A gynecologist will consider multiple reasons for persistent pain with menstruation, including adenomyosis, fibroids and endometriosis.
Dear Dr. Roach: I’m a woman who had terrible experiences with menstruation. I’ve probably seen two dozen different gynecologists, and I complained to every one of them about my painful periods and …. nothing. Not even a painkiller was prescribed.
Once, I told the nurse practitioner that I had a really painful episode, and she asked, “Why didn’t you come into the office? You might have ruptured something.” Had I come to the office, it would have required an ambulance. By then, I had heard about endometriosis. I asked her if she thinks I have it, and she said, “Oooh, you probably do. You’d have to get laparoscopic surgery to know.”
When a woman has pain that doesn’t respond to first-line treatments, such as a heating pad and regular exercise, most primary care doctors, including gynecologists, consider pain medication as well as a trial of hormone treatment . I’m honestly surprised you weren’t ever recommended these treatments, even though I have heard horrific stories of pelvic pain being ignored before.
With endometriosis, there are lesions outside the uterus near the ovaries, pelvic ligaments, bladder or the lining of the pelvic wall in the cul-de-sac . Just like the endometrial tissue in the uterus, these lesions outside the uterus react to hormone levels, and at the time of menstruation, they can typically cause pain or pressure, bowel or bladder symptoms, painful sex, fatigue, and other symptoms.
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