Midcycle menstrual cramps: What causes this?

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Midcycle menstrual cramps: What causes this?

Question

Sometimes I get menstrual-like cramps and breast tenderness in the middle of my cycle. What causes this?

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Answer

The midcycle menstrual cramps you describe may be a common, usually harmless condition called mittelschmerz — pain during ovulation.

Prior to ovulation, the ovary is stretched by the developing follicle. When ovulation occurs, the ovary releases a small amount of fluid — along with the egg — into the abdomen. The fallopian tube takes up the egg but not the fluid. This fluid in the abdomen may irritate the lining of the pelvis (peritoneum) and cause abdominal discomfort — similar to menstrual cramps — in some women. The stretching of the ovary before ovulation may also cause discomfort.

The breast tenderness you describe is probably due to the rise in estrogen, which occurs right before ovulation.

A doctor may diagnose mittelschmerz based on the timing and location of the pain. Mittelschmerz usually doesn't require medical attention and isn't caused by a serious underlying condition. Treatment may include over-the-counter pain medications.

If midcycle pain is severe or accompanied by nausea or fever or if it lasts more than two days, consult your doctor.

Last Updated: 05/25/2006
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