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Dr. Andrew Rynne

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What does one sided hemorrhagic follicle with lower abdominal pain indicate?

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Dr. S Patra

OBGYN

Practicing since :2011

Answered : 4047 Questions

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Posted on Tue, 12 Aug 2014 in Thyroid Problem and Hormonal Problems
Question: My wife was diagonalized with Bilateral PCOD in 2010. Then she was suggested some birth Control Pills which kind of didnt help. Whenever we do an USG, it shows Hemorrhagic follicle from the right side. SHE HAS PAIN ON THE LEFT LOWER abdomen most of the times. Sometimes because of the pain,the leg gets a bit heavier. She doesn't get a proper bleeding during her periods. . She mostly has mucous blood with clots. The leg gets stiff and heavy.
Some radiologists have one view and the others have other. . Some say it is Hemorrhagic follicle and some say it is like Endometrioma.

She has severe pain in the middle of her cycle. the cycle is on an average of 30-32 days. The periods last for 2 days and the bleeding isnt that heavy.


She has a lot of hair fall and the hair has turned grey. Also she has hair growth on her chin.

She had 3 abortions a few years ago and all of them were MTP.

Could you please advice.

Thank you.
doctor
Answered by Dr. S Patra 9 hours later
Brief Answer:
DETAILS ARE GIVEN BELOW.

Detailed Answer:
Hello,

Thanks for giving detailed information. Followings are my comments:

1) One sided hemorrhagic follicle with lower abdominal pain is mostly suggestive of Chocolate Cyst of ovary or Endometrioma, related to endometriosis. Above clinical features are associated with this condition.

TREATMENT: a) Nonsteroidal anti-inflammatory drugs (Painkiller) are the first choice to reduce pelvic pain. GnRH agonist drug and progesterone can be used to treat the condition where combined birth control pill is NOT effective much.

b) Laparoscopic surgical approaches include excision of ovarian adhesions and of endometriomas. It is the BEST choice in case of failed medical therapy.

Here, I suggest you to consult with gynecologist regarding this to proceed clinical examination and necessary investigation for proper management.

2) Excessive abnormal hair in female is called HIRSUTISM. It is related to PCOD as a result of high level of androgen in the body.

Some blood tests like Testosterone level, DHEAS, Serum prolactin, LH/ FSH, TSH etc are to be carried out for complete evaluation.

TREATMENT: a) Anti-androgenic drug treatment with Cyproterone acetate (combined with estrogen) or Flutamide is quite useful. Kindly, consult with her doctor for complete prescription.

b) Laser hair removal, waxing etc are some other method to remove excessive hair.

Hope, it helps for your information. Kindly, close the discussion if you don't have any other query.

Wish her good health and take care yourself.

Regards,
Dr Soumen

For future query, you can directly approach me through

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=63326
Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. S Patra 10 hours later
Thank you, Dr Soumen,

As I mentioned earlier that she had few MTP's and I wanted to know if it is something to do with that?

Is there anything else that you suggest?

Thank you
doctor
Answered by Dr. S Patra 9 hours later
Brief Answer:
DETAILS ARE GIVEN BELOW.

Detailed Answer:
Hello,

Thanks for additional query. Followings are my suggestions:

1) Most common cause of FIRST trimester abortion is chromosomal abnormality. For recurrent Miscarriage, she needs to undergo some baseline investigation to rule out causative agent.

2) Following tests are needed to carried out under the guidance of Gynecologist.

- Test for Anti-phospholipid Antibody Syndrome (APAS).
- TORCH profile to exclude associated infection (if any).
- Endometrial biopsy to rule out Luteal Phase Defect (LPD).
- Test for Ovarian Reserve (Anti-Mullerian Hormone assay).
- Karyotyping of conceptus if miscarriage occurs in next pregnancy.
- Blood test for thrombophilia includes factor V Leiden, Prothrombin, Protein S.
- Serum TSH, Progesterone, Blood sugar (PPBS), Hb%, Blood Group & Rh Typing.

3) Both of you take healthy diet with more green vegetables and fresh fruits, vitamin and Folic acid supplement for at least 3 months, control body weight, avoidance of salty/ fatty/ high calorie foods, drink more water or fruit juice, maintain genital hygiene, avoid mental stress and need sound sleep. These are essential to build a healthy life style.

Hope, I have answered your query. Kindly, close the discussion.

Good luck and all the best.

Regards,
Dr Soumen
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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