Having Abnormal And Heavy Bleeding. Found Thickened Uterus. No Relief From Progesterone. Endometriosis?

Posted on Sat, 20 Apr 2013

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 20 Apr 2013 Answered on

Tue, 14 May 2013 Last reviewed on

Question : I started having abnormal, heavy bleeding in July of 2011. In January of 2012, it only got worse to wear I was having full on periods that were heavy from February one. They took my IUD out in April and they did the ultrasound, they found nothing but a thickened uterus. They gave me pregesterone to help but it did nothing. At the end of May I found out I was pregnant but bled for the first two weeks and then found out I miscarried. In July I had a D&C and then no bleeding for a while. Starting in September, I have had pain in my sides and lower right region (near right ovary). No ultrasound showed anything except a few cysts on the left side. They finally did a hysterectomy in October and the pain subsided for a couple of months. Then in February all the pain started coming back. Cyst pain, cramping that felt like I was having a period, mood swings. It's gone up into my sides again. I've been checked for a kidney infection at least five times. Every doctor I go to tells me its not their problem, including gynecologists. I have one doctor that told me it could be endometriosis but no one else will agree to look. I'm at a loss!

Answered by Dr. Rhea Chanda (1 hour later)

Hello XXXXXXX
Yes,endometriosis can be a possibility here. Since you have had the hysterectomy already,there isnt much active treatment that can be done now. Endometriosis causes heavy cycles and excruciating pain. The problems with endometriosis is that,the pathology may still exist even after an hysterectomy. The only confirmed way to diagnose that is by a diagnostic laproscopy where a camera is inserted and visual confirmation of endometriosis is done. The pain may remain on and off and can be managed by medication. If endometriosis signs remain,and can be confirmed then certain medications can be tried. Only a gynecologist can rule out endometriosis and if its negative then other causes need to be ruled out. By judging from your history,there's a good chance of endometriosis.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rhea Chanda (8 minutes later)

Thank you for your reply. What other medications besides birth control and be used? I react horribly to it. My pathology says my myometrium was thick and a few other signs showed I was nearing menstruation even though I'd had heavy (as in filling tampon and then a pad) for two weeks before that and had only stopped a few days before my hysterectomy. All the ultrasounds I'd had before that also showed I had a thick lining. The doctor I went to on Thursday told me there was no sign of endometriosis in my pathology but that makes no sense. I'm at a loss and in pain...

Thanks,
XXXXXX

Answered by Dr. Rhea Chanda (14 minutes later)

In endometriosis,what happens is that,endometrial tissue is present at other locations other than the uterus like in the ovaries,tubes,rectum etc. Even after hystrectomy, if the tissue is present in such locations, pain will occur. Usually after hysterectomy this pain may reduce a bit. The histopathology wont show signs of endometriosis since the diagnosis is visual.If your ovaries werent removed there is a chance you will have chronic pelvic pain. One option other than OC pills is ablation of the implants. Luperide,zoladex are some medications that help reduce symptoms but work better before surgery. I think you need to find a surgeon who is willing to consider the idea of a diagnostic laproscopy. Chronic pelvic pain is a common complication and can only be managed by medications.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rhea Chanda (2 minutes later)

Thank you. I really appreciate your help! I won't just give up and deal with the pain like I was going to after this last appointment. :)
XXXXXX

Answered by Dr. Rhea Chanda (1 minute later)

Happy to help.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar