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Having severe pain during periods. Ultrasound showed mildly heterogeneous echotexture of the uterus. What to do?

May 2013
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Practicing since : 2006
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I have been having severe pain during my period more months than not for about 9 months now. My endo sent me for a trans vaginal u/s. The impression part of the report says Mildly heterogeneous echotexture of the uterus, otherwise negative pelvic ultrasound.
What does that mean? Can it explain the pain I've been having? Is it anything I need further followup for? We are in the process of moving and I have yet to hear from my endo about this as she was out of the office.
Thank you!
Posted Sun, 2 Sep 2012 in Women's Health
Answered by Dr. Sree Gouri SR 58 minutes later
Thanks for the query.

the possibilities according to your description are,

-adenomyosis: in this condition there will be growth of endometrial layer in myometrium leading to heterogenous appearance of uterine myometrium,
in this condition severe pain during menstruation and/or heavy bleeding during periods may be seen,
-fibroids:these occurs due to over growth of smooth muscle and connective tissue in the uterus, sometimes fibroids can present as heterogenous structures in ultrasound, in these condition also above symptoms can be seen,

if there is only minimal changes in ultrasound probably the symptoms can be reduced with medicines,
so after correlating your symptoms, physical findings and ultrasound features your doctor can come to one conclusion regarding the exact cause,
and if symptoms are able to be managed with analgesics and hormonal therapy you can choose that with her advice,
you have to take regular followups to check the changes in uterus,
rarely if symptoms will not subside with medical therapy surgery may be needed.

Hope I have answered your query. I will be available to answer your follow up queries. If you are satisfied with all my answer, please rate the answer after closing the discussion.
Take care.

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