WOMENS-HEALTH Messages for March, 1999: Re: Advice from one of the doctors here, please?

Re: Advice from one of the doctors here, please?

From: J.Glenn Bradley MD (anonymous@obgyn.net)
Thu, 18 Mar 1999 18:43:19 -0600 (CST)

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In reply to: Diane: "Advice from one of the doctors here, please?"

At Thu, 18 Mar 1999, Diane wrote: >
>Hi...I'm a 34 year old mother of two, that had a tubal 12 years ago
>after my daughter was born...ever since, I'd had heavy periods with
>clotting but hadn't been concerned until last summer when I started
>having them about every 2 weeks for 10 or more days at a time and they
>became very painful. I've been seeing military doctors since September
>and they don't seem to be any closer to finding the cause of it than
>when I started. I've had a pap smear where the first PA felt what she
>considered to be an enlarged uterus and ordered an ultrasound...during
>which, the tech said he saw something that had him concerned but didn't
>say what...the radiologist turned in his report that the uterus was
>within normal range. Then I was put on hormone therapy 14 days of
>Provera and then 3 months of birth control pills...which I finished last
>month. I was still in alot of pain and the bleeding wasn't improving,
>so they referred me to OB/GYN. She did an endometrial biopsy and tested
>for any infections, both of which came back negative. She then did
>another ultrasound and said my ovaries look smaller than normal, so
>she's ruling out ovarian cancer, but when I asked if it might be
>endometriosis, she doesn't seem to think it is. I have another appt
>with her in April and my past 3 periods have been medium to dark brown
>the first few days of it and then light to medium brown again at the end
>of it and I'm still bleeding roughly 10-12 days with the cramping and
>sharp stabbing pains getting worse. I'm always fatigued and have been
>nauseous for the past month. Are there any questions I should be
>prepared to ask at my next appointment? Thanks in advance for any help
>you can give me, I really appreciate it!

IMHO, you have either a submucous fibroid, and/or adenomyosis. I would consider hysteroscopy to check for the former, and if negative, would strongly consider hysterectomy, as it is often the only definitive cure for the adenomyosis. This is not to say that you could not have both. So far it has been demonstrated that hormone therapy is ineffective. A "D&C" will accomplish nothing so IMHO, would not suggest that procedure. Your fatigue could well be due to anemia so have your hemoglobin checked.

Dr.B

--
T

Next message: Kelly: "Re: Norplant"
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In reply to: Diane: "Advice from one of the doctors here, please?"

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