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Menopause

Adhesions + perimenopause ?

01/04/2008

Question:

I`m 43, have long-standing Crohn`s Disease with two small bowel resections, two rectal surgeries, and one c-section delivery. Also, this year, I was diagnosed with mild interstital lung disease. In 2007, I had a CT scan of lungs, torso, and pelvis. A posteriorly displaced uterus was noted, which I was told is common. I`m wondering if it`s possible that adhesions from either disease or surgery could be pulling the uterus out of place and making my very light periods extremely painful with lower back pain and cramping. My cervix is also far to the left. It seems to me that the menstrual flow is having difficulty getting out and this may be causing the extreme pain. I`ve used Percocet, given for the IBD, during the extreme cramping, and sometimes it seems to help bring about a greater flow, as if relaxing the tense muscles helped induce flow. I`m experiencing perimenopausal symptoms, as well.

Because so much attention is spent on treating Crohn`s and lung disease, I haven`t pursued this light period with extreme pain with my physicians. I mentioned it during a pelvic exam by an OB/GYN this year and was dismissed and told that adhesions would cause pain all the time and not just during period. I`m guessing that during menstruation and just before there is a sort of sweling of the inside parts, and I`m guessing the light periods and pain are connected. Is my guess reasonable?

Should I make a point of discussing this with either my gastroenterologist or primary care doctor since the OB/GYN was not so easy to talk to? Is it okay to use Percocet when the cramping pain is extreme without consulting a doctor for using the Percocet this way because maybe this is something serious that I`m ignoring?

I have a busy, active, happy home life where I am a mother and homemaker. Thank you for your time and insight.

Answer:

Adhesions could be contributing to your symptoms as could endometriosis.  Check with your surgeons as to whether they saw any endometriosis at the time of your prior surgeries.  If the cramping is unmanageable, you could discuss the option of hormonal suppression of your menses through various means if you have no contraindication.

For more information:

Go to the Menopause health topic, where you can:

Response by:

Margery   Gass, MD Margery Gass, MD
Formely, Professor, Clinical Obstetrics & Gynecology
College of Medicine
University of Cincinnati