Wednesday, July 23, 2014

Agony of the monthly curse no one talks about: Never mind PMT. Ovulation pain hits one woman in five - and wreaks emotional havoc

  • Sandra Hastings suffers acute pain during ovulation, which leaves her irritable and quick to anger
  • Doctors call this mysterious and agonising condition 'Mittelschmerz'
  • Lasting up to 48 hours, pain can leave sufferers incapacitated
  • Other effects include personality change and relationship breakdown
  • So far doctors are unsure what causes the symptoms
  • One theory is the ovarian wall ruptures during ovulation, causing bruising



  • Like most women, Sandra Hastings experiences uncomfortable tummy pain once a month. She gets irritable and is quick to anger, leaving her family in no  doubt it’s time to be careful around Mum again. 
    Yet Sandra, 39, doesn’t have PMT: instead she suffers an acute pain during ovulation. The mysterious and agonising condition, called Mittelschmerz by doctors, affects around one in five women and can leave sufferers incapacitated. 
    The severe symptoms also have a profound effect on their relationships and working lives, with some women reporting personality changes alongside the pain. 
    Acute pain: Sandra Hastings, 39, suffers extreme pain during ovulation because of a mysterious and agonising condition, called Mittelschmerz
    Acute pain: Sandra Hastings, 39, suffers extreme pain during ovulation because of a mysterious and agonising condition, called Mittelschmerz

    Despite being relatively common, ovulation pain is little known. And, intriguingly for a medical phenomenon that blights the lives of women all over the world, the cause has not been found.
    Sandra, who lives in Newcastle with her partner James, 44, and children Hannah, 11, and Matthew, ten, says: ‘My family bear the brunt. That’s because it’s so painful, I have a much lower tolerance level, particularly towards my children.
     

    ‘I also find myself snapping at James for whatever reason and, bizarrely, I have to clean the house much more. I don’t know if that’s because I’m less tolerant, but during a bout I’m always picking things up and putting them away. 
    ‘I know I’m being irrational but I just can’t help it. It’s the same every month.’
    Ovulation pain usually lasts for up to  48 hours and, although it’s not clear why some women have it and others don’t, experts believe it may be down to genetics. 
    One theory is that during ovulation, the ovarian wall ruptures, causing bruising.
    Unknown cause: One theory is that during ovulation, the ovarian wall ruptures, causing bruising
    Unknown cause: One theory is that during ovulation, the ovarian wall ruptures, causing bruising

    Bini Ajay, consultant gynaecologist and obstetrician at St Anthony’s Hospital, Surrey, says: ‘The name Mittelschmerz is derived from the German word  for “middle pain” which means pain occurring in the middle of  the month.
    ‘It differs from period pain in that it usually occurs on the 14th day of the cycle, rather than during the days of bleeding. Around 20   per cent of women — or one in five — can have ovulation pain, which can occur regularly every month or intermittently.
    ‘Some experts believe the condition may be due to irritation of the abdominal lining at the time of ovulation, by blood or other fluid that is released from the ruptured egg follicle. 
    ‘Another theory is that after ovulation, the ovaries or fallopian tubes contract, which may cause the pain.’ 
    Many women suffer for years without a diagnosis, and the condition is often mistaken for appendicitis — as Sandra discovered when she first experienced ovulation pain at the age of ten and was rushed to hospital.
    ‘Two weeks earlier I’d had my first period, and I woke up in the night with a sharp stabbing sensation in my side,’ she says. 
    ‘Mum took me straight to hospital, where I had a raft of tests and the doctors prepped me for surgery to remove my appendix. But within the hour the pain had gone so the surgery was cancelled. 
    ‘They had no idea what had happened. I had blood tests and internal exams. There were all kinds of diagnoses, from stomach ulcers to bowel spasms. But it wasn’t until months later, when I’d been hospitalised several times, that my mother was told it could be ovulation pain.’
    In common with other sufferers, Sandra agrees the pain is far worse than normal menstrual cramps. 
    ‘It’s as if someone has taken the tip of a hot knife and poked it into my side,’ she says. ‘The longest it’s ever lasted is about an hour. 
    Incapacitated: 'It's as if someone has taken the tip of a hot knife and poked it into my side'
    Incapacitated: 'It's as if someone has taken the tip of a hot knife and poked it into my side'

    ‘It’s usually on my right-hand side — which is probably why it was mistaken for appendicitis — but it can be on both sides. 
    ‘The intensity is breathtaking. Often I’ll have to stop what I’m doing and bend over, holding on to a chair or table, and I’ll press my fingers into the pain to ease it.
    Sandra, who works with people who have dementia, says: ‘Doctors told me it was something I would have to get used to. 
    ‘They prescribe strong painkillers such as naproxen and codeine but I rarely take them because the pain only lasts for about an hour, so it’s gone by the time they kick in.’ 
    When she was younger, Sandra used the Pill to quell the ache. It works, says Bini Ajay, because it prevents the ovary from releasing an egg, effectively stopping ovulation. ‘If you are trying to conceive and come off the contraceptive pill, the pain is likely to return,’ she says. 
    ‘Ovulation pain doesn’t affect fertility — in fact it can be useful if you are trying for a baby because it tells you when you are ovulating.’ 
    Years of suffering: Sandra (pictured as a child on holiday) has suffered from ovulation pain since the age of ten
    Years of suffering: Sandra (pictured as a child on holiday) has suffered from ovulation pain since the age of ten

    However, the crippling pain can put women off making love at the time when their chance of conceiving is highest. 
    When Sandra was in her early 20s she stopped taking the Pill to try for a baby, and the agonising monthly pain returned. She quickly became pregnant but went on to suffer two miscarriages. 
    Sandra says: ‘It’s something that runs in my family — my mother had five miscarriages. I had surgery after mine, which left scar tissue in my fallopian tubes, so we began fertility treatment. 
    ‘When I was on Clomid, the drug used to stimulate ovulation during IVF, I didn’t get the pain, which was strange. I’ve no idea why. 

    DID YOU KNOW?

    'Anovulation' is the term used when no ovulation takes place. Causes can included drastic weight loss and polycystic ovaries
    ‘But once I’d come off it, having decided to adopt our two children rather than go through more treatment, the pain returned.’ 
    Sandra has now gone back on the Pill to try to end her misery.
    Meanwhile, Suzanne Baum, 41, who lives in North-West London with her lawyer husband Lewis Cohen, 40, and their three sons, has suffered from ovulation pain for several days a month since her early 20s. 
    She believes it has affected her mentally as well as physically. 
    ‘When I was 22 and got engaged to Lewis, I began to get pain in my right side,’ she says. ‘Friends and family were saying it was down to stress about the engagement, or that it could be appendicitis. 
    ‘But my father is a surgeon and he knew it couldn’t be appendicitis because I didn’t have a temperature, I still had my appetite and I could sleep though the pain.’
    Looking forward to menopause: Sandra's symptoms will cease when she stops having her period
    Looking forward to menopause: Sandra's symptoms will cease when she stops having her period

    For the next few years, Suzanne went backwards and forwards to her GP as well as some of the top private gynaecologists in the country. But despite a multitude of tests, no one even mentioned ovulation pain.
    ‘I had endless scopes and scans and they ruled out everything, including ovarian cysts and gallstones,’ she says. 
    ‘The physical side was bad enough, but it impacted me more emotionally. 
    ‘I wouldn’t say I was depressed but I didn’t want to socialise while I had it because I was exhausted with the pain — and friends didn’t seem to understand. 
    ‘I’d be so tired that sometimes I couldn’t even walk to school to pick up my children. No amount of painkillers helped.’
    The agony stopped  during all of Suzanne’s pregnancies — with Zack, now 13, Leo, 12, and Jake, four. She says: ‘After I’d had my third child, it stopped for several years and I forgot all about it. But then a year ago it returned. 
    ‘The pains felt random but I suppose it was between days 8-12 of my cycle, and it would last until I had ovulated. 
    ‘From what I can gather, that’s quite extreme for ovulation pain — most women only suffer it for a few hours.’
    Then last year, Suzanne’s father was discussing her symptoms with colleagues when someone mentioned ovulation pain. Suzanne looked it up online. 
    ‘Straight away I knew that must be what I had because the symptoms matched mine,’ she says. ‘It made me feel slightly better psychologically to know there was a name for the condition I was suffering and that it wasn’t anything sinister.’
    Like Sandra, Suzanne has been advised to go back on the Pill.
    Sandra says: ‘I’m 39 now and I suppose I’ll have to deal with this pain until I hit the menopause, which, if my mum is anything to go by, will be around 48. 
    ‘I’m not looking forward to the hot flushes — but it will at least solve the ovulation pain.’


    Read more: http://www.dailymail.co.uk/femail/article-2703238/Agony-monthly-curse-no-one-talks-Never-mind-PMT-Ovulation-pain-hits-one-woman-five-wreaks-emotional-havoc.html#ixzz38Km9fL6D 
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