I have terrible pains in my abdomen at mid-cycle. It hurts to even walk. They last three or four days, then go away. At the time of my period, I have hardly any cramps. Could there be something wrong? I've been trying to get pregnant for the last 10 months.

Mary

Many women have mild ovulation-related mid-cycle pains called mittelschmerz, but these pains are short-lived and not severe. Severe pain lasting several days may be the sign of an ovarian cyst, torsion (twisting) of the ovary, endometriosis, or something else. This certainly should be investigated by your gynecologist, especially as you are trying to become pregnant. Optimally, you will be examined while you are having the pain; pelvic exam or ultrasound at the time may pinpoint the problem.

If you have a large ovarian cyst or if endometriosis is suspected, your doctor may suggest a laparoscopy. This is a surgical procedure, usually done on an outpatient basis, in which your doctor inserts a telescope-like instrument through a cut in your navel to see the pelvic organs. Cysts may be removed, scar tissue may be cut, and endometriosis may be obliterated through a few tiny incisions. Sometimes smaller cysts may be treated non-surgically, via birth control pills to speed up shrinkage of the cyst. Your doctor will be able to give you all the options based on your specific needs, symptoms and findings.