Womb pains, etcetera
Dear Dr Mitchell,
I have severe pain on the right side of my womb. I’m a 33-year-old with four children. I also have hot flashes especially at night and a very low sex drive. I sometimes get headaches above the eyes. I have irregular menses with heavy bleeding. What could be the cause of all this?
The severe pain that you experience on the right side of your womb may be due to an ovarian cyst. This causes pain if it rapidly increases in size, if there is bleeding into the cyst, rupture or leaking of the cyst, or if one ovary twists onto its pedicle or base. In some cases the ovarian torsion can be intermittent when the ovary twists and then spontaneously undoes the twisting. Torsion of the ovary reduces or completely cuts off the blood supply to the ovary and can cause a loss of ovarian function.
Right-sided pelvic pain may also be due to an inflamed Fallopian tube due to sexually transmitted infection (Pelvic Inflammatory Disease). Once this is confirmed and treated with antibiotics the outcome is usually good. If there is a long delay in diagnosis and treatment then the Fallopian tube can then become blocked and this can lead to infertility and chronic pelvic pain.
Pelvic infection can also cause the lining of the uterus to be inflamed and result in heavy maternal bleeding and even painful menstrual periods. Endometriosis is also a relatively common cause of chronic pelvic pain in women and can present in this manner.
The hot flashes and decreased sexual drive may be due to premature ovarian failure or problems with the production of hormones from the thyroid gland. These conditions can also cause abnormal uterine bleeding.
A pelvic ultrasound should be done in addition to a cervical swab to check for any infection. A blood test to check your hormone levels to see if you have early ovarian failure or problems with production of thyroid hormones should be done. These are problems that can be treated to control your symptoms and improve your quality of life.
You should also get a Pap smear done to rule out cervical cancer. Contact your doctor who will advise you further.
Best wishes.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver.com; write to All Woman, 40-42 1/2 Beechwood Ave, Kingston 5; or fax to 968-2025. All responses are published. Dr Mitchell cannot provide personal responses.
DISCLAIMER
The contents of this article are for informational purposes only and must not be relied upon as an alternative to medical advice or treatment from your own doctor.
