My Partners sister 50years old has pain in the female reproductive organs area for over a year which I was told was stomach issues originally. Due to severe pain today I was dispatched to the local pharmacy to collect a few things on a list. While there I asked the pharmacy what the issue was and was then informed that her opinion is that those drugs requested were employed for enflamed Uterus? I asked if a hysterectomy can solve this and she said no. My Missus’ sister is poor but hard working and although I owe her family less than nothing after her father, now a monk, told my lad,8, “Haam Hal Steve” Don’t love Steve (Thanks Buddha, hope he attains the Nirvana he’s hoping for). Her dying would leave my girlfriend devastated and would have a knock on effect on me and everyone.

What’s the best move. What’s a consultation gonna be from a good Hospital. I’m not paying for he treatment unless it’s a one time one and done at a reasonable amount of cash. Even just a 100% diagnostic report second opinion rather than the local town Gyno shop. I’m in a town near Udon and NongKhai.

Thanks

There is no reason for you to pay for anything, she can get treatment for free in the government system as a Thai citizen.

What government hospital is she registered at?

At what hospital (if any) was she examined and these drugs prescribed/advised?

What tests have been performed so far?

And what were the drugs in question? (i would put little to no stock in what the person at the pharmacy -- who may not necessarily have been a trained pharmacist -- told you).

My partners sister does not deal with the hospital. I have dealt with the hospital many times in PhonPhiSai NongKhai no particular issues. It’s my partner’s opinion that a lot of people choose Clinics because the hospital is expensive for the drugs they give up and are slow. That’s why you see masses of people in the waiting rooms at night , at the clinics avoiding the masses of people waiting at the hospital. Although to be fair our lad has urethritis which was diagnosed and meds given in about 10 mins as the clinic was empty when we went. If that was the hospital, in my experience, it would have been an hour and the drugs would have cost 500 baht and have included paracetamol that we have at home anyway.

Anyway Sheryl Thanks for taking up my case. What do you think I’m looking at cost wise for a private consultation at the likes of Wattana Nong Khai ? I understand that the pathway through the government hospital is free and it should deliver a correct diagnosis so why is the private system there ? Do you think getting a rock solid second opinion from a private hospital is required or is a towns private gynaecologist good enough?

1 hour ago, Stevey said:

My partners sister does not deal with the hospital. I have dealt with the hospital many times in PhonPhiSai NongKhai no particular issues. It’s my partner’s opinion that a lot of people choose Clinics because the hospital is expensive for the drugs they give up and are slow. That’s why you see masses of people in the waiting rooms at night , at the clinics avoiding the masses of people waiting at the hospital. Although to be fair our lad has urethritis which was diagnosed and meds given in about 10 mins as the clinic was empty when we went. If that was the hospital, in my experience, it would have been an hour and the drugs would have cost 500 baht and have included paracetamol that we have at home anyway.

Anyway Sheryl Thanks for taking up my case. What do you think I’m looking at cost wise for a private consultation at the likes of Wattana Nong Khai ? I understand that the pathway through the government hospital is free and it should deliver a correct diagnosis so why is the private system there ? Do you think getting a rock solid second opinion from a private hospital is required or is a towns private gynaecologist good enough?

Are you saying she has never seen a doctor about this at all? If so then no reason to assume it is a Gyn problem. Why do you/she think it is? And how can there be a "second opinion" without first having seen a doctor and gotten an initial diagnosis? "Abdominal pain" in a 50 year old woman can be many different things. And how did she decide on medications if she has not seen a doctor at all? And again, what were these medications? (There are no medications specific to "inflammation of the uterus"). What exactly ard her symptoms and how long has this been going on for? There seems to be a lot of missing information here. Please try to fill in the blanks so I can better advise you.

Thais do not have to pay for medications at their registered gvt hospital. Yes they can be crowded....and if the hoepital where she is registered under the universal scheme is just a community hospital they may have to refer her on to a higher level hospital which means even more time initially but would be well worth it in the end. . The main govt hospital in Udon Thani is a regional level facility and arguably the best hospital in that part of Thailand.

Consultations at private hosputals run 600 - 2000 baht depending on the doctor. Tests would be additional -- labs, likely ultrasound -- and would probably run several thousand more at least. Possibly 10,000 - 30,000 + if CT scan or endoscopy needed. Medications at private hospitals cost 4-5 times what they do at a pharmacy so best not to get meds at hospital..

Small upcountry private hospitals can be quite dodgy and are best avoided. If you are determined to take private route, best choive would be Udon, not Nong Khai. Udon Aek hospital for example. The "after hours" clinic In the main govt hospital in Udon town is also an option and perhaps the best one...but you need to know what doctor to ask gor (ditto a private hospital) and I can't advise on that without more info. Consultation there will be probably around 250 - 300 baht.

Please try to provide the missing information and I can then give much clearer and more specific advice.

For simple consultation, quick & easy, more expensive, though not silly priced, as just a consultation, then simply go to BKK Hosp, Udon Thani. Could always have partner ring them up for pricing, so no surprises. Ask about ultrasound cost, while chit chatting with them.

Beats sitting at crowded clinic or govt hosp. Also ask if & where sis is registered for Gold Card plan.

https://www.bangkokhospital.com/en/udon/center-clinic/female-wellness/women-health-bud/overview

There's also the military hosp, cheaper than BKK Hosp, less crowded than Govt General Hosp.

I would take a loved one to Udon Thani Cancer Hospital, ~15 kms south of ring road, down at Nong Phai. I believe they still take walk ins for GYN exam & consultations.

@KhunLA @Sheryl

Thanks both. As luck would have it after I delivered the meds back home to the village and went back to town to spend what turned out be 2 hours to be 2 hours shopping in Mr. yID (causes an issue with you write that out the opposite way round) Consuming nearly 900 regard of my well earned cash.

A call from Missus has us back to the village to pick up sister as she is hurting bad apparently. Didn’t look to bad to me but maybe putting a brave face on. Took her to the Non Government Hospital Pisai Vetchakan

Hospital. Sorry if I wasn’t clear my Missus and Sister and lots here will not go to the Government Hospitals for what ever reason. But these lot also believe that small bottles of Lao Khao are better tasing that bigger bottles and same with fish. It’s private business Clinics for them both for everything.just like choosing a dentist over the dentist at the government hospital.

We get to the Hospital ( a business) in PhonPhiSai NongKhai. They comeback out and I see an ultrasound ? Photo like a baby scan and it show four cysts on her Uterus, she confirms to me. She said that this is the first time she has been told this and my Missus said to her knowledge her last Ultrasound Scan was more like a year ago than 6months ago if she had to guess. The sister says that the last scan didn’t pick them up because they were too small. I can’t imagine having to go a year without being able to work because a local high street private business Gynaecologist clinic she has been under could give her clue what it is. Surely the laws of probability said that cysts were on the list so let’s get a camera up there or the like. Surely she should have been referred back to the government Hospital to take over the treatment or investigation after that Gynaecologist was inconclusive. I’m clutching at straws of how I fix machines.

So with that new info what would be your next most efficient path forward. Maybe starting low to high on the price scale.

I paid for tonight’s scan and drugs 2100baht.

I could probably get that scan if it’s a help.

Cheers.

Cysts in the uterus are almost nonexistant. Can't be what the ultrasound showed.

Are you sure it is not fibroids in the uterus? Or cysts on the ovaries? (Though it would be unusual to have 4 of the latter).

In any event -- and assuming these are the cause of the pain (might or might not be -- fibroids are common and often asymptomatic, so the pain could be due to something else) then the best place to go would be Udon Hospital -- the main government hospital there which is a regional level facility, a far cry from your local government hospital. If your sister in law lives in Phong Phisai District, that hospital is the lowest level, just a small community hospital with very limited capacities which may be why people tend to avoid it. A Regional level hospital is altogether different and has much higher and more speclaized capacities.

If she absolutely refuses, then that leaves either Aek Udon or Udon Bangkok Hospital. Could get quite costly especially if hormonal treatment or surgery is needed.

Try to bring records from the private hospital visit with you, especially the ultrasound.

Hi. She showed me the scan and showed me the four “Look” round balls on the scan. She called them Cysts. And my Partner just pointed at her belly and said yes to the translation of Uterus มดลูก Mot-Luk.

As far as where these Cysts are she doesn’t need her ovaries anymore as she has a 14 and 18 year old already.

It’s a little worrying that you think fibroids don’t sound like the source of pain and it’s unlikely to be cysts on the uterus or ovaries in such quantities. I was hoping that now something could be seen that it could be near the answer. I’ll keep you posted on updates.

@Sheryl Well I can’t edit my own last post or even delete it.

After some YouTube research with the ideas you provided. It’s seems like Fibroids of the uterine. On the way back the Sister mentioned the word “yah Kum” which I know from its danger in dog contraception and where it causes terrible inflammation of the uterine and a mucus discharge. Although in humans it seems that birth control injections which she was taking when in Taiwan while working which her husband until she returned alone and he stayed on. She stopped the Yah Kum which may of led to the rise in symptoms of fibroids already there.

Apparently a fibroid is called เนื้องอกมดลูก (neua-ngok mot-luk) also leiomyoma or Myoma. I’m seeing in some Thai YouTube videos that operating is not always recommended and from one channel VitD is recommended for combating the effects of Oestrogen which is a driver of Fibroids.

Ok that’s a lot to digest so what’s your thoughts

As S pointed out:

The "after hours" clinic In the main govt hospital in Udon town is also an option and perhaps the best one...but you need to know what doctor to ask gor (ditto a private hospital) and I can't advise on that without more info. Consultation there will be probably around 250 - 300 baht.

They open at 5pm. 2nd floor above main entrance. Check in there. Maybe a 30 min wait before you see the doctor. Not crowded.

11 hours ago, Stevey said:

Hi. She showed me the scan and showed me the four “Look” round balls on the scan. She called them Cysts. And my Partner just pointed at her belly and said yes to the translation of Uterus มดลูก Mot-Luk.

As far as where these Cysts are she doesn’t need her ovaries anymore as she has a 14 and 18 year old already.

It’s a little worrying that you think fibroids don’t sound like the source of pain and it’s unlikely to be cysts on the uterus or ovaries in such quantities. I was hoping that now something could be seen that it could be near the answer. I’ll keep you posted on updates.

I did not say that I thought fibroids were not the source of the pain. I said they might ir might not be. Fibroids are a common finding even in asymptomatic women. But in some cases they do cause pain.

Fibroids are not cysts and she definitely does not gave cysts in her uterus.

So pretty sure it is fibroids (which are benign tumors).

IF these are the source of the pain, treatment options are basically hysterectomy vs hormones. Hysterectomy is more definitive but in some cases hormone treayment may be tried instead e.g. if the woman is nearing menopause age but not yet in menopause. Has she slready reached menopause (No longer menstruating)?

13 hours ago, Stevey said:

Hi. She showed me the scan and showed me the four “Look” round balls on the scan. She called them Cysts. And my Partner just pointed at her belly and said yes to the translation of Uterus มดลูก Mot-Luk.

As far as where these Cysts are she doesn’t need her ovaries anymore as she has a 14 and 18 year old already.

It’s a little worrying that you think fibroids don’t sound like the source of pain and it’s unlikely to be cysts on the uterus or ovaries in such quantities. I was hoping that now something could be seen that it could be near the answer. I’ll keep you posted on updates.

This is the scan from last night. Were now agreed the doctor is saying fibroids ‘Neua ngork’ not Cysts. What do you think about Vit D as an oestrogen suppressant and potentially reducing the fibroids? If this ‘private’ hospital who scanned last night are onto the problem would you still recommend getting to the hospitals you mentioned. We’re actually closer to NongKhai btw. 30 mins along the Mekong. Can you please speak more about benefits of hormonal treatment and costs possibly. Thanks.

24 minutes ago, Stevey said:

This is the scan from last night. Were now agreed the doctor is saying fibroids ‘Neua ngork’ not Cysts. What do you think about Vit D as an oestrogen suppressant and potentially reducing the fibroids? If this ‘private’ hospital who scanned last night are onto the problem would you still recommend getting to the hospitals you mentioned. We’re actually closer to NongKhai btw. 30 mins along the Mekong. Can you please speak more about benefits of hormonal treatment and costs possibly. Thanks.

Vitamin D will do nothing.

You did ot answer my question about menopause and this makes all the difference as the point of hormone therapy (even if it works) would be to temporarily control symptoms until menopause, after which the fibroids will hopefully shrink naturally. If on the other hand she has already passed through menopause and still has fibroids large enough to cause significant pain (if in fact this is the cause of the pain and not something else) then that is pretty much a non-starter. Sop please find out about this. ALso does ultrasound report give the size of the fibroids?

Hormone therapy can be done with oral or injectable contraceptives or -- if these do not work -- with a class of drugs called GnRH agonists, the former is quite cheap, latter is expensive. All of these have potential risks/side effects especially in an older woman and this is a temporary not permanent solution.

Hysterectomy at a private hospital will cost around 250-350 k whereas it would be free free going through the government system (which would probably mean getting a referral from her community hospital to either provincial hospital in Nong Khai or the regional hospital in Udon).

If I were you I would think very carefully about paying for her to have surgery privately. Not only is it wasting a significant amount of money, for something in no way life threatening, but it will set up expectations that could easily bankrupt you in future.

Hi Sheryl. My partners sister is not yet starting the menopause, Being 49. She was on an injectable contraceptive previously while she worked in Taiwan together with him but came back in 2022 and stopped. I suppose this was the time the fibroids flared up. So do you think she would end up being advised to restart as a hormone therapy?

I think now it’s going to be treated as fibroids I’ll probably just let them get on with it and help them with going down the government hospital route as you’ve suggested.

Thanks for your efforts and advice. I’ll be back if I have more questions.

11 hours ago, Stevey said:

Hi Sheryl. My partners sister is not yet starting the menopause, Being 49. She was on an injectable contraceptive previously while she worked in Taiwan together with him but came back in 2022 and stopped. I suppose this was the time the fibroids flared up. So do you think she would end up being advised to restart as a hormone therapy?

I think now it’s going to be treated as fibroids I’ll probably just let them get on with it and help them with going down the government hospital route as you’ve suggested.

Thanks for your efforts and advice. I’ll be back if I have more questions.

Since she will likely reach menopause within the next few years, at which point the fibroids may naturally start to shrink, a governmrnt hospitl would probably have her try hormonal contraception first and then consider surgery if it doesn't work (or if she had medical contraindications to hormone treatment). A private hospital on the other hand will often push for costly surgery right off the bat.

It is wise for you to insist they use the government system for this. There may well come times in future when it would make an important difference to pay for some private care, but it would be both unaffordable and unreasonable to pay for it in all cases for all relatives just because they find the government system inconvenient to use, and that would be avbad precedent to set.

On 3/29/2026 at 5:05 PM, Stevey said:

My partners sister does not deal with the hospital. I have dealt with the hospital many times in PhonPhiSai NongKhai no particular issues. It’s my partner’s opinion that a lot of people choose Clinics because the hospital is expensive for the drugs they give up and are slow. That’s why you see masses of people in the waiting rooms at night , at the clinics avoiding the masses of people waiting at the hospital. Although to be fair our lad has urethritis which was diagnosed and meds given in about 10 mins as the clinic was empty when we went. If that was the hospital, in my experience, it would have been an hour and the drugs would have cost 500 baht and have included paracetamol that we have at home anyway.

Anyway Sheryl Thanks for taking up my case. What do you think I’m looking at cost wise for a private consultation at the likes of Wattana Nong Khai ? I understand that the pathway through the government hospital is free and it should deliver a correct diagnosis so why is the private system there ? Do you think getting a rock solid second opinion from a private hospital is required or is a towns private gynaecologist good enough?

For the op: the same doctors that work in the private hospitals around this area in Udon and Nong Khai also work in the government hospitals.

The government hospitals are so much less expensive, and the private hospitals are nothing but a rip-off. So I say, go to the government hospital.

Note for Info.

I had Ultrasound at BKKH Udon Thani, this week.

Procedure THB 3900

Final Bill THB 4350 incl doc & hospital cost.

2 hours ago, Sheryl said:

Since she will likely reach menopause within the next few years, at which point the fibroids may naturally start to shrink, a governmrnt hospitl would probably have her try hormonal contraception first and then consider surgery if it doesn't work (or if she had medical contraindications to hormone treatment). A private hospital on the other hand will often push for costly surgery right off the bat.

It is wise for you to insist they use the government system for this. There may well come times in future when it would make an important difference to pay for some private care, but it would be both unaffordable and unreasonable to pay for it in all cases for all relatives just because they find the government system inconvenient to use, and that would be avbad precedent to set.

I think you’re right about her needing to use the government hospital route. I just told them it’s likely she’ll be advised to go back on contraception. She says she reacted to her previous contraceptive with

2 hours ago, lagavulin1 said:

Note for Info.

I had Ultrasound at BKKH Udon Thani, this week.

Procedure THB 3900

Final Bill THB 4350 incl doc & hospital cost.

Yes. The hospital we went to seems to be the Thai Private hospital in PhonPhiSai called ‘Phisai Vetchacan’ that ultrascan and some meds was 2300Baht all in which was pretty cheap for the sister as I paid it.

I previously mentioned I was willing to pay for something. That was because in the day, a few days back now, I was sent to pick up some meds from the pharmacy in town to help with the pain of this ongoing and up to then undiagnosed issue with pain in the abdomen treated by a Gynaecologist in town. This has been going on a year plus and now the pains were worse than ever. At this time I thought we need to get to a proper place that has the best chance of diagnosis. It looks like this local private hospital has nearly got to the issue pointing out those fibroids, that the Missus’ Sister called ‘Cysts’ originally. So at this time I won’t be splashing out anymore cash right now.

I’ll keep it posted here on the progress.

If a Thai doctor says there are cysts in the uterus causing abdominal pain, I’m 99% sure they mean adenomyosis, or endometriosis of the muscular layer of the uterus. It can cause very severe menstrual cramps. A hysterectomy can help, but there are other options to consider before resorting to it.

On 4/11/2026 at 8:04 PM, PPMMUU said:

If a Thai doctor says there are cysts in the uterus causing abdominal pain, I’m 99% sure they mean adenomyosis, or endometriosis of the muscular layer of the uterus. It can cause very severe menstrual cramps. A hysterectomy can help, but there are other options to consider before resorting to it.

As soon as the Missus sister came out of the hospital she showed a scan and said “Cyst” 4 Cysts. After comments here and research here I put it to her it was Fibroids and she agreed. I’ll ask again as she’s going back soon

On 4/11/2026 at 8:04 PM, PPMMUU said:

If a Thai doctor says there are cysts in the uterus causing abdominal pain, I’m 99% sure they mean adenomyosis, or endometriosis of the muscular layer of the uterus. It can cause very severe menstrual cramps. A hysterectomy can help, but there are other options to consider before resorting to it.

What are the other options?

11 hours ago, Stevey said:

What are the other options?

Hormone treatment ss previously explainef.

It’s hard to believe that a Thai OB doctor would call fibroids “cysts.” Many Thai doctors don’t even use the term “fibroid” and prefer “myoma.” When Thai doctors mention fibroids, they often refer to them as เนื้องอก (literally “tumor”), while “cyst” most often refers to endometriotic cysts or other ovarian cysts.