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Fibroid in uterus, feel pain after sex like labor pains. Tests showed thickened uterine lining. Endometriosis or cancer?

Apr 2013
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Practicing since : 2009
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Hello, I was recently told I have a fibroid in my uterus. A few weeks later, I had intercourse with my husband, and it was so painful afterward...I felt like I was in labor. The pain was in the front and wrapped around the sides and into my back...just like labor..or severe menstrual cramps. The next night we tried again and the same thing happened. I went to my obgyn who scheduled an ultrasound and bloodwork. Bloodwork looked normal, but my uterine lining was thickened. Three weeks before it was at 1.5, and not it's at 8. I'm 40 years old and used to having painful periods. Within the last year I even skipped a couple of them which never happened before. I have a laparoscopic surgery next week and a d&c. Does this sound like endometriosis? Or cancer? He thinks it may be just appendicitis...
Posted Mon, 20 May 2013 in Vaginal and Uterus Health
Answered by Dr. Ivan R. Rommstein 43 minutes later
Hi and welcome to XXXXXXX
First it doesnt sounds like cancer nor appendicits.These 2 would have some other signs and symptoms.

This condition is called dyspareunia and there are vaious disorders which can cause it. In some women this is usually psycogenic,but I doubt this is cause in your case because you have certain uterine pathology.

Common causes of dyspareunia are vaginal issue due to loss of vaginal lubrication but it woul dbe felt during the intercourse, not after.And this is usually found in menopause and postmenopause and you are too young for it of course.
Uterine fibroid can cause it only if it is big enough and it menas that should be sized >6-7cm. Small fibroids have no effect on sexual functioning.

Your uterine lining measures vary in time. Normal values are: cycle day 4, 3-4 mm; ovulation 6-7 mm, before menstruation 10-12 mm so 8m can be normal if found before menstruation. If not, this can be sign of endometrial hyperplasia and cause pain you are describing(in this case it can be treated by D&C and hormonal therapy,it wold also rule out possiblity of cancer).

Endometriosis can also be considered if you feel this pain during the periods,but it would be felt not just after sex,it would be constant pain in lower abdomen during the period.
If you have pain during the ovulation time then there can be ovarian cyst. Ultrasound would detect it if is bigger than 2cm, but laparoscopy is needed for accurate diagnosis.
Of course infections should be ruled out to.

YOu didnt mention what would laparoscopy be done for. If this is just diagnostic then all these conditions I ve mentioned would be seen but CT scan might be better noninvasive solution. If this is therapeutic for fibroid then OK. But I dont see a reason for laparoscopy if there is no obvious pathology.

WIsh you good health. If you have any question I ll be glad to help.
Above answer was peer-reviewed by
Follow-up: Fibroid in uterus, feel pain after sex like labor pains. Tests showed thickened uterine lining. Endometriosis or cancer? 14 minutes later
Hello Dr. Romic,
I appreciate the quick response.
The ultrasound did not detect an ovarian cyst. The fibroid in my uterus is the size of quarter I am told.

The laparoscopic is to find out if my appendix is alright, as well as checking for endometriosis and anything else that stands out. The d&c is to check for abnormal cells.

My concern is that I just moved from a large city to a small town, so I don't believe they have cutting edge technology here. I just want to do this the right way and hopefully be alright in the future. My gyn. Seems very knowledgable, as he has been in practice here for 25 years. Of course I read all of the doom and gloom online, and it all seems to point to Cancer. I would just like to really know if my symptoms send up a huge red flag, or if they are common.

Thank you so much.
Answered by Dr. Ivan R. Rommstein 18 minutes later
This is very common, trust me. and the cancer is the last you should think of.
Endometrial cancer is found later in life +60 age,there would be abnormal vaginal bleeding and different sonographic finding. Ovarian cancer can be found in forties, but as i said it would be seen on US too and manifested with different symptomatology . Your symptoms can be simply caused by hormonal imbalance or causes I ve mentioned above, and I am sure this is nothing serious.
Most of medical institution should be able to perform these procedures, this shouldnt be problem. Laparoscopy is the best diagnostic method for female reproductive organs including endometriosis. But acute appendicits if suspected should be treated within 24 hours. But I am sure that your doctor will do the best for you and I hope you ll be less concerned and do less read online stuff after these results.

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