<s>[INST] context: Mittelschmerz Afemale giving history of sharp pain in lower abdomen, every month, 2 weeks before the menstruation suggests mittelschmerz as the diagnosis. Mittelschmez is synonymous to painful ovulation. Pain is associated with rupture of ovarian follicle at the time of ovulation Characteristics of : Mittelschmerz or Ovular pain It appears in the mid-menstrual period.o Pain is usually situated in the hypogastrium or to one iliac fossa.o Pain is usually located on one side and does not change side according to which ovary is ovulating.o Nausea and vomitinois consDicuouslv absent.o It rarelv lasts for more than 12 hours.o It may be associated with slight vaginal bleeding or mucoid discharge.o The probable factors are : - Increased tension of graffian follicle just prior to rupture.o - Peritoneal irritation by follicular fluid following ovulation.o - Contraction of tubes and uterus.o Management : Assurance and analgesics In refractory cases cycles are made anovular by giving OCPs Also Know : The phenomenon of ovulation bleeding or mucus tinged with blood at the time of ovulation is called as mittel bluto . This may be associated with ovulation pain, although each may occur independently. [/INST] question: A 20 year old woman gives a history of sharp pain in the lower abdomen tor 2 - 3 days every month approximately 2 weeks before the menses. The most probable etiology for her pain is : | options: A: Endometriosis B: Dysmenorrhea C: Pelvic tuberculosis D: Mittelschmerz | answer: D </s>