by Author Name Withheld 87

Created on: April 01, 2009   Last Updated: April 02, 2009

If you've ever experienced a slight cramping or twinge sensation in your lower abdomen, midway through your menstrual cycle, chances are you were experiencing a discomfort associated with ovulation known as mittleschmerz. A German word, literally meaning middle pain, mittleschmerz refers to the cramping or pulling sensations a woman may feel around the time of ovulation.

For a woman, understanding her fertility, and the signs and signals that come and go with her monthly menstrual cycle, can make her body seem a somewhat mysterious place. In order for ovulation, menstruation, and, if desired, conception to take place, a delicate sequence of hormonal and physical changes must coordinate and work together in an elaborate dance that is much more miracle than mystery.

A woman's main reproductive organs consist of the uterus, fallopian tubes and ovaries. In the pre-ovulatory phase of a woman's cycle, that is, from the onset of menstruation to the day of ovulation, a sequence of hormonal changes causes the lining of the uterus to thicken in preparation to receive a fertilized egg and the development follicles in her ovaries.

Follicle is the term given to the fluid filled structure on the surface of the ovaries that contain maturing eggs. In any given cycle multiple follicles will develop on one or both ovaries although generally only one will fully mature and be released by bursting through the ovarian wall at the time of ovulation.

Mittleschmerz, or ovulation pain, has four primary causes:

1) Pain can occur at the exact moment of ovulation when the follicle ruptures and the egg is release. It is usually sharp, localized, occurs on only one side and lasts for a few seconds to a minute.

2) Some discomfort may occur from blood and fluid that is released by the follicle at the time of ovulation that irritates the pelvic lining. This pain is generally a dull cramping sensation that can last for several hours to a day. It can be felt on one or both sides.

3) When ovulation occurs, the finger-like ends of the fallopian tube contracts around the ovary, essentially grabbing on to it, in order to receive the egg. This contraction and subsequent stretching of the ligaments around the uterus can cause a general cramping feeling that can last several hours to a day.

4) Each month as the follicles develop before ovulation, they swell on the surface of the ovaries. This swelling can cause a general achy feeling in the lower abdomen that is usually felt on both sides and can last several

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