Endometrial 'Abscess'

[Neeranam]

My wife has been the doc and has pain in the pelvic area. She has been having some pain for many years after first having a emergency c-section at 6 months, which was seemingly cut vertically and then horizontal ones with the next 2 childbirths.

She got some hormonal injection and the pain is going. Also got an ultrasound. The doc said if it is still sore after 3 months to go back and he'd cut something. Does anyone know if it would be wise to get whatever it is cut or get a second opinion or what? he has been going on about cancer for some time after a friend got it there - is there a danger of this?

[Sheryl]

It is not possible to know for sure but it sounds like the doctor thinks this is endometriosis. From clinical signs and an ultrasound only, the diagnosis can only be tentative. Definitive diagnosis requires a laparcoscopy. Usually when that is done, they will at the same time remove as many of the "chocolate cysts" as they can (these are not abscesses, but rather cysts).

I very much doubt she has an abscess as it would not be treated with hormones, whereas endometriosis is.

IF it is endometriosis, there is no risk of it turning malignant, but it is a painful condition. Treatment is with hormonal medication to start with. Sometimes surgery is required but should indeed get another opinion and if it is done, should be by someone specializing in laparoscopic treatment of endometriosis.

Management also depends on the woman's age and whether she want to have more children. Surgery to remove chocolate cysts is often only of temporary use as they tend to recur. A complete hysterectomy (removal of not only uterus but also ovaries) will cure the condition but at the price of a surgical menopause. Natural menopause will cure the condition as well so if she is close to menopause age might be best to just treat conservatively until menopause.

[Neeranam]

Thanks very much Sheryl, much appreciated.

Yes, cysts, my Thai medical vocab. is not very good.

Very assuring to know it's not a high risk for cancer.

She can't have any more children and she is 37.

Not sure if she is near menopause but her mood has been 'trying' recently.

[Sheryl]

At 37 she still has at least 10 years to go, maybe more.

If the hormones she has been given don't work she'd best see a specialist. Give it some time and then let me know if you need a referral (and if so, where you live).

[arjunadawn]

At 37 she still has at least 10 years to go, maybe more.

If the hormones she has been given don't work she'd best see a specialist. Give it some time and then let me know if you need a referral (and if so, where you live).

Hello, may I make an observation? Remember, this sounds very much like endometriosis. The awful nature of this means tissue that is structurally and functionally the same as the uterus is located in bits and pieces throughout the body, usually in the abdomen and pelvis. Therefore, as the woman's hormones change monthly the specific hormone that acts upon the uterus to cramp, expel, proliferate, etc., will also act on these bits of tissue elsewhere, and they may actually cramp and bleed beneath the surface. The pain is tremendous. The point is, weigh carefully, with a smart and compassionate doctor, all choices, especially surgical. Removal of uterus will not always totally eliminate problem.

My fiancé is also a doctor and she has this condition. It's quit difficult to treat. We are both also trained in eastern medicine and while herbs and acupuncture have various degrees of success, and my fiancé remains optimistic, the results are unremarkable, I feel. She still suffers. Lastly, there are known "Wholeness" interventions that are effective for many woman: assuming problematic cysts are removed, many women benefit from dietary changes, lifestyles changes such as an exercise routine, some incorporate herbs and/or acupuncture, and lastly some women utilize some type of energy work. Yes, this is a mixed bag; but when you later note how intractable this condition is it's easier to understand why such a broad spectrum approach.

[Neeranam]

Thanks Arjunadawn.

She does take some herbal drink that seemingly helps - not sure what it is though.

She''s been feeling dizzy and had like morning sickness!

[Sheryl]

Thanks Arjunadawn.

She does take some herbal drink that seemingly helps - not sure what it is though.

She''s been feeling dizzy and had like morning sickness!

Probably side effects of whatever the herbal drink is.