Pain Down There

Natalie Nodecker

Mittelschmerz, menstrual cramps, and vulvodynia, just to name a few common aches and pains, plague the most sensitive female parts. But what exactly are they, and why won't they leave us the heck alone?

Mittelschmerz
It may sound like a type of German cookie, but it's actually a pain in the side. When a woman ovulates, about two weeks before menstruation, she may feel a slight pain on one side of her lower abdomen. Usually lasting a few hours, this pain, known as Mittelschmerz, is quite common. For most women, the pain is not severe enough to require treatment. It's simply a reminder that ovulation is taking place.

According to Vivien Hanson, M.D., clinical investigator at the University of Washington School of Medicine, the pain probably originates in the spot where the egg breaks out of the ovary as it begins its trip down the fallopian tube. The pain is irregular, meaning it may not show up one month, it may happen on the same side of the abdomen every month, or it can alternate sides. If the pain is severe, an over-the-counter anti-inflammatory such as ibuprofen should take care of the pain, says Hanson. The use of oral contraceptives or the Depo-Provera shot may also help solve the problem by suppressing ovulation.

Menstrual Cramps
Two weeks later, there's a different pain to contend with. Menstrual cramps are caused by the hyperactivity of the pelvic muscles and organs, particularly the uterus, says Howard Glazer, M.D., a clinical associate professor of psychology in psychiatry and in obstetrics and gynecology at Cornell University Medical College and an associate attending psychologist at New York Presbyterian Hospital. Like Mittelschmerz, the discomfort of cramps (which ranges from dull to severe) can be eliminated, or treated by using oral contraceptives or the Depo-Provera shot or by taking pain relievers such as ibuprofen and Naprosyn.

Lifestyle changes may reduce the incidence and severity of cramps. These include

  • practicing yoga
  • adapting stress reduction techniques
  • getting regular exercise
  • making dietary changes such as reducing or eliminating sugar, salt, fatty acid, alcohol and caffeine
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