Mittelschmerz () is a term for pain due to ovulation. It occurs mid-cycle (between days 7 and 24) and can last minutes to up to several days. The pain affects one side of the lower abdomen and may be dull or sharp in nature. Other symptoms may include spotting. Often it occurs monthly and may alternate sides.
The underlying mechanism is unclear but may involve irritation due to release of blood and fluid from the follicle or high blood levels of luteinizing hormone causing contraction of smooth muscle. Diagnosis involves ruling out other potential causes such as appendicitis, endometriosis, ovarian cysts, ectopic pregnancy, and sexually transmitted infections.
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