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Having abdominal pain during menstrual cycle. Worried for endometriosis

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General Surgeon
Practicing since : 2008
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i have abdominal pain monthly... it lasts for 2-3wks at a time..painful... it is on my right side but gradually radiates towards my XXXXXXX back right flank... i have had an endometrial ablation thinking it would have cured everything.. have had this pain for over 3 years... only comes during my menstrual cycle... no pain any other time ... OBGYN said he seen no signs of endometriosis .. cant find anyone who knows why i get these pains....he suggested seeking therapy for muscle pains -what?- my pain is real and occurs monthly.... not constantly... but definitely too
long ... I say its definitely something in the reproductive system.... where or who can I talk to.... I went to a general surgeon he said he wouldn't look further as he trusted what my OBGYN did and said..... in XXXXXXX of 2012 I had an indometrial ablation, hysteroscopy, tubal ligation.
Posted Fri, 22 Mar 2013 in Women's Health
Answered by Dr. Grzegorz Stanko 44 minutes later

Thank you for the query.

The only and the best way to diagnose endometriosis is to perform laparoscopy and see if there are any changes in the abdominal cavity. Endometriosis usually gives pain during the intercourse (this is very characteristic), pain in the lower abdomen more intense during the menses and plentiful bleeding. So if you do suffer from such symptoms and all other abdominal diseases has been ruled out and this pain gets worse you should keep pushing your doctor to perform laparoscopy and finally either confirm or rule endometriosis out.
Disease which can give described by you symptoms other than endometriosis are:
gallstones (the pain is located in the upper right abdomen and radiates to the back)
pancreas inflammation (upper middle and right pain radiating to the back)
ovarian cyst
To rule out other diseases you should have abdominal ultrasound, full blood work, liver tests (AST,ALT,GGTP), amylase, lipase, urine analysis, bilirubin, urine amylase. Abdominal CT should be also done.

Hope this will help. Feel free to ask further questions.
Above answer was peer-reviewed by
Follow-up: Having abdominal pain during menstrual cycle. Worried for endometriosis 35 hours later
its hard remembering everything in one shot...I did have a laparoscopy when the OBGYN ruled out endometriosis .. I had my gall bladder removed several years ago ... no pain during sex.. after my endometrial ablation I don't have my h bleeding during my menstrual cycle.. why would I only get the pain during my menstrual if it were a giving my child birth vis c-section.... is it typical for any of these disease to suddenly appear only with a menstrual? could there be an ovary attached to the abdominal wall or something?? the pain began feeling like a serious rug burn... then felt as if I was tearing apart my skin and of course now it feels like my kidneys ache with the abdominal pain as if its pulling or hanging ... have had blood work... only come back with elevated li er enzymes at which point I'm told to diet... I sometimes feel if I get a tummy tuck they'll cut out the party of my fat where the pain occurs.... always same spot... I will yet another doctor and have him/her run all of the tests you suggested to make certain gets done.... I haven't had a CT scan just an ultrasound at least twice...what more can I do or who exactly should I seek out as for the type of doctor goes
Answered by Dr. Grzegorz Stanko 13 hours later

So the the endometriosis has been ruled out and it seems not being the problem. Only if the laparoscopy has been performed before the C-section, you may suspect this is an endometriosis.
Lac of bleeding is quite strange and should be investigated. Along with the pain during intercourse it may be due to some uterine cervix problem including the cancer. Lac of pain between the menses seems to be not caused by any intestinal or abdominal wall problems. However, it would be good to check whole digestive tract as it can be only a coincidence that this pain appears periodically (sometimes intestines obstruction can give such periodical pains).
CT with oral contrast (enteroclysis) should show small intestine condition, colonoscopy will rule out large intestines problems.
You should also visit your gyneacologist and have cytology performed and consider pelvis CT and hysterography.
This is all that comes to my mind. It is hard to give exact answers from my point, not being able to perform physical examination and see exact results of the performed tests.

Hope this will help. Feel free to ask further questions.
Above answer was peer-reviewed by
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