WOMENS-HEALTH Messages for December, 2002: Re: POST - need DR opinion: pelvic pain and confusion, long

Re: POST - need DR opinion: pelvic pain and confusion, long

From: William McIntosh, MD (anonymous@obgyn.net)
Tue, 31 Dec 2002 09:36:03 -0600 (CST)

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In reply to: Jen: "REPOST - need DR opinion: pelvic pain and confusion, long"

At Tue, 31 Dec 2002, Jen wrote: >
>Hi - have question for anyone. 26 y/o, stocky female, hypothyroid since
>2000, hypoadrenal since 2001. One miscarriage, late 2000, 1 month old
>accidental pregnancy, no kids to this date.
>Huge hx of pelvic pain with menstruation - was investigated for endo in
>Feb 2002 by Lap because of huge clots, left sided pain on bimanual
>examination, and dysmenorrhoea w/ nausea and vomiting.
>
>They found only soft pregnant like tissues, a small retroverted uterus
>and retrograde menstruation. Was having 2 periods a month at that
>point. Tried progestins only to gain a stone (14 lbs) after my uterus
>refused the Mirena coil, over the summer 2002. No benefit.
>
>Went without sex hormones (and sex) til Sept 2002, when double periods
>resolved themselves - i increased my Armour thyroid until it stopped.
>Dysmenorrhoea with periods eased as well.
>
>Started Femodette in September, periods are much lighter, less pain and
>less blood loss.
>
>Downside to Femodette - pain has changed character is is nowsomething
>linked to bcp, and comes in between periods, all month long. Stabbing
>sharp knifepains in my uterine region, but not necessarily in my uterus,
>that last about 10 -15 seconds apiece, many times a day. They happen
>randomly, but seems to be tied to strenuous movement, standing, sitting,
>running, lifting, etc.
>
>Now, if i had no endo in Feb, what is causing me to hurt now? I was told
>at my lap that I was 'over-oestrogenised' so gyn thinks I make too much
>oestrogen because I'm fat (5'1", 168lbs), but all thse stabbing pains
>started since adding the ethinylestradiol into my body ...? Could i be
>feeding a disease that the gyn missed when he did the lap?
>
>Anyone who can help me, please email me jenl at freeuk dot com.
>
>Cheers, Jen.

This is a tough case. Assuming that you truly did not have endo last Feb, it is unlikely that you have it now, but endo can be hard to recognize and might have been missed. The pain pattern is not typical for endo however, as the cramping comes from the uterus itself. The pill usually has a mild to moderate suppressive effect on any endo that you might have. Is it possible that you have a stenotic cervix (abnormally narrow cervical outlet)?

-- William D. McIntosh, MD, FACOG

This is for educational purposes only, and is not a substitute for consultation and examination by a licensed medical professional.

Next message: William McIntosh, MD: "Re: feels like baby kicking anus at 20 weeks-Reposting Doctor or anyone please reply..."
Previous message: William McIntosh, MD: "Re: Birth Control and Anorexia"
In reply to: Jen: "REPOST - need DR opinion: pelvic pain and confusion, long"

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