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Gynae chat with Dr Sarah Brewer
continued from page 2
Are these pains IBS?
Q: I've been suffering from lower abdominal pain and pains right inside my vagina (sometimes when I urinate but mainly throughout the day). My doctor has put me on anti-spasm pills for the abdominal pains, which seem to be working, but I still get the odd one now and again. Now my stomach seems to feel generally unsettled all the time. Is it IBS? broody2003
A: Abdominal pains during periods can be due to excessive production of hormone-like chemicals (prostaglandins) in the womb wall, which can be helped with anti-inflammatory drugs such as mefenamic acid. Although IBS is a possibility, another potential cause could be endometriosis in which womb-lining cells are present in the pelvic cavity. These swell and bleed during a period, just as if they were in the womb, and can cause severe pain during menstruation, pain between periods, pain on making love, and can also make it difficult to conceive. As symptoms have been going on so long, do ask your GP if he or she will refer you to a gynaecologist for assessment and advice.
Conceiving after a loop incision
Q:I had a loop biopsy two weeks ago and was advised to avoid intercourse and bubble bath for four weeks to prevent infection. I should get biopsy results in another week or two. My husband and I were trying to conceive before this and the doctor at the hospital said it would be okay after the four weeks wait is up. In your experience have there been any problems conceiving following treatment? indys2004
A: As long as the procedure was straightforward, then you should be fine, so try not to worry. Very occasionally, if a large area has to be taken away, the cervix may need a stitch inserted during pregnancy to keep it tightly closed, but this is not that common. Most people have a perfectly normal pregnancy and delivery after the treatment.
Tests for polycystic ovarian syndrome (PCOS)
Q: Last month I was diagnosed with PCOS and I'm due to go for my review appointment. During my first appointment I was given two plastic wallets to take to my doctor for blood tests, and information about laparoscopy. They told me I could only have the blood tests and laparoscopy when my period arrives. As yet I haven't had a period for seven months. nuttytart343
A: Try not to worry as the blood tests will probably be done at the time of the clinic appointment - in some ways the fact that you haven't had a period is of diagnostic help in itself. Investigations to confirm the diagnosis of PCOS usually include blood tests to check hormone levels. With PCOS, these will show low progesterone and elevated free testosterone levels. Pelvic examination using transvaginal ultrasonography will show the size of the ovaries and whether or not multiple cysts are present.
Last year, a joint meeting of the European Society for Human Reproduction and the American Society of Reproductive Medicine suggested new guidelines for the diagnosis of PCOS. It was suggested that PCOS may be diagnosed when at least two of the following are present: lack of periods (oligomenorrhoea) and/or lack of ovulation (which you have); clinical or biochemical signs of raised androgen levels; and/or ultrasound findings of polycystic ovaries (which can be done in the clinic, too). It is still important to go along for your appointment.
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Are these pains IBS?
Q: I've been suffering from lower abdominal pain and pains right inside my vagina (sometimes when I urinate but mainly throughout the day). My doctor has put me on anti-spasm pills for the abdominal pains, which seem to be working, but I still get the odd one now and again. Now my stomach seems to feel generally unsettled all the time. Is it IBS? broody2003
A: Abdominal pains during periods can be due to excessive production of hormone-like chemicals (prostaglandins) in the womb wall, which can be helped with anti-inflammatory drugs such as mefenamic acid. Although IBS is a possibility, another potential cause could be endometriosis in which womb-lining cells are present in the pelvic cavity. These swell and bleed during a period, just as if they were in the womb, and can cause severe pain during menstruation, pain between periods, pain on making love, and can also make it difficult to conceive. As symptoms have been going on so long, do ask your GP if he or she will refer you to a gynaecologist for assessment and advice.
Conceiving after a loop incision
Q:I had a loop biopsy two weeks ago and was advised to avoid intercourse and bubble bath for four weeks to prevent infection. I should get biopsy results in another week or two. My husband and I were trying to conceive before this and the doctor at the hospital said it would be okay after the four weeks wait is up. In your experience have there been any problems conceiving following treatment? indys2004
A: As long as the procedure was straightforward, then you should be fine, so try not to worry. Very occasionally, if a large area has to be taken away, the cervix may need a stitch inserted during pregnancy to keep it tightly closed, but this is not that common. Most people have a perfectly normal pregnancy and delivery after the treatment.
Tests for polycystic ovarian syndrome (PCOS)
Q: Last month I was diagnosed with PCOS and I'm due to go for my review appointment. During my first appointment I was given two plastic wallets to take to my doctor for blood tests, and information about laparoscopy. They told me I could only have the blood tests and laparoscopy when my period arrives. As yet I haven't had a period for seven months. nuttytart343
A: Try not to worry as the blood tests will probably be done at the time of the clinic appointment - in some ways the fact that you haven't had a period is of diagnostic help in itself. Investigations to confirm the diagnosis of PCOS usually include blood tests to check hormone levels. With PCOS, these will show low progesterone and elevated free testosterone levels. Pelvic examination using transvaginal ultrasonography will show the size of the ovaries and whether or not multiple cysts are present.
Last year, a joint meeting of the European Society for Human Reproduction and the American Society of Reproductive Medicine suggested new guidelines for the diagnosis of PCOS. It was suggested that PCOS may be diagnosed when at least two of the following are present: lack of periods (oligomenorrhoea) and/or lack of ovulation (which you have); clinical or biochemical signs of raised androgen levels; and/or ultrasound findings of polycystic ovaries (which can be done in the clinic, too). It is still important to go along for your appointment.
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