Mittelschmerz: Understanding Ovulation Pain

Mittelschmerz: Understanding Ovulation Pain

 Ovulation pain, also known as mittelschmerz (meaning middle pain in German), is a sensation that occurs during or around the time of ovulation due to the release of an egg from one of the ovaries. This discomfort can last anywhere from a few minutes to 48 hours [1].

 It is experienced by approximately 20% of women and is characterised by pain on one side of the pelvis, typically corresponding to the ovary that is ovulating in that cycle. In this blog post, we will explore the physical and emotional aspects of ovulation pain, debunk some myths, and provide strategies for managing the discomfort. If you have any questions or feedback, don't hesitate to reach out. 

Understanding Ovulation Pain

Contrary to popular belief, it is not always felt precisely in the middle of a 28-day cycle. The pain can vary from a mild ache to severe, debilitating cramps. Some women may not experience any pain at all. [3].

While the exact cause of ovulation pain isn't fully known, it's believed to be triggered by the egg breaking through the ovarian wall. Another hypothesis suggests that the pain is due to the fallopian tubes contracting in response to the released egg. A blood or fluid that's released from the ruptured follicle may also cause irritation to the abdominal lining, resulting in discomfort [2].

Debunking Myths

There are several myths surrounding ovulation pain. Some sources claim that it is a sign of fertility or an indicator of the best time to conceive. However, relying solely on ovulation pain to time intercourse may result in missing the window of opportunity, as the egg only lives for up to 24 hours. It is crucial to consider other signs of ovulation, such as cervical mucus and sexual arousal, to improve chances of conception.

Additionally, ovulation pain should not be dismissed as normal without further investigation. While some pain or discomfort can be expected, severe or prolonged pain may indicate underlying issues, such as ovarian cysts, endometriosis, bacterial infections, or other conditions. Seeking medical advice is essential to rule out any potential complications.

Managing Ovulation Pain

If you experience ovulation pain, there are strategies to manage and reduce discomfort. Physical support, such as pelvic exercises and self-care practices, can improve the pelvic area's health and reduce inflammation. Strengthening ovulation can also help minimise pain.

Emotional well-being plays a significant role in managing ovulation pain. Stress can impact fertility and hormonal balance, intensifying physical symptoms. Creating space in the pelvic area and practising stress-reducing techniques, such as mindfulness or relaxation exercises, can contribute to overall well-being.

CBD & CBG Vaginal Suppositories for Pain 

We’ve all heard of CBD, and the word ‘suppository’ is in most of our vocabularies. But the concept of CBD vaginal suppositories themselves may be an unfamiliar one for ovulation pain. 

What is CBD & CBG?

Cannabidiol (CBD)  and Cannabigerol (CBG) are naturally occurring chemicals in the Cannabis sativa plant, which is more commonly known as the cannabis or hemp plant. CBD  and CBG act on the cannabinoid receptors that are present in the nerve cells in the brain, spinal cord, and parts of the gastrointestinal, reproductive, and urinary tracts. Research also suggests that CBG has potent anti-inflammatory, antibacterial, and neuroprotective effects [4].

Both CBD & CBG work on the body’s naturally occuring endocannabinoid system, a paramount element of the body's central nervous system that allows for homestatic regulator of human physiology [5].

CBD & CBG Benefits During Ovulation

Anti-Inflammatory Properties: Inflammation plays a critical role in period pain, and CBD is known for its anti-inflammatory properties. By interacting with cannabinoid receptors in the body's endocannabinoid system, CBD can reduce the release and effect of pro-inflammatory substances during menstruation. Similarly, CBG has potent anti-inflammatory properties. It can reduce the production of inflammatory markers, which could be beneficial in managing the inflammation-induced pain experienced during periods.

Pain Relief: CBD can interact with various neurotransmitters and modulate the pain perception pathways in the central nervous system. It inhibits the absorption of anandamide, a natural cannabinoid molecule associated with pain regulation. Higher levels of anandamide in the bloodstream can lessen the perception of pain.CBG is known for its analgesic (pain-relieving) effects. It works by interacting with the CB1 and CB2 receptors in the endocannabinoid system. These receptors play a key role in pain regulation, and their activation can help alleviate period pain.

Muscle Relaxation: CBD has been shown to have muscle relaxant properties, which can be beneficial in alleviating the muscle contractions and cramps that occur during menstruation.

Mood Regulation: CBG can aid in regulating mood, acting as an antidepressant and anxiolytic, helping to manage mood swings and anxiety that can often accompany periods [6].

When to Seek Medical Help

While ovulation pain is typically harmless, severe or prolonged pain could signal a more serious condition, like endometriosis or ovarian cysts. If the pain is accompanied by fever, vomiting, heavy bleeding, or difficulty breathing, it's crucial to seek medical attention immediately [7].

Understanding ovulation pain can help women navigate their reproductive health more confidently. It's always recommended to reach out to healthcare professionals for advice or concerns related to reproductive health.

The Evolution of Ovulation Pain

In the past, ovulation pain was often considered normal due to the limited technology available to detect underlying issues. However, advancements in vaginal ultrasound have allowed us to identify small cysts and endometriosis that can contribute to ovulation pain. It is no longer accurate to assume that ovulation pain is normal without further investigation.

The Role of Vaginal Ultrasound

Vaginal ultrasound has revolutionised the detection of gynaecological conditions. Unlike traditional abdominal ultrasound, vaginal ultrasound provides a closer view of the uterus, making it easier to identify cysts and endometriosis. This technology has allowed us to understand the true nature of ovulation pain and its connection to various conditions.

Understanding Endometriosis

Endometriosis is a common cause of ovulation pain. It occurs when the tissue lining the uterus grows outside of it, leading to inflammation, pain, and other complications. While endometriosis may not always be visible on ultrasounds, more advanced techniques such as laparoscopy or deep endo scan can accurately diagnose this condition.

Pelvic Adhesions and Ovulation Pain

Pelvic adhesions, another common cause of ovulation pain, occur when organs or tissues in the pelvic region stick together. This can result from conditions such as endometriosis, previous pelvic infections, or previous surgeries. The adhesions can irritate surrounding structures during ovulation, causing pain.

Importance of Identifying the Cause

Understanding the underlying cause of ovulation pain is crucial for several reasons. Firstly, it allows for early detection and treatment of conditions like endometriosis, which can cause severe pain and fertility issues if left untreated. Secondly, identifying the cause can help determine the most appropriate course of action to improve fertility outcomes.

Conclusion

Understanding ovulation pain, or Middleschmertz, can provide valuable insights into your fertility journey. It is not just a symptom to brush off but an opportunity to improve your reproductive health. By addressing physical and emotional aspects, seeking medical advice when necessary, and exploring strategies to manage pain, you can enhance your fertility awareness and overall well-being.

[1]: "Ovulation Pain: Causes and Treatment", Johns Hopkins Medicine, <https://www.hopkinsmedicine.org/health/conditions-and-diseases/ovulation-pain>

[2]: "Ovulation Pain", Mayo Clinic, <https://www.mayoclinic.org/diseases-conditions/mittelschmerz/symptoms-causes/syc-20375122>

[3]: "Painful Ovulation (Mittelschmerz)", Cleveland Clinic, <https://my.clevelandclinic.org/health/diseases/16536-painful-ovulation-mittelschmerz>

[4]: "Discover CBD for Wellness: Potential Benefits, Uses, and Misconceptions", AIMA, <https://my-aima.com/blogs/news/discover-cbd-for-wellness-benefits-uses-and-misconceptions>

[5]: “How CBD and CBG Work Together to Reduce Pain and Inflammation”, AIMA,<https://my-aima.com/blogs/news/how-cbd-and-cbg-work-together-to-reduce-pain-and-inflammation>

[6] How CBD and CBG Work Together to Reduce Pain and Inflammation”, AIMA, <https://my-aima.com/blogs/news/how-cbd-and-cbg-work-together-to-reduce-pain-and-inflammation>

[7]: "When Should You Worry About Ovulation Pain", Healthline, <https://www.healthline.com/health/pregnancy/ovulation-pain 

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