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What Do Abdominal Pain, Breast Tenderness, Spotting And Intermittent Nausea Indicate?

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Posted on Wed, 4 Oct 2017
Question: I have been post menopausal for well over 5+ years. I have had lower abdominal discomfort (not pain), breast tenderness and occasional nausea for the past month or so. Abdominal discomfort started first, then breast tenderness a couple weeks later. I started having vaginal bleeding yesterday. I looked into symptoms but cannot find anything that matches all of my symptoms. i.e. uterine fibroids and endometriosis have the abdominal pain and bleeding, but no breast tenderness and nothing about occasional nausea
doctor
Answered by Dr. Dr. Antoneta Zotaj (58 minutes later)
Brief Answer:
You will need some examinations- explained in detail below

Detailed Answer:
Hello,

Thank you for asking at healthcaremagic.
I carefully read your question and understand your concern.

You are wright that fibroids and endometriosis can cause some of your symptoms but not all of them and very likely are not the cause of them. These conditions also tend to regress with menopause as it is estrogen needed to cause fibroids grow and they shrink with menopause and endometriosis is directly related to menstruation.

You seem to have had a little early menopause, was it natural or you had any surgery?

If you have not been bleeding for the last several years and now you are bleeding this is an indication for a vaginal examination and a transvaginal ultrasound to visualize the inner layer of the uterus and rule out increased thickness there. This examination will visualize the uterine cervix also.

A pap smear might be recommended also to rule out problems of the uterine cervix.

So to conclude I would recommend you to have:
1. a gynecological examination
2. a pap smear done
3. a vaginal ultrasound

These should be able to rule out issues with the uterine cervix and inner layers.

As for the breasts, if it is pain on both sides and no mass to palpation, generally is not anything to worry, it very likely mastalgia and most of the time in your age is innocent but having your doctor palpate your breasts is recommended.

I hope this answers to your question but please feel free to contact me in case anymore clarifications are needed on this.

Kind regards,

Antoneta Zotaj, MD
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Dr. Antoneta Zotaj (55 minutes later)
I had a peripheral nerve sheath tumor in the retrperitoneal area in 2000 with chemo, 2 surgeries and radiation causing early menopause.
Both of my breasts are tender which I started noticing a couple of weeks after my lower abdomen discomfort and bloating. I did have a mamogram in January which was fine.
doctor
Answered by Dr. Dr. Antoneta Zotaj (3 hours later)
Brief Answer:
Further advises given

Detailed Answer:
Hello,
Thank you for the reply and the extra info included.

I would say that if mammogram was normal in January you just need a doctor to examine your breast and very likely this will be all. It is common for women in menopause to have breast discomfort and if it is symmetrical there is nothing to worry but just having pain killers is recommended.

Abdominal discomfort can come also from bowel especially if you are having difficult bowel movements but also need to rule out other causes related to the pelvic organs like the uterus. So it is important to have the transvaginal ultrasound for further examination. Vaginal exam and pap smear are important also.

Please feel free to write me in case other clarifications are needed on this.

Kind regards,

Antoneta Zotaj, MD


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Dr. Antoneta Zotaj (3 hours later)
So the breast tenderness, abdominal discomfort, and vaginal bleeding aren't related to each other?

No problems with bowels at all.
Im postmenopausal, menopause was years and years ago. What are causes for breast tenderness post menopause?
My bigger concern though is abdominal discomfort and vaginal bleeding. What are causes of those?
doctor
Answered by Dr. Dr. Antoneta Zotaj (6 hours later)
Brief Answer:
They may not be related- see more explanations

Detailed Answer:
Hello again,

There may be no obvious connection between the breast tenderness and the abdominal discomfort and vaginal bleeding. The last two might be connected with one another but not with the breast tenderness. I know that this might sound confusing as it seems they relate in time but there is no true medical condition that might justify them together so I think it is incidental they are overlapping in time.

It is more common to have breast pain in young age and while a woman is menstruating but sometimes it might happen with menopause and not necessarily a cause is identified but normally if it is symmetrical (both sides) it is not generally something serious or to worry about. Just having pain killers (tylenol or advil) and not very loose or tight bra is sometimes enough and it settles down with time.

It's great you have no problem with bowel. The abdominal discomfort and the vaginal bleeding might be related to one another and be caused by a common cause but to say for sure what it is, you need the tests mentioned above to rule out structural causes of them.

I hope this helps clarify the questions but please feel free to write me in case still more clarification is needed on this.

Kind regards,


Antoneta Zotaj, MD
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. Kampana
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Answered by
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Dr. Dr. Antoneta Zotaj

General & Family Physician

Practicing since :2004

Answered : 4435 Questions

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What Do Abdominal Pain, Breast Tenderness, Spotting And Intermittent Nausea Indicate?

Brief Answer: You will need some examinations- explained in detail below Detailed Answer: Hello, Thank you for asking at healthcaremagic. I carefully read your question and understand your concern. You are wright that fibroids and endometriosis can cause some of your symptoms but not all of them and very likely are not the cause of them. These conditions also tend to regress with menopause as it is estrogen needed to cause fibroids grow and they shrink with menopause and endometriosis is directly related to menstruation. You seem to have had a little early menopause, was it natural or you had any surgery? If you have not been bleeding for the last several years and now you are bleeding this is an indication for a vaginal examination and a transvaginal ultrasound to visualize the inner layer of the uterus and rule out increased thickness there. This examination will visualize the uterine cervix also. A pap smear might be recommended also to rule out problems of the uterine cervix. So to conclude I would recommend you to have: 1. a gynecological examination 2. a pap smear done 3. a vaginal ultrasound These should be able to rule out issues with the uterine cervix and inner layers. As for the breasts, if it is pain on both sides and no mass to palpation, generally is not anything to worry, it very likely mastalgia and most of the time in your age is innocent but having your doctor palpate your breasts is recommended. I hope this answers to your question but please feel free to contact me in case anymore clarifications are needed on this. Kind regards, Antoneta Zotaj, MD