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Irregular cycle, swollen abdomen. Negative hpt. Transvaginal scan showed enlarged uterus. Sore breasts. Worried

Answered by
Dr.
Dr. Sree Gouri SR

OBGYN

Practicing since :2006

Answered : 5164 Questions

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Posted on Wed, 10 Apr 2013 in Vaginal and Uterus Health
Question: Hi I have Endo but normally have regular cycles. I am 42. I have had erratic cycles since Oct and recently a swollen abdomen which looks 19weeks pregnant. My hpt's have been negative so my doc won't do a serum test, but I have had a transvaginal scan which revealed an 'empty' but enlarged uterus. I have sore swollen breasts and movement in my abd (bowel?) I know something's not right as I'm usually slim and this 'swelling' is recent and unusual. I have read about 'incarcerated uterus' but with negative hpts I'm finding it difficult to get proper investigation... I'm very worried that there's something serious going on and no-ones really listening.... I know my body. What advice can you give me?
doctor
Answered by Dr. Sree Gouri SR 15 minutes later
Hi,
Thanks for the query.
There is very less possibility for incarcerated uterus. It is rarely seen in some conditions of retroverted gravid uterus.
There is possibility of adenomyosis in your case.
Which is growth of endometrial tissue into myometrium. In that case uterus size can increase.
As you are thin individual sometimes you can feel that enlargement.
If you are not having associated symptoms like excessive pain during periods, severe dysmenorrhea etc., no need to bother about it.
Your breast swelling can be due to hormonal changes. If the pain persists better to get examined once and go for mammogram if needed.
Usually once you attain menopause the size of the uterus will decrease.

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.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sree Gouri SR 16 minutes later
Hi thanks for your response but there are other details that I need to make you aware of. I have movement and, on a couple of occassions, what has felt like kicks. These sensations are increasing.
I had suffered chronic fatigue like never before between oct-dec and at the same time developed a severe rosacea rash on my face which I have NEVER had before, my Doc even ran tests for SLE but this too has been left inconclusive. I then felt better between Dec-Mar but in the past few weeks the fatigue and skin problem has recurred. I have had my hormones and thyroid blood work done which all came back within normal ranges and not peri-menopause, but my progesterone and HCG were NOT included in these blood tests.
Now I am also dizzy and feeling faint these past few days, I have difficulty moving my bowels and can't easily urinate though I'm constantly going to the bathroom. I have pressure on my rectum and a fast pulsing in my abdomen which does not match my heart rhythm as I am bradycardic, hence my query for incarcerated uterus.
Please review your answer in light of this further information.
doctor
Answered by Dr. Sree Gouri SR 20 hours later
hi,
thanks for the query.
You didn't mentiom when you had your last period and the date of your scan.
Anyhow you once go for complete abdominal and pelvis scan now.
Which will rule out the possibility of pregnancy and also other possibilities like abdominal masses or aneurysms etc.
By this you can comeout from the thoight of prehnancy and can also detect the possible cause for your problem.
Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sree Gouri SR 36 minutes later
Hi thanks for coming back to me. I stated in my first message that have had erratic cycles since October, they used to be very regular 28-30 day cycles with 5 day bleeds, 2 days would be very heavy. Since October they have been 24,34,42,21 day cycles and shorter, lighter with old blood very little 'fresh' bleed. I chart my temperatures and I had a triphasic pattern in Sept-oct all temps since have and a steady increase throughout oct-nov but been up and down since. My cousin bled cyclically throughout her pregnancy in her 40's too.
I had a transvaginal scan which revealed no cysts. I have had an upper abdominal scan to rule out organ problems but NOT a mid-abdominal scan such as they do in obstetrics, which is crazy as this is where the 'swelling' is.... So far they areas NOT swollen are the only bits that the doc here will scan. Until then I can't rule out the possibility of an abdominal pregnancy or incarcerated uterus.
I have a child already and during my 3rd trimester I suffered symptoms of a partially incarcerated uterus which led to complications and long 36 hour labour because she was stuck in my pelvis. I have also suffered many miscarriages, including 2x ectopic and 1x heterotopic so I am high risk for complications such as abdominal pregnancy or incarcerated uterus due to my severe Endo.
My urine tests have all come back negative but I didn't do one before 12 weeks so could be suffering the prozone or hook effect. Would an HCG serum test be affected by the hook effect too? I just cant seem to conclusively rule out pregnancy yet because of my symptoms and history.
Please advise


doctor
Answered by Dr. Sree Gouri SR 27 hours later
Hi,

Yes, sometimes when the beta hCG concentration is high hook effect can be seen in blood test also. But it is rare.
If ultrasound and blood test for pregnancy both rules out the possibility of pregnancy then that be taken as confirmation for absence of pregnancy.
So you better undergo blood test for pregnancy and one ultrasound whole abdomen and pelvis.

Wish you Good Health, If you are satisfied with my response please rate the answer after closing the discussion.
Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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