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Question: Please Help my Daughter I have a 13 year old daughter who started her menstrual cycle last year. She has already undergone a D&C but without a scope. Since then her heavy bleeding and pain has continued. She has been placed her on OVcon-50 birth control pills. The bleeding is now under control, but for the past 3 months the day she starts or the day before, she is in excruciating pain to the point that she vomits. I don't know what else to do, she has been to the doctor so many times she almost hates the fact that she is a female all together now. Can you tell me anything to do for the next step? |
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Answer: I would certainly defer to the physician caring for your daughter. You may want to ask if the pill might be switched to a lower dose formulation over time, since 50 microgram pills can be associated with increased side effects. As far as an explanation for the pain, that is something that also best comes from her own doctor. There are many reasons why there can be significant pain associated with the beginning of a period in a teenager, and additional consultation from a pediatric/adolescent gynecologist may be helpful in some cases. Good luck, and thank you for your e-mail! David Toub, M.D. |
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Question: Vaginal Pain in a
Teenager I have a 14 year old daughter who has had 3 incidents of severe vaginal pain. My wife states that her vaginal area becomes very inflamed. It is so bad that she screams with pain every time she uses the bathroom. Simply moving will cause her to burst into tears. It appears that it occurs immediately after an illness such as the flu. She has been to see her pediatrician on two of those occasions. The first time she tested positive for vaginal strep and negative for genital herpes. On her second visit the Dr. indicated that she believes our daughter has genital herpes. We are still waiting for the test results; however, my daughter has come to me several times, very upset, and indicated that she has not had any sexual partners. Our Dr. simply feels that our daughter is not being truthful. We have a very good relationship with our daughter, and I truly feel that she is being truthful. Can anything else cause these problems? Can genital herpes be passed by any other method? She had the chicken pox vaccine, could there be any side effects from this? Any help would be appreciated, Thank you. |
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Answer: I think that it remains unclear what is going on, such as whether or not this is herpes, so I would defer to the clinical judgment of your daughter's doctor. In addition, consultation with a gynecologist, and even a pediatric/adolescent gynecologist, might be useful if the situation remains unclear. Please discuss this further with your daughter's physician. Good luck, and thank you for your e-mail! David Toub, M.D. |
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| Question: Persistent
Pain I am a 37 yr. old woman and have had a history of alcohol and narcotic use for ten years. I am now clean but have had persistent knife like pain on the right side half way down my back, I have all the appropriate tests and the results say I have a mal-rotation of the kidney and my ovary is enlarged with a cystic lesion. What can be done for this; it is has been 7 months and the pain is worse. Please help me, I cannot take the pain any longer. I am also having a lot of frequent urination and releasing a lot of urine, which is very abnormal for me, I never even felt this during my 2 healthy pregnancy's. |
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| Answer: Please consult your doctor as soon as possible to establish what the “cystic lesion” is on the ovary. It is important to determine if this should be managed by repeat ultrasound in a few weeks, or surgery. The plan of action requires more detailed knowledge of your ultrasound, and that is best managed by your own doctor. Good luck, and thank you for your e-mail! David Toub, M.D. |
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| Question: Ovarian
Cysts I recently found out that I have "Corpus Lopus Cysts". I think that is the way you spell it. It hurts on my left side. Can you tell me what it is, and what is usually done about it. Thank you |
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| Answer:
I think you may be referring to corpus luteum cysts, which are normal occurrences due to ovulation. In general, they resolve on their own, but in some cases can bleed into the cyst itself and occasionally can require surgery. Most corpus luteum cysts do not require any treatment whatsoever, but should be followed up with ultrasound to make sure they have gone away. If persistent, it may be that this represents something other than benign corpus luteum cysts. Please discuss this further with your doctor, who can best provide individualized guidance on this matter. Good luck, and thank you for your e-mail! David Toub, M.D. |
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Question: CPP Post
Hysterectomy I am 52 years old and had a hysterectomy in 1999 due to vaginal bleeding, my ovaries were not removed. Since the surgery I have suffered from some severe pelvic pain. In 2001 I had a laparoscopy to remove some adhesions. The pain on the right side stopped but I still hurt on the left side and now the pain sometimes goes down my leg. My gynecologist did not see a problem and now I am seeing a gastroenterologist. Could please tell what to do? |
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Answer:
I can’t tell you what to do---that is best handled by your doctors---but I can say that there are many possible reasons for pain in your situation. In any event, please discuss this with your doctor. You may want to ask your doctor if evaluation by a different specialist, in addition to the gastroenterologist, may be useful. Good luck, and thank you for your e-mail! David Toub, M.D. |
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Question: Adenomyosis Due to excessive bleeding my obgyn advises that I have adenomyosis and has suggested that I have hysteroscopy with resection. In checking over the inter net if I read correctly it suggests that I have an MRI. Can this be diagnosed via vaginal ultrasound? Do you think I should go for the procedure or get a second opinion? |
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Answer:
It is not appropriate for anyone other than your own physicians to instruct you whether or not to have a medical procedure. That said, if you are uncertain, a second opinion can prove helpful. Adenomyosis is not often easily diagnosed prior to hysterectomy, since definitive diagnosis generally requires a microscopic exam of the uterus by a pathologist. However, MRI can be useful in confirming the impression of adenomyosis, although as I understand it, MRI can’t necessarily rule it out either. In addition, as with any test, MRI has false positive rates as well (i.e. incorrectly diagnosing adenomyosis when it is not present), so it is important to keep these things in perspective. If you are talking about an endometrial ablation/endometrial resection procedure (as opposed to a hysteroscopic biopsy of the uterus, which may or may not be helpful in diagnosing adenomyosis), I would say it might be helpful to get a second opinion. Ablation/resection is not generally effective in women with significant adenomyosis, so it is important to get all the facts from your doctor and/or a second opinion consultant. Vaginal ultrasound is not as reliable as MRI in diagnosing adenomyosis, and MRI is still not the gold standard on which to base a diagnosis of adenomyosis (although as stated, it can be helpful in many circumstances). Please discuss this further with your doctor. Good luck, and thank you for your e-mail! David Toub, M.D. |
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Question: Adhesions
Clinical Trial My doctor told me there is a current clinical trial for a new drug to reduce adhesion formation following surgery. I was advised to wait before having surgery to see if the drug proved successful. I would like to know if there is a name for this drug or if you are aware of the clinical trial? |
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Answer: There are many ongoing clinical trials-you might want to ask your doctor for the specific name or consult the FDA’s Web site (www.fda.org) for possible information. Good luck, and thank you for your e-mail! David Toub, M.D. |
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Question: Pain
Post Thermal Ablation Five months after I had a Uterine Thermal Ablation done in April, 2002, I started experiencing cramping and severe right sided pain daily, once or twice a day, lasting 1-3 hours. I was diagnosed as having "fluid pockets" of blood in my uterus. This was the result of the thermal ablation not being totally effective due to my enlarged uterus. I have seen two physicians for the pain and after my problem was diagnosed by the second physician, he is recommending a hysterectomy. I asked if there were any alternatives and he mentioned a hysteroscopy but didn't know if it would be effective. Do you have any knowledge of this condition or an effective way to treat it? With thermal ablation being fairly new, I am not finding any information on this issue. I am 43 years old and, although I do not plan on having any more children, I do not want to have a hysterectomy. Since my thermal ablation, I have had no bleeding to minimal bleeding, only for 1-2 hours the first day. After my exam and ultrasound for this issue in November, I had slightly more bleeding than usual and was then pain free for approximately three weeks until my next period. Do you have any information on this condition? |
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Question: Is Surgery an Option?
I'm 16 years old, and have noticed that the outer lips of my vagina are larger than normal, and I want to know if I could have surgery done in order to look more normal. It's become a problem as it is hard to hide in bathing suits, and makes me very self conscious. I know there may be risk involved, but I'd just like to know if surgery is possible. |
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Answer: This is generally a normal variation, but you should certainly discuss any concerns with your doctor. Speaking in general, surgery for this is usually not necessary and can cause more harm than good. Again, every patient is an individual, and has individual circumstances, but please consult your doctor for personalized guidance in this matter. Thank you for your e-mail! David Toub, M.D. |
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| DISCLAIMER: The above represents material for educational and discussion purposes only. The material provided should NOT be used for diagnosing or treating any health problem or condition. It is NOT a substitute for consultation with and advice from qualified healthcare providers. If you have or suspect you have a health problem, consult a qualified healthcare provider. The author and any other party involved in the preparation or dissemination of the material presented are not responsible for any errors or omissions in the material provided above, or any results obtained from the use of such material. |
