MITTELSCHMERZ: PAIN DURING OVULATION
A 27 year old woman came to me complaining
of pain in the right lower area of the abdomen. She said
that this pain had been recurring since the last 3-4 months.
It would come in spasms and then disappear after few days.
On examination I tried to rule out whether this was appendicitis
as the pain was in the same area. Also I wanted to make
sure that there was no kidney stone. As I found nothing
on examination I asked her to do a sonography and a urine
routine. Both these tests were normal and as there was
no fever or any other symptom to indicate appendicitis
I ruled out that out.
Finally I asked her about her periods and whether there
was any relation between the pain and her menstrual cycle.
I asked her to observe this and she told me that she got
pain about 15 days after her period had ended. From the
above case history I deduced that this woman was suffering
from nothing more than OVULATION PAIN OR MITTELSCHMERZ.
WHAT IS MITTELSCHMERZ?
This peculiar sounding medical term is derived
from a German word meaning "middle pain". Mittelschmerz
is pain during ovulation, which a woman experiences midway
through her menstrual cycle, about 14 days before the
onset of her next period. Though this may sound unusual
ovulation pain is quite common and is experienced by many
woman at some point during their reproductive years. However
the pain is normally bearable and ceases after some time
therefore it is not of any significance. Most women hardly
notice it. But there are those who get severe pain nearly
every single cycle and some may even bleed a little during
ovulation.
WHAT CAUSES THIS PROBLEM?
There are a few theories on why this pain
occurs during ovulation. When you ovulate the follicle
produced enlarges and stretches the lining of the ovary.
This may cause pain. Also another theory is that when
the follicle ruptures it may release a little fluid or
blood. This fluid or blood can irritate the lining of
the abdomen producing pain.
WHAT ARE THE SIGNS AND SYMPTOMS OF MITTELSCHMERZ?
The main symptom of this problem is pain
during ovulation. The pain may be of different types.
It could be just a dull ache or severe cramping pain.
The pain may remain for just a few minutes in the day
or for a few days.
Also the pain is always present on the side that you are
ovulating. For example if your right ovary is producing
the egg, which ruptures and releases the egg then the
pain will be on the right side. Some women experience
pain on alternating sides while others may have pain on
the same side for months.
There may be slight bleeding from the vagina during ovulation
due to the sudden drop in oestrogen levels but this is
not common.
WHAT IS THE TREATMENT FOR MITTELSCHMERZ?
It is very important to first investigate
all other medical possibility before coming to a diagnosis
of Mittelschmerz or ovulation pain. Normally this problem
does not require any treatment because the woman only
experiences a mild discomfort. However if you are experiencing
pain regularly in the middle of your menstrual cycle then
you need the correct Homoeopathy treatment.
A complete case history must be taken with
details about the constitution and symptoms of the patient.
Certain tests like a sonography should be done if possible.
The remedy should be prescribed on the totality of the
patient's symptoms. However there are a few remedies,
which will help ease the pain and give the patient quick
relief. I have given a few examples below.
AMBRA GRISEA
This is a very handy remedy in treating
cases of ovulation pain. Ambra grisea woman will complaint
of stitching pain in the ovarian region. This pain is
worse by applying pressure. There may also be discharge
of blood in between the periods, which is aggravated by
the slightest pressure like passing a hard stool, or walking
extra.
Ambra Grisea is a good remedy for itching of the vulva
and vagina. There is soreness and swelling of the area.
Give Ambra Grisea 200, 5 pills 4 times a
day till the ovulation pain and bleeding ceases completely.
CIMICIFUGA
The case of the 27 year old woman I mentioned
above received this medicine. She described her pain as
a shooting pain going upwards and down the thighs. Sometimes
the pain would travel from one hip to the other. She also
had problems during her periods. There is normally intense
pain especially when the flow is more. In cimicifuga more
the flow more the pain.
All the symptoms seemed to be worse on the left side.
Cimicifuga is a very useful remedy for threatened abortion
and false labor pains.
I gave her Cimicifuga 200, 5 pills 4 times
a day and not only her ovulation pain but also her period
pain got relieved.
CAULOPHYLLUM
This is one of the acute remedies used in
relieving the pain of ovulation. It is given as a specific
were the pain comes in spasms and is unbearable. The patient
feels better by applying some warm application or hot
pad.
Caulophyllum 200, 5 pills in frequent doses
till the pain ceases.
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