Editing Mittelschmerz (section)

==Signs and symptoms==
Mittelschmerz is characterized by lower [[abdominal]] and [[human pelvis|pelvic]] pain that occurs roughly midway through a woman's [[menstrual cycle]]. The pain can appear suddenly and usually subsides within hours, although it may sometimes last two or three days.<!--
 --><ref name="kippley">{{cite book | first=John | last=Kippley |author2=Sheila Kippley | year=1996 | title=The Art of Natural Family Planning | edition=4th | publisher=The Couple to Couple League | location=Cincinnati, OH | isbn=0-926412-13-2 | pages=83–84 }}</ref>{{ums|date=December 2017}} In some cases it can last up to the following cycle. In some women, the mittelschmerz is localized enough so that they can tell which of their two [[Ovary|ovaries]] provided the egg in a given month.{{citation needed|date=June 2012}}  Because ovulation occurs on a random ovary each cycle, the pain may switch sides or stay on the same side from one cycle to another.

===Other ovulation symptoms===
Women may notice other physical symptoms associated with their mittelschmerz, during or near ovulation.  The most common sign is the appearance of fertile cervical mucus in the days leading up to ovulation.  Cervical mucus is one of the primary signs used by various fertility awareness methods.  Other symptoms are sometimes called ''secondary fertility signs'' to distinguish from the [[Fertility awareness#Primary fertility signs|three primary signs]].<ref name="tcoyf" />{{ums|date=December 2017}}

* Mid-cycle or ovulatory bleeding is thought to result from the sudden drop in estrogen that occurs just before ovulation.  This drop in hormones can trigger withdrawal bleeding in the same way that switching from active to placebo [[combined oral contraceptive pill|birth control pills]] does.  The rise in hormones that occurs after ovulation prevents such mid-cycle spotting from becoming as heavy or long lasting as a typical menstruation.  Spotting is more common in longer cycles.<ref name="tcoyf" />{{ums|date=December 2017}}
* A woman's [[vulva]] may swell just prior to ovulation, especially the side on which ovulation will occur.<ref name="tcoyf" />{{ums|date=December 2017}}
* One of the groin lymph nodes (on the side on which ovulation will occur) will swell to about the size of a pea, and may become tender.<ref name="tcoyf" />{{ums|date=December 2017}}