How to explain a hypothalamus problem in Thai?

[RandolphGB]

My girlfriend had an operation for endometriosis last year to remove a chocolate cyst... and recently she's had body temperature problems. 

 

I don't know if the two are linked... but I'm guessing that there is some issue with her hypothalamus, which regulates hormones for feeling hot and cold. 

 

For example, just stepping outside and walking to the BTS station her face will be dripping with sweat and she'll complain of being hot. Even tourists don't seem that hot, though. Or in air con rooms she'll feel cold.

 

How can I explain in Thai this medical possibility to her? I tried, but I couldn't explain it. 

 

Yes, I have tried to get her to the doctor but she doesn't want to go and I really don't think they'd be that useful unless they're in detail in Thai what I think the problem could be - eg the hypothalamus. 

 

Any help much appreciated... or if somebody recommends a good doctor in BK for this kind of thing that would be useful!

 

 

[Sheryl]

It is extremely unlikely that what you describe is due to the hypothalmus. The hypothalmus does regulate body temperature, but changes in internal body temperature are not the same thing as the subjective feelings of hot and cold and heat intolerance that you describe.

 

The usual causes  in women are (1)  flunctuations of estrogen levels  due to menopause/ perimenopause (if the operation she had was a total hysterectomy, i.e. removal of uterus and ovaries, it will have caused a "surgical menopause" which is especially severe and defininitely requires estrogen replacement therapy; otherwise, might be the beginning of normal age-related menopause if she is 40 or over.); (2) side effects of certain sex hormones including birth control injections/pills and hormones prescribed to control endometriosis -- if she did not  have a complete hysterectomy then it is highly likely she was placed on such medication and (3) thyroid imbalance (this last can be true in men as well).

 

Given the history of endometriosis, and your description of the surgery she had, (which sounds like it was not a hysterectomy), side effects of hormonal medication she is taking is the most probable cause. These might be what are called Gonadotropin-releasing hormone agonists/antagonists prescribed specifically for endometriosis (which do tend to cause menopausal-like side effects including hot flashes and heat intolerance) , or they might be birth control pills, injections or medicated IUD (used both to prevent pregnancy and to help control endometriosis). If she is taking Gn-RH agonists/antagonists, a low dose of estrogen/progesterone supplementation can help offset these side effects.  If she is taking birth control pills/injections or using a medicated IUD, a change of medication may help. The best person to discuss all this with is the doctor who is treating her endometriosis.

 

 

 

 

[RandolphGB]

Hi Sheryl, thank you so much for the reply. No, it wasn't a full hysterectomy and she's 32. The doctor did initially give medicine after the operation but 6 months later it was changed to the pill, standard contraceptive medicine. So I assume the sweating is caused by the pill.

 

The last doctor discharged her and at the minute she's not being treated by anybody for endometriosis. This seems strange to me as the cyst could come back. She doesn't have any symptoms though, so it just seems like a case of waiting for something that may or may not return.

 

I want to take her to the doctor but last time they said there was nothing wrong, so there was nothing there that they needed to do.

[Sheryl]

Early menopause is a possibility - it does happen. Blood tests can tell whether this is the case with her. They are best done immediately after a period OK.

 

If tests show she is not starting early menopause, the problem  may well be the pill in which  case a change of brand or change to a different contraceptive altogether may help her.

 

If you are in Bangkok this doctor is reputed to be among the best for this sort of thing http://www.vichaiyut.co.th/thai/doctor_detail.asp?id=44

 

Blood test for menopause is best done on the 3rd day of a menstrual cycle (first day of menstruation = day 1) so might want to time the doctor visit accordingly

 

BTW what brand pill is she taking?

[RandolphGB]

It's Microgynon 30 ED...