I had been bleeding for the better part of 4 months. About a month ago I started having huge clots pass. I'm used to having clots and highly irregular periods. It wasn't anymore painful than a normal period and I don't have health insurance, so I didn't seek medical attention. Last week on Monday, I awoke in severe pain feeling like I was being stabbed down where my ovary is on the right. I had a blood clot that was black and filled the whole toilet. I immediately rushed to the ER. The ran tests including an ultrasound. Everything came back normal. The said I had dysfunctional uterine bleeding and that's what was causing the pain. They put me on provera which immediately stopped the bleeding. They told me to see the gyno. I went last Thursday. This was a new doc for me and he did nothing. Told me I was fine and that my pain would go away as I "healed". By Sunday night, the pain had worsened to the point that I couldn't even sit comfortably. The only thing that I could do was lay down and I was still in tears I was in so much pain. I went back to the ER. They did a cat scan and found a cyst. They gave me pain meds and told me to see my gyno right away. I went to a different doctor yesterday. She said that the cyst is the size of an orange and my pain doesn't make sense. She said maybe there was another cyst that I had burst or something, but I still shouldn't be in this kind of pain. She's putting me on birth control and says that it will shrink the cyst and that my pain should just go away. I practically had to beg for pain meds. She gave me percoset. Last night, it worked like a wonderdrug. Now today, the pain is worse (as it typically is each day) and the meds aren't helping as much. I'm not supposed to start the birth control until Sunday night. I don't understand how she could tell me that everything was normal and that my pain doesn't make sense. She didn't even look at the cat scan herself, she looked at the written report. She wasn't concerned that I had bled for 4 months and was having terrible clots. Wasn't concerned that the pain has had me throwing up and barely able to walk. Is it just me, or should she be checking this cyst a little more carefully?! What would you do if you were me? The pain goes around in my back and down into my leg. When the pain get to be its worst, I feel drunk I'm so dizzy and nauseated. If anyone can offer any advice, I would gladly listen and appreciate any help that anyone can offer!!
How old are you ? Before you were put on Provera, where you on any other form of hormonal birth control ? Mirena IUD or oral contraceptives ?
A diagnosis of dysfunctional uterine bleeding cannot be made until all other causes are ruled out so don't accept this as given. Also, do you know what kind of cyst you have on your ovary ? Is it a fluid filled cyst or something else ?
The first thing you should do is to get a copy of the ultrasound / cat scan report and read what that professional's opinion is. Usually the radiologist who does the scan will give his or her opinion of what is going on and a recommendation of what should follow. This alone will give you a second (third) opinion.
I feel that I should mention that oral contraceptives have now been proven not to be any more effective than simple watchful waiting when it comes to shrinking cysts. I was on the birth control pill for about 20 years and I developed an abnormal ovarian cyst of around 8-9 cms which eventually had to be removed with surgery. Mine was a fluid filled cyst (the least threatening kind) but it was not the normal follicular cyst that we all get with ovulation and it kept growing instead of going away.
If your cyst is fluid filled, it may be simply a normal follicular cyst or a corpus luteal cyst. These cysts are the normal kind of cysts that contain the egg that is released into the uterus (one occurs before the egg comes out and the other occurs after). If this is the case then the cyst will go away on its own, usually within three menstrual cycles. If the cyst persists (mine hung around for a year and a half, growing little by little) then it is most likely not a functional cyst (the normal type of cyst) but what they call an abnormal cyst (serous, mucinous, hemorrhagic, dermoid etc.. depending upon what it is filled with). Some of these cysts, like the hemorrhagic kind, may still go away on their own but some do cause pain because sometimes they leak fluid into the abdomen and the abdominal wall gets irritated. The wall will absorb the liquid but depending upon what it is, it can be quite painful (for example, blood is more irritating to the abdomen than serous fluid). If the cyst is meant to go away, it will, with or without the pill. For your doctor to tell you that you should not be feeling any pain is assinine since obviously you are.
As for the bleeding, I am wondering if they checked the thickness of your endometrial lining ? This is the lining of your uterus. A thickened lining could cause heavy bleeding. Keep in mind that just before your period your lining will be thicker than just after, however, if a lining is very thick then this may be causing the irregular bleeding. This is very likely considering the fact that you have always been irregular. If your lining is thickened, they need to perform an endometrial biopsy just to see what is going on. This is a short procedure performed in the doctor's office. If you do have this done, take a couple of ibuprofen an hour before so that you don't have any cramping afterwards.
For the pain, have you tried ibuprofen instead of pain killers ? An ibuprofen or anti-inflammatory like Advil, Motrin, Naproxen etc.. may be more effective against your type of pain than a narcotic. Don't think that just because you get Advil over the counter that it is less strong or effective than a narcotic that is prescribed by a doctor. It is important to take the right medication for the right type of pain. Ibuprofen is a Cox 1 and Cox 2 inhibitor and may work more effectively for your pain. Also, narcotics have the nasty side effect of constipation so be sure to drink lots of water and to eat plenty of fibre when you are on them (doctors almost never tell patients this and it leads sometimes to another horrible problem). You can also supplement your pain control with a heating pad on the pelvic area or soaking in a nice warm bath. Heat will improve circulation and relax your muscles down there. And water (aka hydrotherapy) has been proven to help with pain as well. A week after my surgery, my ovulation was extremely painful, probably because I was not fully healed and the fluid that leaked out of my remaining ovary during ovulation increased the irritation even more (like putting acid on a wound). I tried two Advil plus the warm bath and then the heating pad and this seemed to alleviate the pain. I have had painful ovulations since I went off the pill and Advil always seems to work for me (or the heating pad).
I hope this information helps you a little. Get a copy of those reports and read them for yourself. If you need help reading through the medical jargon, you can come back and let us know and I am sure that either myself or someone with more experience can be of assistance. If you continue to be dismissed by your doctor, find another one, preferably by recommendation from a friend or colleague. A lot of these folks simply want to stop the symptoms rather than look for and treat the cause and this is what is most infuriating to us patients.
I'm 26. I should've started with that myself. haha I had been on two different types of the pill and on the shot two different times. (A year each) They all stopped me from having a period at all for the most part. My doctor told me NOTHING about my cyst. She didn't even see the scan for herself. She went off of the reports that were faxed to her. I can honestly say that she wasn't listening to me much either. She told me that it's impossible to get a cyst while on birth control and that this will for sure shrink mine. Ran no tests of her own. Ignored the amount of pain I'm in. She said "You're normal, everything's normal." I asked her if my mother could come in the room so she could explain to her and she said "There's nothing to explain. Everything is normal."
First I was on Ibuprofen 800's and then Ultram for the pain. The 800's barely touched it and the Ultram did nothing but back me sick. And I mean sick. Dizzy, throwing up, awful headache.
I've had a lot of pain the past 2 days. The percoset is barely helping now. The heating pad has made me more comfortable, but hasn't really helped the pain. I started having small clots again a couple of days ago, and today they've started getting quite a bit bigger again. My entire stomach is swollen and the pain runs into my back. For anyone who doesn't know me to look at me, they wouldn't notice the swelling, as I am heavy. Since January, I had lost 45 lbs. I've gained about 10 of that back, however I look as though I've gained it all back I am so swollen. I thought that I was crazy, but my mom brought it to my attention earlier. If I cough, I get stabbing pains down where my ovary is. I can't breathe too deep without feeling it down there. Is it possible that this is all caused from the cyst? How can a doctor who hasn't even examined me tell me everything's normal and my pain makes no sense? I really don't know what to do. I feel like I'm being dismissed because I don't have health insurance. I was afraid that I had put something serious off for too long, but the doctors aren't helping me anyhow. Thank you for responding. You've given me more comfort than any of the doctors have!
Get a copy of the report that your doctor was looking at. It will have more details than simply, "you are fine". The reason your doctor said that it is impossible to have cysts while on the pill is because the pill is an antiovulant. This means that it keeps your ovaries from ovulating and is therefore supposed to keep you from developing normal functional cysts. HOWEVER, there are other types of cysts besides the normal functional kind and this is why you need to verify what type of cyst you have. If a cyst is fluid filled, doctors always assume that it is a normal functional cyst because most of the time, it is. In my case, this is what my doctors thought, even though I was on the pill at the time (however, I had just gone off it because of heavy irregular bleeding so perhaps my cyst developed just after that). They said,"Oh, it will disappear in 1-3 cycles, you're perfectly normal". They were wrong. It turned out to be an abnormal cyst which is the most common type of abnormal cyst, a serous cyst (you can also have a hemorraghic cyst which is filled with blood or a dermoid cyst which is filled with things like hair and teeth .. keep in mind that the ovaries help create new human beings). Mine kept growing and had to be removed through surgery eventually.
As for the bleeding, the reason I ask about the birth control is that in my own case, the pill was causing the heavy bleeding. My doctors told me this but when I asked them why this is happening now, when I have been on the same pill for 20 years, they could not answer this question. They wanted to change my pill to something stronger and at this point I made the simple deduction that if the pill was causing this problem then perhaps going off the pill will stop it. No doctor gave me this option and in retrospect I am furious that I had to find this option for myself (although it is quite simple really). Sure enough when I went off the pill, my periods went back to normal and I no longer had any more heavy bleeding with those horrible clots that you speak of (unlike the irregular bleeding, those clots are nothing to be too concerned about, by the way, they occur because you are bleeding more heavily and the body cannot put out enough of a certain chemical to keep up with the amount of blood so it tends naturally to clot .. they are more scary than anything else .. the reason they are darker is just because when they encounter oxygen, the clots turn brown or black).
Endometrial atrophy is a side effect of the pill which can have one of two symptoms, each one the opposite of the other:
The most common symptom of endometrial atrophy is simply to stop bleeding altogether and not get a period at all. At any rate, bleeding while on the pill is not really menstruating but withdrawal bleeding because the hormones that have an effect on the uterus (estrogen and progesterone) are taken away (those are the sugar pills or the week of taking no pills). Because the pill keeps the endometrium so very thin, it will often have nothing to expel during the withdrawal period. Some of the newer pills have even taken away the placebo week of pills completely and women are now on continuous hormone therapy. The side effect of this is often spotting and breakthrough bleeding.
Another less common symptom of endometrial atrophy is heavy irregular bleeding. This is what I had. Sometimes the progesterone in the pill is quite harsh on the uterus. It keeps it very thin, so thin in fact, that the lining begins to have problems and becomes very fragile. What happens in this case is that veins within the uterus begin to bleed, much like hemmorrhoids in the rectum do. This is why the pill is associated with a reduced risk of developing uterine cancer. It is because the progesterone in the pill keeps the lining very thin. An overly thickened lining can sometimes lead to endometrial hyperplasia where the cells begin to change and this can be a precursor to uterine cancer. If the lining remains thin, this will often not happen (at least for the most common form of uterine cancer .. there are other rarer types).
If you have been on the pill and you developed the irregular bleeding while on it, it is very possible that the pill could be causing the bleeding. I also had pain with the irregular bleeding and this is why they did an ultrasound and found my cyst (I was freaking out about the pain and the weird pulling sensations that I was feeling). As it turned out, the cyst was not causing my symptoms, the atrophied endometrium was.
If you have pain like you describe, do not accept the doctor's diagnosis that you are fine. I find this to be so completely assinine it is beyond belief. If doctors cannot explain the pain they should simply say so and refer you to someone who can look further if they are unwilling to do so. Saying you are "fine" even though you are in pain makes absolutely no sense. If you are having problems with this doctor, get a copy of ALL of your reports (ultrasound and CT scan) and haul your butt to another doctor who will help you. While it is true that your cyst may not be causing the pain (it may very well be a normal follicular cyst and this is why it was not on the ultrasound but on the CT scan .. these things come and go) something else obviously is.
Get your mom involved as sometimes doctors will believe an older woman over a younger one (a lot of doctors think that young women are all a bunch of hysterical monkeys .. not all doctors .. just a certain number). If you cannot get a copy of those reports, have your mom call. You paid for them so you have a right to have a copy of them.
In the meantime, keep the heating pad on and if you have been on the pill continuously when the bleeding occurred, consider the fact that the pill itself is to blame (discuss this possibility with your doctor). If you do decide to give the pill a rest though, please be sure to use another form of birth control. You do not want to compound one problem with another bigger one. For the bloating, try peppermint or cammomile tea. They both help with digestion and peppermint is a natural diuretic. Also, try adding a metamucil tablet with a couple of glasses of water every day to your routine. This will also help with the bloating (just be sure to drink when you add fibre because if you don't, fibre has the opposite effect). When I ovulate I have a lot of pain and get very bloated and this always seems to help.
Maybe it ruptured? I have a ruptured ovarian cyst. I had to take myself to the ER and after running a CT scan, the doctor said "you have a cyst on your ovary but I don't understand why that would be causing so much pain".
I went to the clinic a couple of days later, she said "you actually have cysts on both your ovaries and one has ruptured". They wanted to do an ultrasound but I don't have health insurance.
The ER doctor was a moron and didn't even read the report correctly.
Did your doctor offer to do an ultrasound? If not, then I think you need to keep shopping for a new gyno because that's pretty standard from what I've read.