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Why You Need a Pelvic Ultrasound To Determine These Causes of Your Menstrual Pain

March 13, 2019

  1. Pelvic pain can be elusive as it can be due to a variety of causes from symptoms of ovulation, to pelvic muscle tension or many gynecologic issues.
  2. Women who have had gynecologic procedures can have long term side effects that produce pain. For instance, Endometrial Ablations work by preventing menstrual lining regrowth and thus preventing cycles. Eventually, in the years after an ablation, the ongoing hormonal production from the ovaries may cause the lining to regrow. Pelvic examinations do not determine lining thickness, only an ultrasound can.
  3. Ultrasounds can determine many uterine conditions, can look at the wall of the uterus, outside a uterus, and whether there is blood within the cavity. Aging causes a condition of endometriosis within the wall of the uterus, known as adenomyosis. But research and repeat ultrasounds have shown even much younger women can have this condition. It too is diagnosed by ultrasound.
  4. There are rare causes of hematometra that wouldn’t be caused by the endometrial ablation. If a young woman has vaginal tract abnormalities that cause blood to back within the vagina, before backing up with in the uterus, the term is hematocolpos.
  5. Pelvic inflammatory disease (PID) can cause pain. If the fallopian tube (tubes) is dilated with blood as well, the term is hematosalpinx. If the condition is in the fallopian tube after an endometrial ablation it is called a post endometrial ablation syndrome. It also can be seen on ultrasound. Many causes of this hematometra, or blood trap are due to infections, usually an infection of the cervix, but it may have been the whole uterus.
  6. Other causes are scaring, prior surgeries such as endometrial ablations (not a common cause of this), Ascherman’s syndrome with scaring in side the uterus itself, tumors of the cervix, or even some cases due to radiation treatments after cancers. IUDs are not typical causes of hematometra. The symptoms are usually sharp pains, often in a cyclic timing, and they usually are located very low in the pelvis or the abdomen, right in the mid line. Sometimes the ultrasound testing to determine what is going on may have to be accompanied by a fluid test called SIS or even cultures.
  7. It takes a gynecologist to diagnose this condition. Pelvic exam is helpful but the best tool for the first diagnosis is an ultrasound. Often the best treatment is just opening up the block, but physically looking into the cervix to see if pockets of blood can be released via a surgical procedure. Some cases are more complex than this.
  8. For women still wanting to conceive treatment can reverse the symptoms and causes of pelvic pain.

For an appointment call 217-356-3736

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