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38 Year Old Female. Been Diagnosed With Moderate/severe Adenomyosis And

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Posted on Sun, 12 Jul 2020
Question: 38 year old female. Been diagnosed with moderate/severe Adenomyosis and PCOS. Symptoms range in severity over the course of a monthly cycle. I also have irregular cycles, sometimes I don’t have a period for a couple of months. My main symptoms include very severe cramping pretty much all month long, prolonged very heavy periods, and enlarged and hard lower abdomen which again size wise depends where I am in monthly cycle. For the past few months however symptoms have changed to some extent. I've still been suffering with very painful cramping and lower abdomen has enlarged even more than usual (quite severe) and has become very rigid to touch; however I have not had a period in this time. I am used to all these symptoms now having had this condition for about 5 years now, however the prolonged lack of periods, increased cramping and lower abdominal enlargement for the past few months is a new thing. In the last 24hours cramping has significantly increased to the worst it has been, feels much more intense. Are these symptoms all a normal part of these conditions?!?!
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Follow up: Dr. Ramadevi Wani (0 minute later)
38 year old female. Been diagnosed with moderate/severe Adenomyosis and PCOS. Symptoms range in severity over the course of a monthly cycle. I also have irregular cycles, sometimes I don’t have a period for a couple of months. My main symptoms include very severe cramping pretty much all month long, prolonged very heavy periods, and enlarged and hard lower abdomen which again size wise depends where I am in monthly cycle. For the past few months however symptoms have changed to some extent. I've still been suffering with very painful cramping and lower abdomen has enlarged even more than usual (quite severe) and has become very rigid to touch; however I have not had a period in this time. I am used to all these symptoms now having had this condition for about 5 years now, however the prolonged lack of periods, increased cramping and lower abdominal enlargement for the past few months is a new thing. In the last 24hours cramping has significantly increased to the worst it has been, feels much more intense. Are these symptoms all a normal part of these conditions?!?!
doctor
Answered by Dr. Ramadevi Wani (43 minutes later)
Brief Answer:
Details below.

Detailed Answer:
Hi,
Welcome to 'Ask a Doctor'. I am Dr Ramadevi Wani. I will be answering your concerns today.
All these symptoms that you are having now could be due to PCOS with adenomyosis. Are you sexually active? If yes, then you need to get a pregnancy test done to find out if pregnancy is the reason for prolonged lack of periods.
If that is excluded, the increased cramping is probably because your periods may start shortly. Discuss with your doctor and get a LNG -IUS system inserted into your uterus. That will reduce the pain due to adenomyosis to some extent.
Best wishes.


Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Ramadevi Wani (0 minute later)
Brief Answer:
Details below.

Detailed Answer:
Hi,
Welcome to 'Ask a Doctor'. I am Dr Ramadevi Wani. I will be answering your concerns today.
All these symptoms that you are having now could be due to PCOS with adenomyosis. Are you sexually active? If yes, then you need to get a pregnancy test done to find out if pregnancy is the reason for prolonged lack of periods.
If that is excluded, the increased cramping is probably because your periods may start shortly. Discuss with your doctor and get a LNG -IUS system inserted into your uterus. That will reduce the pain due to adenomyosis to some extent.
Best wishes.


Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Ramadevi Wani (3 hours later)
Pregnancy is not something tha5 has even crossed my mind due to having these conditions symptoms that go with them. My last period was 18th September, although I have had a couple of occasions of very light bleeding since then. Are you saying that this is a possibility given my symptoms?
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Follow up: Dr. Ramadevi Wani (0 minute later)
Pregnancy is not something tha5 has even crossed my mind due to having these conditions symptoms that go with them. My last period was 18th September, although I have had a couple of occasions of very light bleeding since then. Are you saying that this is a possibility given my symptoms?
doctor
Answered by Dr. Ramadevi Wani (1 hour later)
Brief Answer:
Details below.

Detailed Answer:
Hi,
welcome back.
If you have not had period for more than a month, it is important for us to evaluate for pregnancy as occasionally pregnancy also can cause such symptoms which can get exaggerated by adenomyosis.
Therefore my first step would be to get a pregnancy test done.

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Ramadevi Wani (0 minute later)
Brief Answer:
Details below.

Detailed Answer:
Hi,
welcome back.
If you have not had period for more than a month, it is important for us to evaluate for pregnancy as occasionally pregnancy also can cause such symptoms which can get exaggerated by adenomyosis.
Therefore my first step would be to get a pregnancy test done.

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Ramadevi Wani (58 minutes later)
I have just used an in-date pregnancy test that my sister had here from when she was trying to conceive a couple of years ago. I am totally shocked to say that the test was positive. What could this mean with regards to my symptoms?
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Follow up: Dr. Ramadevi Wani (0 minute later)
I have just used an in-date pregnancy test that my sister had here from when she was trying to conceive a couple of years ago. I am totally shocked to say that the test was positive. What could this mean with regards to my symptoms?
doctor
Answered by Dr. Ramadevi Wani (1 hour later)
Brief Answer:
Details below.

Detailed Answer:
Hi,
I presume that the test kit had not expired. Do check the expire date on the kit.
Do consult your doctor for an ultrasound scan today. The ultrasound scan helps us to understand better as to why the abdominal cramps have increased. We can take it from there.

Best wishes.

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Ramadevi Wani (0 minute later)
Brief Answer:
Details below.

Detailed Answer:
Hi,
I presume that the test kit had not expired. Do check the expire date on the kit.
Do consult your doctor for an ultrasound scan today. The ultrasound scan helps us to understand better as to why the abdominal cramps have increased. We can take it from there.

Best wishes.

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Ramadevi Wani (28 minutes later)
I have actually now taken 2 different tests, both are within date I checked. Are you saying that I need a scan today? How likely is it that I am quite far along in this pregnancy?
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Follow up: Dr. Ramadevi Wani (0 minute later)
I have actually now taken 2 different tests, both are within date I checked. Are you saying that I need a scan today? How likely is it that I am quite far along in this pregnancy?
doctor
Answered by Dr. Ramadevi Wani (41 hours later)
Brief Answer:
Details below.

Detailed Answer:
Hi
Extremely sorry for the delay. Had very busy duty and did not check this .

Yes , you need to have ultrasound scan. It is Duffy to say how far you are in pregnancy as you did have light bleeding in between.
Only scan will help us know correctly.
Best wishes.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Ramadevi Wani (0 minute later)
Brief Answer:
Details below.

Detailed Answer:
Hi
Extremely sorry for the delay. Had very busy duty and did not check this .

Yes , you need to have ultrasound scan. It is Duffy to say how far you are in pregnancy as you did have light bleeding in between.
Only scan will help us know correctly.
Best wishes.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Ramadevi Wani (25 minutes later)
No worries about the delay. I understand you are busy. Last night I decided to attend an emergency clinic as I needed to know for sure. Was seen quickly and given a scan. The good news is there’s nothing wrong. The utterly shocking news is that I am 39 weeks. I can’t even believe this, how is it possible I’ve carried a baby to full term without knowing I’m pregnant?? In addition to this they have said that my cervix is 3cm dilated (yesterday) and in easy labour. Am back home now, the clinic are quickly trying to organise the services of an independent midwife to help me at home when the time comes. In your experience how long does it normally take to go from 3.5cm to what they referred to as active labour? They said that with first pregnancies it can take a while? Still in complete shock.
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Follow up: Dr. Ramadevi Wani (0 minute later)
No worries about the delay. I understand you are busy. Last night I decided to attend an emergency clinic as I needed to know for sure. Was seen quickly and given a scan. The good news is there’s nothing wrong. The utterly shocking news is that I am 39 weeks. I can’t even believe this, how is it possible I’ve carried a baby to full term without knowing I’m pregnant?? In addition to this they have said that my cervix is 3cm dilated (yesterday) and in easy labour. Am back home now, the clinic are quickly trying to organise the services of an independent midwife to help me at home when the time comes. In your experience how long does it normally take to go from 3.5cm to what they referred to as active labour? They said that with first pregnancies it can take a while? Still in complete shock.
doctor
Answered by Dr. Ramadevi Wani (4 hours later)
Brief Answer:
Details below.

Detailed Answer:
Hi,
I am delighted and at the same time surprised that you are 9 months pregnant and did not get a hint. What is the expected baby weight? Hope your blood pressure is normal. Did they check for your hemoglobin and blood sugar. I hope the results are normal.
Again because it is first pregnancy, cannot say when actually you will go into labour. It may take 2-3 days.
I shall just give you some relevant information.
When you start getting intermittent abdominal tightening once every 15 minutes or so, or persistent low backache you need to see your midwife. If the water breaks or if you notice some vaginal browninsh discharge or spotting, you need to consult. These are the signs that labour has set in.
I would suggest that you opt for hospital delivery. Are there arrangements in place in case you need to visit hospital for delivery.
Best wishes.
Relax and enjoy your pregnancy.
Good luck.
Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Ramadevi Wani (0 minute later)
Brief Answer:
Details below.

Detailed Answer:
Hi,
I am delighted and at the same time surprised that you are 9 months pregnant and did not get a hint. What is the expected baby weight? Hope your blood pressure is normal. Did they check for your hemoglobin and blood sugar. I hope the results are normal.
Again because it is first pregnancy, cannot say when actually you will go into labour. It may take 2-3 days.
I shall just give you some relevant information.
When you start getting intermittent abdominal tightening once every 15 minutes or so, or persistent low backache you need to see your midwife. If the water breaks or if you notice some vaginal browninsh discharge or spotting, you need to consult. These are the signs that labour has set in.
I would suggest that you opt for hospital delivery. Are there arrangements in place in case you need to visit hospital for delivery.
Best wishes.
Relax and enjoy your pregnancy.
Good luck.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Ramadevi Wani (1 hour later)
I totally understand your XXXXXXX as. to why I hadn’t considered pregnancy. I feel beyond stupid and obviously in absolute shock. For example why didn’t I question why my breasts felt so full and heavy all the time and tender, even though I wasn’t having periods. Why didn’t I question why my usual adenomyosis abdominal enlargement which normally makes me look about 6 months pregnant, had increased quite a lot more than that: Also because I’d had the 3 episodes of light bleeding too I suppose I just wasn’t thinking that I could be pregnant. So many things I didn’t question stupidly. I mean I really still can’t believe it, I’ve carried a baby to full term without knowing it. It just feels so surreal for this to be happening. They said all my blood levels looked good and BP was good. The expected baby weight is 7lbs 8oz. The midwife has been approx. 2 hours ago (after My waters broke) and has said that I am 5.5cm dilated, they have now left again because they said that due to it being first pregnancy it’s unlikely that I will progress quickly and that I should call again when contractions are much closer together. Are you saying that it’s not a good idea to have a home birth in this situation? At present I don’t have a back up plan/arrangements for going to hospital for delivery, just because everything has occurred so quickly in the last 48 hours. Feel like I have no clue what I’m doing, due to having no prep time :( When the midwife left 2 hours ago I was 5.5cm dilated and contractions were 40 mins apart. Now they are currently 25 mins apart. In your experience how far away would active labour be? I’m so sorry for all the questions!
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Follow up: Dr. Ramadevi Wani (0 minute later)
I totally understand your XXXXXXX as. to why I hadn’t considered pregnancy. I feel beyond stupid and obviously in absolute shock. For example why didn’t I question why my breasts felt so full and heavy all the time and tender, even though I wasn’t having periods. Why didn’t I question why my usual adenomyosis abdominal enlargement which normally makes me look about 6 months pregnant, had increased quite a lot more than that: Also because I’d had the 3 episodes of light bleeding too I suppose I just wasn’t thinking that I could be pregnant. So many things I didn’t question stupidly. I mean I really still can’t believe it, I’ve carried a baby to full term without knowing it. It just feels so surreal for this to be happening. They said all my blood levels looked good and BP was good. The expected baby weight is 7lbs 8oz. The midwife has been approx. 2 hours ago (after My waters broke) and has said that I am 5.5cm dilated, they have now left again because they said that due to it being first pregnancy it’s unlikely that I will progress quickly and that I should call again when contractions are much closer together. Are you saying that it’s not a good idea to have a home birth in this situation? At present I don’t have a back up plan/arrangements for going to hospital for delivery, just because everything has occurred so quickly in the last 48 hours. Feel like I have no clue what I’m doing, due to having no prep time :( When the midwife left 2 hours ago I was 5.5cm dilated and contractions were 40 mins apart. Now they are currently 25 mins apart. In your experience how far away would active labour be? I’m so sorry for all the questions!
doctor
Answered by Dr. Ramadevi Wani (7 hours later)
Brief Answer:
Details below.

Detailed Answer:
Hi
If the cervix is 5.5 cms dilated, it means that you are already in active labour. The way you are progressing, you must have delivered by now.

I practice in XXXXXXX I am not used to this home delivery. That is the reason I asked about a back up plan.
Best wishes.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Ramadevi Wani (0 minute later)
Brief Answer:
Details below.

Detailed Answer:
Hi
If the cervix is 5.5 cms dilated, it means that you are already in active labour. The way you are progressing, you must have delivered by now.

I practice in XXXXXXX I am not used to this home delivery. That is the reason I asked about a back up plan.
Best wishes.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Ramadevi Wani (8 hours later)
Wanted to update you with the outcome, because of your kindness and reassurance throughout this crazy time, and because if it hadn’t been for you mentioning pregnancy, honestly I may not have known until I gave birth. Approximately 11 hours ago I safely delivered an 8lb baby boy at home (heavier than expected!) I ended up progressing much much more quickly than the midwife had anticipated and she only just arrived back in time. I say in time, she literally arrived back less than 10 mins before I delivered. She was shocked because she said for first time babies it normally takes about 3 hours of pushing from full dilation to birth. Mine I was only in the pushing stage for 45mins. Not that anything about this pregnancy has been normal! The most surreal and crazy 72hours of my life. Thank you so much for everything!!
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Follow up: Dr. Ramadevi Wani (0 minute later)
Wanted to update you with the outcome, because of your kindness and reassurance throughout this crazy time, and because if it hadn’t been for you mentioning pregnancy, honestly I may not have known until I gave birth. Approximately 11 hours ago I safely delivered an 8lb baby boy at home (heavier than expected!) I ended up progressing much much more quickly than the midwife had anticipated and she only just arrived back in time. I say in time, she literally arrived back less than 10 mins before I delivered. She was shocked because she said for first time babies it normally takes about 3 hours of pushing from full dilation to birth. Mine I was only in the pushing stage for 45mins. Not that anything about this pregnancy has been normal! The most surreal and crazy 72hours of my life. Thank you so much for everything!!
doctor
Answered by Dr. Ramadevi Wani (9 minutes later)
Brief Answer:
Hearty congratulations

Detailed Answer:
Hi,
Very glad to know that you had a normal home delivery without any problems.

Now enjoy your motherhood with the little darling.
Say hi to him.
Best wishes.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Ramadevi Wani (0 minute later)
Brief Answer:
Hearty congratulations

Detailed Answer:
Hi,
Very glad to know that you had a normal home delivery without any problems.

Now enjoy your motherhood with the little darling.
Say hi to him.
Best wishes.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Ramadevi Wani (46 minutes later)
Thank you so much for your best wishes and your advice :)
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Follow up: Dr. Ramadevi Wani (0 minute later)
Thank you so much for your best wishes and your advice :)
doctor
Answered by Dr. Ramadevi Wani (32 minutes later)
Brief Answer:
You are most welcome.

Detailed Answer:
Hi
Thanks for trusting Ask a Doctor.

Take care.
Best wishes.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Ramadevi Wani (0 minute later)
Brief Answer:
You are most welcome.

Detailed Answer:
Hi
Thanks for trusting Ask a Doctor.

Take care.
Best wishes.
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Dr. Ramadevi Wani

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38 Year Old Female. Been Diagnosed With Moderate/severe Adenomyosis And

38 year old female. Been diagnosed with moderate/severe Adenomyosis and PCOS. Symptoms range in severity over the course of a monthly cycle. I also have irregular cycles, sometimes I don’t have a period for a couple of months. My main symptoms include very severe cramping pretty much all month long, prolonged very heavy periods, and enlarged and hard lower abdomen which again size wise depends where I am in monthly cycle. For the past few months however symptoms have changed to some extent. I've still been suffering with very painful cramping and lower abdomen has enlarged even more than usual (quite severe) and has become very rigid to touch; however I have not had a period in this time. I am used to all these symptoms now having had this condition for about 5 years now, however the prolonged lack of periods, increased cramping and lower abdominal enlargement for the past few months is a new thing. In the last 24hours cramping has significantly increased to the worst it has been, feels much more intense. Are these symptoms all a normal part of these conditions?!?!