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Gynecology

Endometriosis .. or what??!!

03/22/2006

Question:

Hi, Im 20 years old and I deffinately have something wrong. I`ve gone to the doctor about 20 different times within 4 months [5 different doctors], and I`m not really sure of what they think I have [endometriosis]. Well my symptoms are, pain in lower left abdomen and irregular mentsrual cycles since I was 13. I was diagnosed with a grape sized ovarian cyst at age 15 and was told that it was nothing to worry about it would go away on its own. Well it never bothered me until exactly one year ago. 4 months ago they find out the `cyst` is not actually on any of my ovaries, but looks like it MIGHT be on my uterus [it`s somewhere in front of my bladder above my uterus]. I`ve never had painful periods or heavy bleeding until the doctors put me on birth control to try and shrink the cyst. It was shrinking quite a bit and went from 8cm x 8cm to 5cm x 5cm in 3 months but stopped there. They suggest that I have endometriosis but somehow I feel that it might not be. This is the 5th doctor I`ve seen and what he says and does makes sense to me, but he doesnt know for sure either. Does this sound like endometriosis? And do you think it would help if I were to conceive before surgery if it is?? I would really hate for them to remove something other than the growth, which they`ve told me that theres always a chance they would. Everyday I experience pain in that area [moderate to minor pain] or cramping and it`s very hard for me to get up and go to work everyday. I know you dont diagnose anything w/o examining, but if you could give me a little feedback I`d appreciate it very much, thanks.

Answer:

Endometriosis (EM) is a condition where the lining of the uterus is growing outside the uterus, in the pelvic cavity. The typical symptoms in women who have them are painful, but regular menses, pain with intercourse and infertility. It can also cause some ovarian cysts. Your symptoms don't exactly sound like EM, but it can have variable symptoms. Oral contraceptives typically improve the pain with endometriosis, not worsen it. Bleeding is also usually less while on the pills. The fact that the cyst hasn't resolved and is not of ovarian origin, means that there is more work to be done to determine what it is. An MRI (special X-ray) may help, but you may require a minor surgical procedure to find out what it is and why you are having the pain.

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Response by:

No longer associated Thomas A deHoop, MD
Formerly Associate Professor of Clinical Obstetrics and Gynecology
Director, Medical Student Education
No longer associated
Thomas  A deHoop, MD