Mittelschmerz syndrome: symptoms, causes and treatment

Mittelschmerz syndrome is associated with pain during the menstrual cycle; let's see how it is.

It is estimated that 20% of women suffer from ovulation-related discomfort in the middle of the menstrual cycle. The pain is sharp, but uncomfortable, accompanied by expulsion of blood and slowing of the bowels.

This problem is called Mittelschmerz syndrome syndrome and, although in most cases it usually lasts less than two days and is not dangerous, it may indicate that something is wrong with the ovaries.

Below we will delve into this syndrome, what are its main symptoms, what causes it, treatment, prevention and when to worry.

What is Mittelschmerz syndrome?

Mittelschmerz syndrome, also called intermenstrual pain, is a unilateral lower abdominal pain associated with ovulation. The word "Mittelschmerz" comes from German and means "pain in the middle", referring to the fact that it occurs in the middle of menstrual periods, about two weeks after the previous one and two weeks before the next one..

Gynecologists believe 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 in the middle of 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 indicate a hormonal, infectious or abdominal problem.

Symptoms

Mittelschmerz syndrome usually manifests itself in the form of abdominal discomfort that can last from minutes to hours. syndrome usually manifests itself in the form of abdominal discomfort that can last from minutes to hours, usually 6 to 8 hours, although in some cases it can last one or two days.It is not usually severe and does not involve severe pain. It is not usually severe and does not involve severe pain, although it is uncomfortable. A woman may suspect 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 and is dull and cramp-like. It may appear sharp and sudden, and may be accompanied by light vaginal bleeding and nausea.

The pain appears on the side of the ovary that is expelling the egg during that particular menstrual cycle. during that particular menstrual cycle, and may change sides every month or there may be several months in a row when 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 these 14 days that a series of hormonal changes occur. a series of hormonal changes 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, producing pain.

When the ovary is stimulated, its follicles swell, preparing to release the egg inside, a phenomenon that can cause some discomfort. Only one of these follicles, the one we could call the dominant one, will eventually release its egg and deposit 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 fluid can slow down bowel activity, causing gas retention and abdominal discomfort.

As we said, Mittelschmerz syndrome occurs in the middle of the menstrual cycle, which means that any pain occurring at any other time can cause abdominal discomfort, any pain that occurs at another time in the cycle cannot be considered intermenstrual pain..

This discomfort may be normal menstrual pain, i.e. dysmenorrhea, or it may be caused by other abdominal or pelvic problems not associated with the cycle, such as infection, indigestion or drug intoxication. In all these cases it is preferable to consult a gynecologist.

Treatment

Mittelschmerz syndrome has a relatively short duration. In many cases it can last at most about 8 hours, although its discomfort can hinder the day to day life of the affected woman. Fortunately, there are several inexpensive, effective home remedies to reduce the pain of this intermenstrual syndrome.

One of the most common remedies is to apply heat to the abdomen, either by using a wet bandage or by applying heat to the abdomen.One of the most common remedies is to apply heat to the abdomen, either by using a bandage soaked in hot water or a heating pad. Another, also at home, is to exert gentle pressure or massage the abdomen, relieving bloating caused by the accumulation of gases produced by the slowing of intestinal activity. Drinking plenty of water is recommended.

The other more effective and quicker way is the use of drugs. On the one hand we have the use of Anti-Inflammatory drugs, such as ibuprofen or naproxen sodium, which can reduce pain although they should be taken on a full stomach. On the other hand we have the consumption of tablets for the expulsion of gas containing simethicone and, also, the use of infusions that help to evacuate flatulence, reducing intestinal pain by making the intestines less distended.

Prevention

Normal menstruation is neither a pathology nor a problem to be treated. It is a natural part of life for any woman with healthy ovaries and associated structures. Before pathologizing and eradicating the normal discomforts associated with this process it is preferable to learn strategies to cope with and manage the occasional pains of this process. of this process. It is not healthy to take medication every month if the pain is relatively mild and you can continue to live a normal life.

However, any woman is free to decide whether she prefers to suffer briefly from the symptoms of Mittelschmerz syndrome or to avoid them, especially if they are very intense and prevent her from living a normal life. The main preventive options for Mittelschmerz syndrome involve the use of hormonal contraceptives, contraceptive patches and rings.. These treatments suppress ovulation and, with it, the irritation and pain associated with follicle rupture.

These measures should be recommended and monitored by a gynecologist since, like any other treatment, they involve side effects. It should be assessed whether the advantages of no longer suffering from Mittelschmerz syndrome outweigh the possible disadvantages associated with the mechanism of action or hormonal alterations of contraceptive drugs and interventions. Any decision assessed by the physician should be made with the priority objective of ensuring the well-being and good health of the person affected by the syndrome.

When to be concerned?

As mentioned above, Mittelschmerz syndrome is a relatively common and mild problem. However, if the discomfort is very significant and occurs very frequently with each menstrual cycle, it may be an indication that something is wrong. Sometimes it may indicate that the ovaries have a disease or that there is an infection in the pelvic floor.. Among the symptoms that can alert us that something is wrong we have:

• High fever
• Pain that is not relieved by heat, massage or drugs.
• Pelvic pain that lasts for more than two or three days
• Heavy bleeding during ovulation
• Vaginal discharge and pelvic pain together
• Increasing pain
• Abdominal pain and pain in one or both shoulder blades
• Vomiting blood
• Bloody stools
• Dizziness
• Painful urination
• Difficulty breathing
• Bloating or abdominal distention

If one or more of these symptoms occur, you should see your health care provider urgently.. The symptoms presented here are not due to a normal Mittelschmerz syndrome, but to a much more aggravated Mittelschmerz syndrome accompanied by other medical problems. Particularly serious are bloody stools and vomiting, as they may indicate internal bleeding.

Literature references:

• Stone C, et al (2011). Current Diagnosis & Treatment Emergency Medicine. 7th ed. New York, N.Y.: The McGraw-Hill Company.
• Won HA, et al (2010). Optimal management of chronic cyclic pelvic pain: An evidence-based and pragmatic approach. International Journal of Women's Health. 2:263.