Mittelschmerz

From: cathy:- (anonymous@medispecialty.com)
Sat Oct 20 23:34:44 2001


At Sat, 20 Oct 2001, Nancy wrote: >
>Now I have a request for you - educate me on "mittelschmerz". I've
>never heard the term before, and curiosity killed the cat ;)
>

Oooo, I get to be pedantic, which I like even better than venting! :-) Mittelschmerz is a German word, literally "middle pain" and it refers to pain on ovulation that approx 20% of women experience. There are 2 theories on why it hurts. Theory #1 is that when the ovary pops out the egg it breaks a few blood vessels on the way out, and there are a lot of hormones there, too, and that the resulting fluid is irritating to the peritonium. Theory #2 is that the blood/fluid makes the ovary sticky, and it sticks to the abdominal wall and this causes pain. Hmmmm... Do either of those explanations sound slightly familiar to everyone around here???

I had mittelschmerz for the first time as an 18-yr-old, and for the next 8-1/2 years it was a very minor thing, really a curiosity more than anything else. I have always been educated about cervical mucus signs of ovulation, and I would notice that most months it was one of those things where if I turned or moved in just the right way I would get a little pinch, and I would think about the other signs I was seeing and say, "Aha! I'm ovulating!"

At 27 I went on the pill, then 3 years later went off and got pregnant right away. I didn't ovulate again until my son was a year old (i.e. one year after my c-section, the only surgery I've ever had). What I noticed is that the pain was a lot sharper and more intense and would go on for about 12 hours. If I held totally still I could get the pain to almost go away. Sharp movements were unbearable, so I basically looked like Quasimodo a lot for 12 hours each month. My post-operative c-section experience was incredibly traumatic, and by this point in my life my only really important goal was to have nothing whatsoever to do with any medical or nursing personnel ever again. I did some research at the library, and on the internet, and got an excellent book on natural family planning, and all of this research convinced me that mittelschmerz, even the real painful kind, was an utterly innocuous thing. Also in the previous decade I had mentioned it on several occasions to doctors and also got the same message, that this was merely a curiosity.

So now I've been ovulating approx 5 years out of the last 7-1/2. (I had another baby in between -- a grueling 53-hour non-progressing back labor that ended in a triumphant VBAC. And now I find that adhesions can cause babies to be "sunny-side up" like my daughter was. Babies are supposed to be head down facing your back when you are laboring, and if they are facing towards your front the machanics of contractions don't work as well to dialate the cervix. The way that babies get into the ideal position is that the uterus has a certain shape and that is the least-crowded position to be in. If adhesions change the shape of the uterus, babies get into wrong positions...)

Each month that I've ovulated I've been in quite a lot of pain, but have never sought treatment. Until last month when I chose mittelschmerz as a reference point to describe the abdominal pain that I have been having. The pain is in the same spot as the mittelschmerz is, and like the mittelschmerz it is a sharp pulling pain. The family practitioner immediately thought that my description sounded like adhesions, and that adhesions are terribly painful (hey -- I figure I'm doing pretty good so far, given other people's experiences with doctors!) And then she dropped the little bombshell and said that the bleeding into the abdomen with the mittelschmerz can actually CAUSE adhesions. As opposed to being some totally innocuous curiosity that happens to have some symptoms similar to adhesions...

ok, I'll stop being pedantic now!

cathy :-)


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