Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
189 Doctors are Online

Causes and treatment for heavy menses with pain in RLQ - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Very Good Posted in: Menstruation and Miscarriage
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1762 Questions
User :   I was put on loestrin 2 yrs ago for heavy and prolonged (3-4 week) menses. Last year I was switched to microgestin d/t cost issues. I have always been regular since. Now I am going on 1 month of heavy menses, with pain in my RLQ of my abd radiating to groin/pelvic area. I was on Biaxin XL 1 month ago and had a regular cycle after. I take my pills at the same time, every day. I have taken a pregnancy test and it is negative. I'm a 24 y/o/f. What could be the cause and treatment of possible causes?
Doctor :   Hi
User :   hi
Doctor :  
Please give me some time to read your history
User :   Iam on microgestin daily, nexium 40 daily, and inderal 40 dail
User :   hx: HTN, tachycardia w/ syncopal episodes, GERD, PUD
User :   hello?
Doctor :  
ya i m here
Doctor :  
please proceed
User :   i am an RN so I understand medical terminology and am concerned because I know this isn't a normal function
Doctor :   were your menstrual cycles regular before
User :   before I was on the pill or before this episode?
Doctor :  
before the pills
User :   no, heavy and 3-4 week menses at times
User :   that's why they started me on them
Doctor :   at that time was any investigations like ultrasound or D and C was done
Doctor :   Hi are you back ?
User :   no, i do believe i have had a miscarriage in the past
Doctor :  
Hi are you back
User :   yes
User :   hello?
Doctor :   Please proceed
User :   never had an ultrasound tho
Doctor :  
there is browser or techical issue from your side
User :   but no d & c
Doctor :   ok
User :   i know, popups for friend referrals
Doctor :  
no Ultrasound and D and C
User :   does it sound like an ovarian cyst or some sort of uterine fibroid tumor?
User :   that's my main concern
Doctor :  
can i ask few questions
User :   yes
Doctor :   do you have abdominal pain rt or lt side
User :   yes, RLQ pain radiating to groin/pelvic area, very sharp at times
Doctor :   any lower back ache
User :   at times, i always thought it was d/t lifting pts tho
Doctor :  
or white discharge per vagina
User :   no, on my menses, but when off i do have white discharge daily
Doctor :   is the white discharge curdy
Doctor :  
associcated with ithcing
Doctor :  
or any foul smelling discharge
User :   like with a yeast infection, i get those regularly, but it doesn't feel like a normal yeast infection
Doctor :   ok
User :   also loss of appetite and trouble sleeping
Doctor :   ok
Doctor :  
do you any distrubance in bowel or bladder issues
User :   no change in b/b habits
Doctor :  
As per your histroy
Doctor :  
the following diagnosis fit
Doctor :  
1. PID- pelvic inflamatory disease due to vaginitis
Doctor :  
2. Fibroid uterus
Doctor :  
as you were on OCPs
Doctor :  
3. Adenomyosis
Doctor :  
4. Small sized Ovarian cyst
User :   i am familiar with the first 2, what is adenomyosis?
Doctor :   i will explain this to you
User :   ok, ty
Doctor :  
Its the presence of endometial tissue
Doctor :  
in the myometrium
Doctor :  
edometrium and myometruim are the layers of uterus
Doctor :  
Patient presents with heavy bleed
Doctor :  
Its more towards PID or Fibroid
User :   could these affect childbearing issues? this is my main concern
Doctor :  
yes
Doctor :  
but be realaxed
User :   ok. what are common treatment modalities?
Doctor :  
child bearing issues can be tackled easily
Doctor :  
To get a Ultrasound abdomen done
Doctor :  
so the exact diagnosis can me made out
Doctor :  
and if required Dilatation and curretage
User :   would an increase in my hormones help at all? i'm on low-dose OCP
Doctor :  
ok
Doctor :  
Ocp will help to tackle the adenomyosis
Doctor :  
but a proper dosage and duration is required
Doctor :  
i will sugget you the following investigations
User :   as far a fibroid or PID, what are conservative treatments
Doctor :  
1. Complete blood count
User :   ok
Doctor :  
2. Ultrasound abdomen and pelvis
Doctor :  
3. Dilatation and curretage
Doctor :  
These investigations will help us to come to the diagnosis
Doctor :  
so that the proper treatment is iniated at an early stage
Doctor :  
are you still in OCPs
User :   ok, i know you can't diagnose without seeing a pt. but if it were to be PID or fibroid uterous, is d&c the only option or are there other more conservative measures to be tried first
User :   yes i have still been taking my pills as prescribed
Doctor :   I will guide you the treatment options in PID

User :   ty
Doctor :  
1. high dose antibiotics
Doctor :   including antibiotics against anaerobic bacteria
Doctor :  
the treatment of yeast or fungal infection is very important
Doctor :  
as local vaginal infection can spread up high to cervix and result in PID
User :   so diflucan and possibly,? vanco, kelfex, that sort of thing
Doctor :  
along with it symptomatic management for right sided pain
Doctor :  
Diflucan is mainly for candidial infections
Doctor :  
can use as oral tablets or vaginal pessaries
User :   i notified my OBGYN and they just suggested extra contraception measures and a f/u if this continues
Doctor :  
2. In a case of fibroid
Doctor :   It mainly depends on the size and location of the fibroid

User :   ok, i guess i worry, we pulled a 10 lb fibroid out of a woman the other day
Question is related to
Drug/Medication
© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor