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Forum Name: Gynecology

Question: Sudden Pelvic pain and strange bleeding 4 yrs post Mirena!


 chelleybub - Fri Apr 03, 2009 11:25 am

Hi, I am a mum of 3 and had the Mirena put in 4 years ago after an ectopic which resolved naturally, when I had that ectopic they could not find a pregnancy in the womb only a fluid filled cyst on my ovary so they thought it was an ovarian ectopic. I had the usual symptoms of spotting etc for about a year but eventually my periods became regular and lighter (they have never stopped) though they can last for 10 days. Last month I noticed pre menstrually a lot of breast tenderness, the level I normally get when I am preggers. I started my period a few days late and it was very light, lighter even than normal, no tampons required. Then on the 7th March about 7 days into this light period out of the blue while shopping I got cramping and started bleeding really heavily. Sometimes the pains were uterine and other times it felt more painful on my left side, where I imagine my ovary is, (in fact it was the exact discomfort I experienced with the previous ectopic pregnancy). The next day I rested but I still bled just a bit lighter and I felt achey and bloated. 2 days later I went shopping and on the way back I could feel the bleeding really increase. By the time I got back I had to sit on the loo and just let it run out, with big clots. Also when I wiped I noticed some stretchy tough membrane???
I went to the doc that evening and he prescribed anti-imflammatories. He felt my tum which was tender and took my temp which was slightly raised. He thought it was a hormone imbalance even though I told him about the intermittent pain on one side. He asked me to take a pregnancy test which I did that night and it was negative. The doc also asked me to book in for swabs (which because a nurse was off sick and a long waiting list, I couldnt have until the 26th)
I went back to the doc a week after the initial appointment and he had a student doc with him and they both seemed to thing this strangeness is something to do with my hormones because the mirena is now 4 years old and even suggested I take extra hormones. But because of the one sided discomfort I was wondering if I have a cyst on my ovary?
The Bleeding bloating and cramping tailed off but the one sided pain continued over a period of about a week. Then the bleeding stopped for about 4 or 5 days and I nearly felt normal again. Then I started spotting and light bleeding and that has lasted for a week, feeling bloated again and now its again easing off just light spotting. Through all this I have been feeling stressed about what is wrong with me, worrying that I have something really serious (my aunt died of ovarian cancer though she was in her mid 70's).
I rang for my swabs today and they said 2 out of 3 have come back so far and they are normal. The receptionist said they came back the same day they were taken on the 26th which I thought was wierd because I thought it took time to culture the samples? am I wrong about that?
So sorry for all the waffle but can you give me any other ideas about what might be wrong with me so I am more armed when I go back to see my GP?
I truly appreciate the time anyone takes in replying to this!

Michelle
 Debbie Miller, RN - Sat Apr 04, 2009 4:20 pm

User avatar Hello,
I agree that this is most likely hormonal fluctuation. Most women do not have consistent levels of hormones with resulting predictable periods. I do not think anything seriously is wrong, though you could be entering the period of perimenopause which can last for several years prior to the actual cessation of periods. Irregular bleeding patterns is very typical of this period.

The fact that your doctor has done the screenings we recommend is reassuring that you probably have nothing to be alarmed about. Since I don't know exactly what tests were done with the "swabs" I am assuming it is a pap smear with screening for sexually transmitted diseases. Usually pap smear results take a little while because the sample is sent out to a lab. If you have questions about which tests were performed and the results, you should call the office back and ask for a consultation appointment to discuss your results and ongoing symptoms.

It can take a while and different medications to establish a good pattern of hormonal function. Hopefully they will be able to help you to the degree you can feel "normal" while functioning as you should. Regular periods are not important for good health and your pattern can be normal even if it is irregular. Each woman's experience with Mirena or other contraceptive methods is different.

Your doctor may recommend an ongoing regimen of anti-inflammatory medication and/or hormones if this helps but it may take a little while of trial and error to get the right treatment.

Best wishes.
 chelleybub - Sun Apr 05, 2009 4:59 am

hi Debbie, Thank you so much for your reply. Just to update, I have not had a smear test, my last one,which was clear, was 2 year ago. Should I ask for one?
So could the Mirena have been masking this pre menopause symptoms and now the level in the mirena is dropping I am experiencing them? Could also this drop of hormone in the mirena explain the extra breast tenderness I had just before this month long bleeding? Do you think I may have ovulated again after a long break? I also noticed a rise in libido after 4 years of it being very low the month before all this pain and bleeding.
Also am I possibly entering the menopause early because I started my periods early (aged 11). My mum didnt go through hers until she was 50 and I am not yet 39 and she started menstruating at 13.
One more thing, should I ask for a scan because of the achy pain I get on my low left side?

Thanks again you for your time and effort.

Michelle
 Debbie Miller, RN - Sun Apr 05, 2009 7:45 pm

User avatar Hello,
An ovarian cyst is always a possibility but these are quite common, often disappear on their own so you may not actually need to have a scan. If you benefit from the additional hormones, you can probably just go forward with that treatment.

Perimenopause is not the same as menopause and onset is varied among women; can even last 10 years prior so if you are entering that you still may not reach menopause for several years. Discuss this with your doctor. It is possible you could experience menopause a little earlier due to early menarche but not necessarily.

Best to you

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