ARTICLES

MITTELSCHMERZ: PAIN DURING OVULATION

A 27 year old woman came to me complaining of pain in the right lower area of the abdomen. She said that this pain had been recurring since the last 3-4 months. It would come in spasms and then disappear after few days. On examination I tried to rule out whether this was appendicitis as the pain was in the same area. Also I wanted to make sure that there was no kidney stone. As I found nothing on examination I asked her to do a sonography and a urine routine. Both these tests were normal and as there was no fever or any other symptom to indicate appendicitis I ruled out that out.
Finally I asked her about her periods and whether there was any relation between the pain and her menstrual cycle. I asked her to observe this and she told me that she got pain about 15 days after her period had ended. From the above case history I deduced that this woman was suffering from nothing more than OVULATION PAIN OR MITTELSCHMERZ.

WHAT IS MITTELSCHMERZ?

This peculiar sounding medical term is derived from a German word meaning "middle pain". Mittelschmerz is pain during ovulation, which a woman experiences midway through her menstrual cycle, about 14 days before the onset of her next period. Though this may sound unusual ovulation pain is quite common and is experienced by many woman at some point during their reproductive years. However the pain is normally bearable and ceases after some time therefore it is not of any significance. Most women hardly notice it. But there are those who get severe pain nearly every single cycle and some may even bleed a little during ovulation.

WHAT CAUSES THIS PROBLEM?

There are a few theories on why this pain occurs during ovulation. When you ovulate the follicle produced enlarges and stretches the lining of the ovary. This may cause pain. Also another theory is that when the follicle ruptures it may release a little fluid or blood. This fluid or blood can irritate the lining of the abdomen producing pain.

WHAT ARE THE SIGNS AND SYMPTOMS OF MITTELSCHMERZ?

The main symptom of this problem is pain during ovulation. The pain may be of different types. It could be just a dull ache or severe cramping pain. The pain may remain for just a few minutes in the day or for a few days.
Also the pain is always present on the side that you are ovulating. For example if your right ovary is producing the egg, which ruptures and releases the egg then the pain will be on the right side. Some women experience pain on alternating sides while others may have pain on the same side for months.
There may be slight bleeding from the vagina during ovulation due to the sudden drop in oestrogen levels but this is not common.

WHAT IS THE TREATMENT FOR MITTELSCHMERZ?

It is very important to first investigate all other medical possibility before coming to a diagnosis of Mittelschmerz or ovulation pain. Normally this problem does not require any treatment because the woman only experiences a mild discomfort. However if you are experiencing pain regularly in the middle of your menstrual cycle then you need the correct Homoeopathy treatment.

A complete case history must be taken with details about the constitution and symptoms of the patient. Certain tests like a sonography should be done if possible. The remedy should be prescribed on the totality of the patient's symptoms. However there are a few remedies, which will help ease the pain and give the patient quick relief. I have given a few examples below.

AMBRA GRISEA

This is a very handy remedy in treating cases of ovulation pain. Ambra grisea woman will complaint of stitching pain in the ovarian region. This pain is worse by applying pressure. There may also be discharge of blood in between the periods, which is aggravated by the slightest pressure like passing a hard stool, or walking extra.
Ambra Grisea is a good remedy for itching of the vulva and vagina. There is soreness and swelling of the area.

Give Ambra Grisea 200, 5 pills 4 times a day till the ovulation pain and bleeding ceases completely.

CIMICIFUGA

The case of the 27 year old woman I mentioned above received this medicine. She described her pain as a shooting pain going upwards and down the thighs. Sometimes the pain would travel from one hip to the other. She also had problems during her periods. There is normally intense pain especially when the flow is more. In cimicifuga more the flow more the pain.
All the symptoms seemed to be worse on the left side. Cimicifuga is a very useful remedy for threatened abortion and false labor pains.

I gave her Cimicifuga 200, 5 pills 4 times a day and not only her ovulation pain but also her period pain got relieved.

CAULOPHYLLUM

This is one of the acute remedies used in relieving the pain of ovulation. It is given as a specific were the pain comes in spasms and is unbearable. The patient feels better by applying some warm application or hot pad.

Caulophyllum 200, 5 pills in frequent doses till the pain ceases.