Re: chronic pelvic pain patient

From: Steve Raymond (eryl@intekom.co.za)
Mon Feb 23 12:40:11 2004


I didn't say vaginal atrophy. This is not the same thing. This is progestagen induced "pelvic peritoneal atrophy" which results in pelvic pain and goes away when you reverse the progestagen or withdraw it. I am suggesting you try it first before doing something irreversible. Endometriosis and adenomyosis are usually improved by progestagens. Endometriosis has been excluded on laparoscopy. I repeat, I'll be willing to bet she has no improvement after adnexectomy! Steve

Richard Chudacoff, MD wrote:

>She is on Depo-Provera and the Nuvaring. She actually had a menstrual cycle
>this last month (first in about a year) and the pain was worse, suggesting
>adenomyosis as well. I don't believe she has pelvic atrophy. The vaginal is
>pink, moist and Pap smear doesn't show basal cells
>
>Richard Chudacoff, MD
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of Steve &
>Eryl Raymond
>Sent: Saturday, February 21, 2004 1:12 PM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: chronic pelvic pain patient
>
>The reason she is getting pain is all the progestagen that she has on board.
>She has what I call, for want of a better term, "pelvic atrophy". Stop her
>progestagens or give her a bit of oestrogen, or both and I'll be willing to
>bet she will be pain free. I am also willing to bet that if you remove her
>right adnexa she will still have pain.
>Steve
>





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