Mittelschmerz

BACKGROUND: Tranexamic acid reduces blood loss in patients with bleeding diatheses and is used in a number of gynaecologic and non-gynaecologic conditions. CASE: We discuss the case of a 27-year-old woman with type 1 von Willebrand disease, who presented with a two-year history of severe mittelschmerz secondary to recurrent hemorrhagic cysts. The patient refused oral contraception and reported that traditional analgesia did not significantly alleviate symptoms. We theorized that the underlying von Willebrand disease compounded the degree of hemorrhage into her recurrent cysts...

PURPOSE: To determine if severe periovulatory diarrhea in a woman with Crohn's disease for just one day may be related to increased permeability of the large bowel related to hormonal changes that occur at this time of menstrual cycle. MATERIALS AND METHODS: Dextroamphetamine sulfate was given to a woman whose Crohn's disease was markedly improved by adalimumab but who still had one day of severe diarrhea at mid-cycle. RESULTS: She did not have any diarrhea or frequent defecation for the first two periovulatory times before she achieved pregnancy...

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A sizeable literature corroborates the multiple health benefits of oral contraceptive use. The first estrogen/progestin combination pills were marketed to treat a variety of menstrual disorders. Although currently used oral contraceptives no longer carry FDA-approved labeling for these indications, they remain important therapeutic options for a variety of gynecologic conditions. Well-established gynecologic benefits include a reduction in dysmenorrhea and menorrhagia, iron-deficiency anemia, ectopic pregnancy, and PID...

Many women remain unaware of classic oral contraceptive (OC) noncontraceptive health benefits even as new health advantages emerge from experience and research. An extensive body of evidence has established that OC protect women against dysmenorrhea and menorrhagia, menstrual cycle irregularities, iron deficiency anemia, ectopic pregnancy, pelvic inflammatory disease, ovarian cysts, benign breast disease, endometrial cancer, and ovarian cancer. In addition, the FDA has stated for the first time that an OC-triphasic norgestimate/35 micrograms ethinyl estradiol--is an effective treatment for moderate acne vulgaris...

In a paediatric surgical practice over a 10 year period, 59 children presenting with left sided abdominal pain, acute or chronic, were investigated and followed up to identify the cause. Only two were found to have an identifiable surgically significant cause, one being hydronephrosis and the other being congenital uterine abnormality. Other causes suspected were Mittelschmerz, faecal retention or gastroenteritis, functional, abdominal migraine and allergy. Two boys developed torsion of the testis within 2 years of an episode of left sided abdominal pain...

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Real time ultrasonography was used to examine the ovaries of 50 patients at the calculated time for artificial insemination with donor semen (AID). Forty-two (84%) had one or more follicles greater than 13 mm in diameter. Both ovaries were monitored daily until the main follicle had ruptured (mean number of examinations, 2.4 per patient; range, 1 to 5). Seven women became pregnant (mean follicular diameter, 21.6 mm; range, 18 to 25 mm). The fecundability rate was 12%, compared with 6% for a corresponding group of 50 patients who were not examined with ultrasound...

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Cyclic pelvic pain is a common gynecologic problem caused by relatively few diseases, which usually can be diagnosed and remedied quickly. Some complaints reflect normal physiologic aspects of the menstrual cycle (mittelschmerz, menstrual awareness). Premenstrual syndrome can be diagnosed, but an effective and convenient treatment is lacking. Dysmenorrhea is the commonest source of cyclic pain, diagnosed by its characteristic history and rapid relief on administration of antiprostaglandin agents. Endometriosis is diagnosed surgically and best treated either surgically then, or medically by danazol or GnRH agonists...

Prediction of ovulation was carried out by B-ultrasonography, BBT graph, cervical mucus and appearance of mittelschmerz in 45 normally menstruation women for a total of 72 cycles. LH peak values were also determined in 20 cases (20 cycles). The results were as follows: 1. The relation-ship between each index and ovulation: (1) The ultrasound image of follicle: average daily follicular growth during the 4-5 day before ovulation was 2.5 +/- 2.1 mm (means +/- s). Average diameter of the biggest follicles one day before ovulation was 20...

One hundred eighty-three women with chronic pelvic pain were referred to a multidisciplinary chronic pelvic pain clinic after negative laparoscopy. One hundred twenty-two of them completed a thorough medical and psychologic evaluation and were followed for a minimum of six months after completion of therapy. Occult somatic pathology was diagnosed in 57 women (47%), including 19 in whom coexistent psychopathology was diagnosed. Myofascial pain was the most common somatic diagnosis, followed by atypical cyclic pain (dysmenorrhea or mittelschmerz); gastroenterologic, urologic and infectious diseases; and pelvic vascular congestion...

Ultrasonography of the pelvis at mid-menstrual cycle in normal women has demonstrated small quantities of free fluid in 40% of cycles. Two thirds of the cycles associated with pain had ultrasonically demonstrated fluid at ovulation. These sonographic findings at Mittelschmerz confirm the physiological trauma of ovulation.