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Abdominal pain during periods, moving to thighs. Ultrasound shows bulky uterus, thick endometrium. Treatment?

hello, I am 21 years old female.Durimg my periods I suffer from severe pain in the lower abdomen.Sometimes in the right sometimes in the left and the pain goes downstream inthe thigh.My USG report says i have anteverted & bulky (AP 4.6cm) uterus. Myometrium of the uterus is normal but endometrium is thick.thickness is about 15mm. uterine cavity is empty.both ovaries are normal in size. Cul-de-sac is free of any collection. what are the reasons for these kind of problems and what will be the treatment?
Asked On : Thu, 13 Sep 2012
Answers:  1 Views:  35
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OBGYN 's  Response
hello and welcome,

The most likely reason for this seems to be a condition called endometriosis. In this menstrual tissue grows inside the uterus and sheds there during periods leading to pain. It cannot be seen on ultrasound unless it produces ovarian cysts [ chocolate cysts] or tubal pathologies. Can be detected by a doctor on vaginal examination and also by laparoscopy.

Other reasons are pelvic congestion where there is increased blood flow to the pelvis. Usually relieved after periods.

Pelvic infections may also produce pain.

The endometrium is thick if there is increased estrogen. So it depends which day of the cycle the scan was done. If done on day 13-14 this is just slightly more 1-2mm more than expected.

Al in all the best empirical treatment for you now is either low dose oral contraceptive pills like ginette or progesterone [ medroxyprogesterone twice daily] from day 15 to 21 of every cycle. A cervical swab test may be undertaken if infection is suspected and then antibiotics will help.

Discuss these options with your doctor and then start treatment.
Hope this was helpful.
Feel free to ask any further queries and I will be happy to help.
Thanks for using HCM.     
Have a good day.
Dr Nilajkumar Bagde          
Consultant Obstetrics and Gynecology
Answered: Tue, 15 Apr 2014
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