During a pelvic exam, your doctor inserts two gloved fingers inside your vagina. While simultaneously pressing down on your abdomen, he or she can evaluate your uterus, ovaries and other pelvic organs.
To diagnose mittelschmerz, your doctor will start by asking you questions to get a clear idea of your medical history, especially regarding your menstrual periods. Your doctor may also perform a physical exam, including a pelvic exam, to check for signs of an underlying condition that could be contributing to the pain.
Possible treatments for mittelschmerz include:
- Pain relievers. For the relief of discomfort from mittelschmerz, try an over-the-counter drug such as acetaminophen (Tylenol, others), aspirin, ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve).
- Birth control pills (oral contraceptives). If mittelschmerz causes you a lot of discomfort or occurs monthly, ask your doctor about taking birth control pills. Some types of birth control pills suppress ovulation, which could help ease ovulation pain while you're taking them.
Lifestyle and home remedies
To ease mittelschmerz discomfort that lasts more than a few minutes, try some home remedies. Because heat increases blood flow, relaxes tense muscles and eases cramping, you might want to:
- Soak in a hot bath
- Use a heating pad where the pain is
Preparing for your appointment
In most cases, you won't need to see a doctor for mittelschmerz. However, if your pain is especially troublesome, you may make an appointment to confirm a diagnosis of mittelschmerz or to explore treatment options.
What you can do
You may want to write a list that includes:
- Detailed descriptions of your symptoms
- The dates when your last two menstrual periods began
- Information about medical problems you've had
- Information about the medical problems of your parents or siblings
- All the medications and dietary supplements you take
- Questions to ask the doctor
Preparing a list of questions for your doctor will help you make the most of your time together. For mittelschmerz, some basic questions to ask include:
- What is likely causing my symptoms?
- Are there other possible causes for my symptoms?
- Are my symptoms likely to change over time?
- Do I need tests?
- What treatments or home remedies might help?
- Do you have brochures or other printed materials I can have? What websites do you recommend?
Don't hesitate to ask other questions, as well.
What to expect from your doctor
Your doctor is likely to ask you a number of questions, such as:
- How many days apart are your menstrual periods, and how long do they last?
- How would you describe your symptoms?
- Where is your pain?
- How long have you been experiencing this pain? Is it constant or does it subside after a few minutes or hours?
- On a scale of 1 to 10, how severe is your pain?
- How long before or after your period does the pain occur?
- Do you have other symptoms, such as nausea, vomiting, diarrhea, back pain, dizziness or headache?
Sept. 25, 2020
- Sharp HT. Evaluation and management of ruptured ovarian cyst. https://www.uptodate.com/contents/search. Accessed Sept. 2, 2020.
- Cameron P, et al., eds. Pelvic pain. In: Textbook of Adult Emergency Medicine. 5th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Sept. 2, 2020.
- Won HA, et al. Optimal management of chronic cyclic pelvic pain: An evidence-based and pragmatic approach. International Journal of Women's Health. 2010; doi:10.2147/IJWH.S7991.
- Jameson JL, et al., eds. Disorders of the female reproductive system. In: Harrison's Manual of Medicine. 20th ed. McGraw Hill; 2020. https://accessmedicine.mhmedical.com. Accessed Sept. 2, 2020.
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