerz pain can be:

  • located on one side of your lower abdomen
  • dull and similar to cramps
  • sudden and sharp
  • accompanied by mild discharge or vaginal bleeding
  • in rarer cases, severe

“If the pain lasts longer than a two or three days, an evaluation by a gynecologist is warranted,” explained Dr. Barbieri. Most likely your gynecologist will start with a thorough history and physical examination. A pelvic sonogram may also be obtained to assess for the presence of ovarian cysts or uterine abnormalities such as fibroids.

Learn more about evaluation and treatment of gynecologic conditions, including pelvic pain, ovarian cysts, uterine fibroids, and endometriosis at the Brigham and Women’s Hospital Department of Obstetrics, Gynecology and Reproductive Biology.


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