bacteria as well as improves comfort. Many
women wear tampons during athletic activities
such as bicycling, swimming, dancing, and run-
ning. However, a woman should not sit in the
bath tub or in a hot tub while wearing a tampon
because the combination of heat and inactivity
may draw bacteria into the vagina via the tam-
pon’s removal cord, which extends from the vagi-
nal opening. A woman should also change her
tampon immediately after water activities such as
swimming.
For further discussion of menstruation within
the context of the structures and functions of
reproduction and sexuality, please see the
overview section “The Reproductive System.”
See also AGING, REPRODUCTIVE AND SEXUAL
CHANGES THAT OCCUR WITH; AMENORRHEA; DYSMENOR-
RHEA; MENARCHE; MENOPAUSE; OVA; PUBERTY.
miscarriage See ABORTION.
mittelschmerz Discomfort a woman may feel on
one side of her lower abdomen around the time
she ovulates. The word is German for “middle
PAIN,” a reference to the occurrence of the discom-
fort midway through the MENSTRUAL CYCLE. The
discomfort is often a sharp, achy pain that most
commonly lasts from 2 to 12 hours though may
continue up to 48 hours. Some women find the
discomfort shifts sides from one menstrual period
to another and some women have discomfort
always on the same side. The side of the pain does
not necessarily indicate which ovary is releasing
an ovum as ovarian pain may refer to the opposite
side of the lower abdomen.
Doctors believe mittelschmerz results from irri-
tation the released ovum and the fluids that sur-
round it create in the abdominal cavity, or from
the pressure of the ovarian follicle immediately
before its rupture to release the ovum. Mit-
telschmerz is a normal part of the menstrual cycle
for many women and does not signal any under-
lying health concerns, though a doctor should
evaluate any changes that may occur in the
nature of the discomfort.
See also OVA; OVARIAN CYST; OVULATION.
morning sickness The NAUSEAand VOMITINGthat
may occur during PREGNANCY, notably in the first
trimester though it may continue through the sec-
ond trimester and occasionally for the duration of
the pregnancy. The term morning sickness is a
misnomer as the nausea may occur at any time,
day or night. However, many women do experi-
ence the nausea of pregnancy primarily in the
morning when they first awaken. Many women
find certain odors, tastes, or even appearances of
food act as triggers for morning sickness.
Though doctors do not know for certain what
causes morning sickness, they believe it is a reac-
tion to the multitude of hormonal changes rapidly
taking place in the woman’s body as the preg-
nancy establishes itself. The onset of morning sick-
ness, typically at about six weeks into the
pregnancy, correlates with the surge of human
chorionic gonadotropin (hCG) that emerges from
the newly formed PLACENTA. Morning sickness,
though disruptive, is not harmful for the preg-
nancy unless it prevents the woman from drink-
ing enough water to remain hydrated. Most
weight gain in pregnancy occurs in the second and
early part of the third trimesters, and most women
are able to eat enough to remain well nourished.
Nonpharmaceutical remedies for morning sick-
ness include- gingerroot shavings or tea
- flat GINGERale (made with real ginger)
- cola syrup (available in drugstores) or flat cola
soda - soda crackers (such as saltines)
- not mixing solids and liquids
- small meals eaten frequently throughout the
waking hours, and small snacks when awake
during the night, so there is always something
in the STOMACH - ACUPUNCTUREor acupressure (including motion
sickness wristbands that apply pressure to
acupuncture points for nausea)
If these efforts are unsuccessful and morning
sickness interferes with normal eating and drink-
ing, the doctor may recommend or prescribe
ANTIEMETIC MEDICATIONSthat are safe to take during
pregnancy. Some women experience relief with
vitamin B 6 supplement, though doctors are unsure
why this is. Because some medications may bemorning sickness 305