Charting and natural remedies for Mittelschmerz

posted on August 22, 2015 by Emily Kennedy Emily Kennedy

Mittelschmerz is German for “middle pain”:  it’s a telltale sign that your body is in ovulation mode. It happens in twenty percent of women and is literally pain that results from a mature follicle pressing against the wall of one of your ovaries, trying to break through and release an egg.

Ovulation is not an instantaneous process (check out here an amazing video about it). It may take a few minutes for rupture to actually occur, and this after who knows how long a time spent pressing against your ovarian wall. Mittleschmerz that happens before ovulation may be felt on both sides or on one side.

Mittelschmerz may also happen just as ovulation occurs, as fluid and blood may be released from the follicle, causing irritation in the abdominal cavity. It sometimes continues after ovulation.

Ovulation and mittleschmerz Natural Womanhood

Oocyte in follicle / Credit: Ivor Mason, KCL. Wellcome Images / Creative Common License http://bit.ly/1hPdc8i

To me, that’s good to know, good because ovulation is a good thing, ovulation is a sign of health and I want to know that I am healthy. Don’t you?

But of course, pain is not so good. Is it a sign that something is wrong? Yes, usually. But in this case, I’m not so sure.

Women who go to mainstream doctors complaining of pain that occurs every month may be prescribed birth control to suppress ovulation. Given that ovulation is a normal, healthy thing for a woman, arguably even an essential part of what makes us a woman, you gotta wonder if suppressing it is the right thing to do. Besides, hormonal birth control may affect your body in other negative ways.

First, it’s important to determine that the pain is actually due to the egg-releasing process, and not a symptom of a disorder. To do so, you need to figure out the timing of the pain and to see if there is a pattern.

Women do not ovulate at the same time every month; they may have long cycles or short cycles, and we know that only a minority of women actually ovulate 14 days after the first day of their periods. What is more consistent, however, is that women’s periods normally start 14 days after ovulation. The pain can be dull or sharp, usually short lived, and not accompanied by fever. If the pain persists, or if you have doubt, consult a medical professional.

Put a symbol on your calendar indicating when the pain occurred and on what side. If you want to be the best expert on YOUR BODY, do what one client of mine does and put abbreviations like “RAP” or “LAP” for right ab pain or left ab pain. Or make up your own appropriate symbols based on where the pain occurred, ie. low back, etc.

After charting your discomfort, mark when your period starts and stops. Then, after a few months, you’ll be able to see if there is a relationship between your body’s efforts to ovulate and your discomfort.

Of course if you’re charting with a formal method of fertility awareness, you are trained to recognize exactly the timing of your ovulation, and you will have no problem connecting the cramp and your ovulation. You can put a marker on your chart, whether it’s a phone app or a paper chart. You can also know if it’s something else if the cramp does not coincide with the ovulation process. Women may find that their discomfort is not ovulatory but premenstrual. A pelvic exam may reveal yet other disorders such as endometriosis or abnormal cysts. In these cases the pain is not a sign of a healthy process, and there are treatments that get to the root cause of these issues.

You may never know the cause if you don’t learn to chart your cycles….

Okay, so let’s say you’ve documented your suspected Mittelschmerz pain for a few months. You know it is always roughly the same distance from the start of your period and you want to do something about it, not just suppress it.

More good news. Pain, especially temporary pain, is easy to manage with salicyclates (aspirin) or ibuprofen. Or, if you’re like me, you’d rather take a hot bath, increase blood flow and get your body to relax and do its thing.

A hot bath can be beneficial, preferably with some Epsom salts for the muscle relaxing effect of magnesium sulfate directly absorbed through the skin, thus bypassing any gut issues.

Other options include using a heating pad, or one of those microwaveable hot-cold bags filled with beans, would help increase blood flow, too.

Gentle yoga with deep breathing into the abdominal cavity, or massage that is specifically designed for your reproductive organs can also work.

Keep in mind that it is a natural process causing this pain, and it is useful for informing you of peak fertility. Go with it. Be kinder to yourself during this time. Take it easy. Maybe make yourself a ginger turmeric tea (see recipe below). That stuff always helps me feel less achy after a good workout.

Essential oils that promote relaxation and tension may also be helpful, chamomile and lavender being the go-to flavors. Add a few drops to your bath, hot compress or massage oil.

The take-home message is that you’ve identified something that proves you can ovulate—which is not something to take for granted—and it will pass! Yes, it may come back next month, but that’s not entirely a bad thing, especially if you share it with partner and discuss implications in terms of upcoming PMS-ish symptoms and, of course, potential for baby making.

Remember that documenting when will tell you what exactly you are dealing with.

Here’s that turmeric tea I was talking about before. Takes two seconds to make and I love the hit of ginger! Highly anti-inflammatory. Tons written on turmeric to be found if you Google it (even studies pitting it against ibuprofen. Guess who won?)

Pain-Mellowing Yellow Tea

½ teaspoon turmeric powder – find it in the spice aisle, no need to go to a health food store
1 tablespoon goat’s milk powder, or ½ cup of the milk that agrees with you most
½ cup of hot water (if using goat’s milk powder)
a pinch of ground ginger – again, in your tantalizing spice aisle

Put everything in your favorite mug, stir, inhale the steamy goodness…and enjoy, maybe in a hot bath!

Be well,

Emily

Posted by Emily Kennedy Emily Kennedy
Emily Kennedy, MSc is a nutritionist health coach and fertility educator in Raleigh, NC. She loves all things natural and evidence-based, especially if it leads to something good to eat.

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