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excruciating pain during every other period
mrhea posted:
hello. im a 28 year old female. mother of one. i have horribly painful periods alternating months. the pain is so bad that it causes me to pass out and vomit at times. Its much worse than labor and lasts about 1 to 3 days with no relief in between. It started when i was 23. i had one episode and ended up in the E.R. Then got pregnant so i didnt have another episode until I was 24. but since the its like clock work (every 56 days) alternating periods. the pain is always on my right side. my doc has tested me for every std and has done numerous sonograms etc. In aug 2012 he did a laparoscopic procedure and found a "signifigant" amount of endometriosis. He told me the procedure should give me a couple years of relief, but my pain was back in Nov. Also i have pain in between periods (feels like there is a rock in my back) and i have been growing thick wirey facial hair. my doc still insists its not a hormonal problem. Please help! I feel like im missing out on my life!
mrhea responded:
forgot to mention that my blood flow during the painful months is much less than the non painful months....
Jane Harrison Hohner, RN, RNP responded:
Dear mrhea: Often the severe cramping, accompanied by nausea and vomiting, is a result of excessive prostaglandin production. Most menstrual cramps are caused by the release of prostaglandins from the lining of the uterus. Prostaglandins create both the cramps of labor and menstrual cramps by making the uterus contract. Common cramps may start prior to the onset of flow and usually last 72 hours. There are also receptor sites for prostaglandins in the bowel and central nervous system. Thus prostaglandins can produce not just cramps but also nausea/vomiting, diarrhea, headaches, and other "flu-like" symptoms.

In your specific case you also have the known, marked endometriosis ("endo"). Sometimes the endo can even invade the muscular walls of the uterus--this is called adenomyosis. In both instances the pain of menstruation, caused by prostaglandins, is amplified by the pain from the bleeding of the endometriosis implants.

What is most perplexing to me is the precisely every other month (right side only) severity of your pain. Endo implants do not usually act this way. One thing I would wonder is if your uterus is to the right of the midline of your body--or if there are more endo implants on the right side. Some women do seem to have unequal menstrual pain from month to month.MULTIPLE literature searches at the National Library of Medicine site did not yield any useful citations. One journal article from 1984 described a patient with a pelvic mass on the right from a supposed IUD caused infection where pain was erratic.

In terms if the coarse facial hair, one cause MIGHT be increased male hormones ("androgens"), or decreased levels of sex hormone binding protein produced in the liver. One of the common causes of this can be polycystic ovarian syndrome (PCOS). Usually women with PCOS are plagued with irregular/missed periods, acne, unwanted hair growth, and may be overweight. Typically none of these would be likely to cause your pain symptoms.

I would urge you to return to your GYN about the reappearance of the severe pain. They may want to do a trial of one of several types of hormone therapy used to suppress endometriosis to see if this can eliminate the cyclic pain. Gosh, we hope something can be found to give you back your quality of life.

In Sympathy,
mrhea replied to Jane Harrison Hohner, RN, RNP's response:
Thank yor for replying. My doc put me on depo and I haven't had the excruciating pain for 6 months thank God! He also put me on Spironolactone for the facial hair but I stopped it after a month because my veins were swelling in my feet and pulsing really hard(not sure if the spironolactone contributed to it). I am not sure why I had this horrible pain for 7 years and depo has stopped it but I am glad it did. I wish there was a specialist I could see about all this because I hate being on hormones but for the time being it is working..
as7241 responded:
I know I'm late to reply to this but I'm experiencing the SAME EXACT thing. Im 29, it just recently started for me though. April was the first month and it was god awful, 10/10 on the pain scale and I'm not one to fuss over anything. May was fine and then in June, the pain was back but worse, only on my right side. I ended up in the hospital with a BP of 80/40 and no answers. I have to follow up with my GYN but I'm freaking out because my cycle is about to start and I'm terrified the pain will be back. Have you had continued success with depo?
mrhea replied to as7241's response:
Hi, I'm sorry to hear that u are going through this as well. I stopped taking the depo because I was growing massive amounts of facial hair and I was spotting everyday for months. My pain is back as I suspected it would be and I'm going to request a cat scan on my pelvic region. I truly feel that something other than the endometriosis is causing the pain because most women with endometriosis have heavy periods and mine are very light when I'm in pain. Another thing that I'm concerned with is that when I had my last ultra sounds the technician asked me if I have ever had a tubal ligation on my right side, which I have not. I live in a small town and unfortunately it takes months to get into doctors and the last time I went I asked for my hormones to be checked and he refused because since I do experience bleeding every 28 days I'm "having normal periods so my hormones are just fine". I spend hours on end every chance I get scouring the Internet looking for some sort of answers and I do remember reading somewhere that if your overies aren't producing enough hormones prior to your menses that it causes light blood flow. I really want to get the the root of this problem and try to solve it the best I can without hormone therapy or pain meds. I'm not sure about u but this is ruining my life. The pain in my back is everyday now and it's preventing me from working to the best of my ability and doing things with my daughter. I really hope u don't go through this as long as I have. I have a doctors appt tomorrow with a new primary care doctor and I'm going to ask to be referred to a specialist so I will let u know how that goes. Best of luck to u!

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