Severe womb pains
Dear Dr Mitchell,
I have a severe pain on the right side of my womb. I’m a 33-year-old with four kids. 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 pelvic pain that you experience on the right side of your uterus may be due to an ovarian tumour. This is an abnormal growth in the ovary which could be due to cancer of the ovary or a non-cancerous (benign) growth in the ovary. The irregular menstrual period, abnormal uterine bleeding and hot flashes may be a result of an abnormal growth in the ovary.
An ovarian tumour sometimes produces excessive androgens (male hormone) which can cause irregular menstrual bleeding by altering the process of ovulation. The low oestrogen level that results because of a failure to ovulate can cause hot flashes.
Other possible causes of abnormal menstrual bleeding, hot flashes and headaches include thyroid problems and premature onset of the menopause. Ovarian failure may be familial and a history of a similar problem in your siblings may suggest that this is the underlying cause. Thyroid problems, both hypo and hyperthyroidism, can cause abnormal uterine bleeding. Hyperthyroidism can cause an increased metabolic rate and associated hot flashes. The low sex drive and frontal headaches may be due to a low blood count (anaemia) which could be as a result of the heavy menstrual bleeding. It may also be due to an underlying hormonal imbalance, especially if the ovaries have failed prematurely.
In all women with abnormal uterine bleeding, it is very important to get a Pap smear done to screen for cervical cancer. This can present with heavy menstrual bleeding and pelvic pain.
Cervical cancer is the second most common cancer in women in developing countries and is sexually transmitted. It can be prevented by vaccinating women to prevent persistent human papilloma virus infection. The vaccine is given to women between the ages of 10 to 55 years. A pelvic ultrasound should be done to rule out an ovarian tumour and to get a detailed view of the lining of the uterus to rule out an abnormal growth or thickening in the cavity of the uterus.
A pelvic infection can cause abnormal uterine bleeding and pelvic pain. An endocervical swab and complete blood count should be done to determine if you have a sexually transmitted infection and to screen for anaemia. A blood test can also be done to check the level of thyroid hormones, follicular stimulating hormone (FSH), and leutinizing hormone (LH) to rule out thyroid problems and premature ovarian failure. Consult your family doctor or gynaecologist who will examine you and do all the appropriate investigations to determine the underlying cause of your problem.
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.
