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Question

I am a 48 year old female, in good health. But lately I have been having an ache in the low down Pubic/pelvic/vaginal area for about 20 days. It comes and goes and becomes more obvious later in the day. My shins and hamstrings also ache. I had my period normally last week but continue to have this ache. I have had it before over the last year but it goes away after a week or so. Last Nov I had a D&C and endometrial ablation to treat a thick uterine lining/irregular bleeding and fibroids. I have had regular light periods since then.In January, my OB/Gyn confirmed the surgery went well...all was benign. I did have adenomyosis but should not cause too much trouble.Also my Pap was normal. The ultrasound showed all the cavity/ovaries normal. So is this ache due to adenomyosis, perimenopausal hormone changes or some muscular issues? I do exercise on the elliptical 5 days a week, eat healthy, don't smoke or drink. My weight is 137lbs, 5ft 5ins.

Submitted: 24 days and 5 hours ago.
Category: Health
Value: $18
Status: CLOSED
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Optional Information

Gender: Female
Age: 48

Already Tried:
Ibuprofen 200 mg a day. I avoid medications. I had my tubes tied after my 3rd child was born. Not on any hormones etc.

Posted by Lisa, MSN, FNP-BC, CCRN 24 days and 4 hours ago.

Answer

Hello; Thank you for writing in today. Obviously, it would be difficult to isolate this problem, since we don't have access to any of your diagnostic reports. However, I think I might be able to offer some assistance. Obviously, there could be some hormonal influence from the perimenopause, and the adenomyosis may be contributing to this discomfort. Now, with this being said, I am suspicious of possible pelvic congestion syndrome. This syndrome effects a number of women. It is though to be related to venous congestion, mainly varicose veins in the pelvic area. Pregnancy is thought to be the primary reason for developing varicose veins in the pelvic reason. In addition, some people just have a genetic predisposition to weaker veins. If you have varicose veins in your legs, you may have some in your pelvic region. Now, with this being said, I would recommend visiting with your provider for an assessment. In particular, you need to have your adenomyosis evaluated. Also, discuss pelvic congestion syndrome with your provider. Get his/her input. I am attaching a link to some information about this syndrome. Feel free to read it over, and let me know what you think. http://www.veindirectory.org/content/pelvic-congestion-syndrome.asp. I hope this helps. If you have any additional questions or concerns, please let me know. Lisa

24 days and 4 hours ago.

Reply

I am concerned my lining might have grown again even though I had a D&C and ablation last November. Can it grow thick so soon after the surgery? The Doctor ( in Jan 2009) after the surgery, said the uterine and cervical cavity was normal apart from the adenomyosis. I do not have any varicose veins....although you can see a cluster of fine veins on my thighs. I do have thin skin. No discharge or irregular bleeding.

Accepted Answer

Hello; Thank you for responding. Unfortunately, yes, there could be some recurrence of your adenomyosis. Yes, the lining can grow thick again. Also, fibroids, as they grow can cause some fullness and discomfort. The reason I mentioned pelvic congestion syndrome is because your symptoms are worse as the day progresses and you are also having some lower leg discomfort. The adenomyosis may be the most logical cause, given your history; however, there are other possible explanations. In your case, since this has been worse over the last 3 weeks approximately, I think it's time to go in again. You definitely need adenomyosis evaluated. An ultrasound can look at the lining of your uterus. If this has developed again, you may want to discuss more permanent options, such as hysterectomy. Lisa

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Expert: Lisa, MSN, FNP-BC, CCRN
Pos. Feedback: 100.0 %
Accepts: 
Answered: 10/29/2009

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