Is This Endometriosis?
Hello everyone! Since my teenage years, I've been grappling with intense menstrual pain, to the extent that it occasionally leads to vomiting. My periods are also characterized by a heavy flow, necessitating long-term blood iron supplements. Additionally, my menstrual cycle has always been unpredictable, varying in length from four to twelve days and appearing anywhere between fourteen to forty days apart. A few years ago, I began experiencing significant pelvic discomfort and consulted a gynecologist. Although my ultrasound results appeared normal, hormone tests indicated elevated androgen levels, and I was merely advised to lose some weight. To ease my symptoms and establish a more regular cycle, I chose to start taking birth control three years ago. Last year, I often experienced severe pelvic pain while running, which I initially attributed to muscle fatigue. During the summer, I thought I had developed a urinary tract infection and underwent eight rounds of antibiotics, yet nothing alleviated my discomfort. Eventually, I ended up in the hospital due to severe pain and was diagnosed with bacterial vaginosis (BV), which led me to a new gynecologist. She noted that my symptoms were not typical. Following an ultrasound and hysteroscopy, she confirmed I have adenomyosis, although my uterus wasn’t enlarged enough to impact my bladder. I was referred for a cystoscopy with hydrodistention to rule out bladder issues, and fortunately, no inflammation was detected, and bladder capacity was normal. After treating the BV, I now endure ongoing pelvic pain, heavy and irregular menstrual cycles even while on birth control, vulvodynia, vaginismus, and urinary urgency, all of which fluctuate with my cycle phases. Additionally, for years I've battled severe IBS symptoms, but since adopting an anti-inflammatory diet, there has been some improvement. However, I still experience pain during bowel movements around menstruation, along with significant bloating that sometimes makes me appear pregnant. It has also been revealed that I have hypothyroidism and possibly polycystic ovary syndrome (PCOS). During my six-month checkup with my gynecologist, she observed that my uterus tilts abnormally forward and that my left ovary is misplaced. She instructed me to discontinue birth control to confirm the PCOS diagnosis and to check my CA-125 levels. She suspects that I might have endometriosis alongside adenomyosis, as the two conditions can co-occur. If my symptoms persist after stopping birth control, we might need to schedule an exploratory laparoscopy in the coming months. Could it be that I have endometriosis as well, or would adenomyosis alone suffice to explain these issues?
Answers (1)
3/24/2025, 12:20:59 AM
OpenHealth AI
It sounds like you are experiencing a complex array of symptoms that can be frustrating and concerning. Given your history of intense menstrual pain, heavy bleeding, hormonal imbalances, and the diagnosis of adenomyosis, it is indeed possible that you could also have endometriosis. Let’s break down the key concerns and next steps for you.
Main Points:
- Your symptoms, including painful menstruation, heavy and irregular cycles, and pelvic discomfort, align with both adenomyosis and potentially endometriosis.
- Ongoing symptoms after stopping birth control may provide more clarity for diagnosis.
- Keeping track of your symptoms and discussing them with your gynecologist is crucial at this stage.
Explanation:
Adenomyosis occurs when the endometrial tissue grows into the uterus's muscular wall, leading to painful and heavy periods. Endometriosis is a condition where similar tissue grows outside the uterus, causing pain that can be severe. The two can coexist and may amplify each other’s symptoms. Your elevated androgen levels and the symptoms you’re detailing, like bowel pain during menstruation and urinary urgency, commonly overlap with both conditions.
Since you are now working with a new gynecologist who is considering further exploration through laparoscopy, this could help visualize any endometrial tissue outside the uterus and provide confirmation if endometriosis is a factor in your pain.
Next Steps:
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Symptom Diary: Start documenting your menstrual cycles, pain intensity, bowel symptoms, and any other occurrences like urinary urgency. Note how these symptoms correlate with your cycle phases. This information is valuable for your healthcare provider.
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Follow Your Gynecologist's Recommendations: Continue to follow up with your gynecologist about stopping birth control and awaiting the CA-125 results. If symptoms persist, push for an exploratory laparoscopy if warranted.
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Manage Pain and Comfort: Continue to follow your anti-inflammatory diet, which has provided some improvement for your IBS. Additionally, consider heat therapy (like heating pads) during painful periods and gentle exercises or stretches to alleviate discomfort, if tolerated.
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Support System: Connect with support groups for adenomyosis or endometriosis patients. Sharing experiences may offer both encouragement and practical tips for managing your symptoms.
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Monitor Mental Health: Given the challenges you face, consider strategies or practices (like mindfulness or counseling) to support your mental well-being, which can be impacted by chronic pain.
Make sure you communicate openly with your healthcare provider about all your symptoms and concerns, as this will aid in finding the best management approach for your health. You're navigating a challenging situation, and taking these steps can help empower you in your care.
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