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20.07.2010 Social & Status

Dealing With Painful Ovulation

20.07.2010 LISTEN
By Daily Guide

NO DOUBT women are all too familiar with  pre-menstrual syndrome (PMS), cramping, headaches, bloating, constipation or diarrhea that accompanies their period every month.

What you don't hear about often but which some women also experience is mid-cycle (ovulation) pain, usually beginning in their middle to late teens although it can start much later.

Mid-cycle pain also called mittelschmerz, affects about twenty percent of women and ranges from mild to severe. Relief is usually available but first, it is crucial to see your gynecologist to rule out other possible causes.

Painful ovulation, when severe, is referred to as mittelschmerz, a German word that means, "middle pain."

Most women who experience painful ovulation usually report a nagging pain that begins as a sharp twinge and diminishes into a dull ache for the next day or so.

But for other women, the pain can be severe enough to be disabling and can even be confused with appendicitis.

While the discomfort can occur on either side of the abdomen, it is more commonly experienced on the right. Mittelschmerz can occur during intercourse or it can be aggravated by intercourse, working out or other physical activity.

In addition to pain, some women also experience gastrointestinal symptoms and increased frequency of urination.

It is not associated with endometriosis, in which the pain occurs at the onset of the menstrual period rather than in mid-cycle. It may occur every month, but more typically occurs every third to fourth cycle.

Ovulation occurs at the mid-point in the menstrual cycle. Usually from day 14 and refers to the release of an egg from a woman's ovary into her fallopian tube. Over the following three days, the egg travels down the tube to the uterus.

If fertilization doesn't occur during this time, the egg dies and then disintegrates.

With the disintegration of the egg, the lining of the uterus also begins to degenerate, producing the bleeding that is characteristic of each menstrual cycle.

What causes ovulation pain?
According to Dr John Mensah-Annan, a gynecologist, mittelschmerz is believed to be caused by a small leakage of blood from the ovary that occurs at the time of ovulation.

This blood, which is later re-absorbed, is thought to cause an irritation of the abdominal wall.

The degree of pain you feel depends on your individual pain threshold and the volume of blood that is released, among other factors. He says the amount of space that exists between a woman's ovary and her abdominal wall can also affect the severity of irritation.

“The best way to diagnose your discomfort is to keep a chart or diary showing when the pain occurs in relation to the start of your menstrual periods.

Your doctor/gynecologist will use this diary in conjunction with your medical history, a physical exam, and perhaps some other medical tests to rule out other possible causes of your pain before making a definite diagnosis,” Dr. Mensah-Annan noted.

He said occasionally a patient would require laparoscopy, in which a laparoscope--a narrow tube with a fiber-optic light on the end--is introduced through a small incision below the navel and into the abdominal wall. This procedure allows for a direct view of the pelvic organs.

Because ovulation pain can provoke anxiety and if severe enough, confused with appendicitis, he cautions women to be careful not to "get pushed into undergoing unnecessary gynecologic surgery."

How to relieve the pain
To relieve symptoms of ovulation pain women may rest until they feel better, drink plenty of fluids and take their temperature every four hours.

Over-the-counter pain relievers, such as paracetamol or aspirin will usually provide relief, if not something stronger may be prescribed.

“If the pain is disabling and you do not wish to become pregnant right away, you may want to ask your gynecologist to prescribe oral contraceptives. They will inhibit ovulation, thereby solving the problem,” he notes.

However, if the pain does not go away within two or three days, or if women have vaginal bleeding or discharge, they are advised to see a doctor immediately.  

By Nancy Arthur

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