Left Lower Abdominal Pain and Rectal Discomfort in Women - Obstetrics and Gynecology

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Understanding left lower abdominal pain and rectal discomfort in women can be quite complex, especially in the context of pre-existing conditions like polycystic ovary syndrome (PCOS) and irregular menstrual cycles. Your symptoms, including prolonged menstrual bleeding, left lower abdominal pain, and rectal discomfort, warrant a thorough investigation to determine their underlying causes.

Firstly, it’s important to recognize that PCOS can lead to a variety of symptoms, including irregular periods, pelvic pain, and hormonal imbalances. The prolonged menstrual bleeding you described, lasting over 15 days, can be attributed to the hormonal irregularities associated with PCOS. This condition often leads to anovulatory cycles, where ovulation does not occur, resulting in prolonged or heavy menstrual bleeding. The injection you received may have been aimed at regulating your menstrual cycle or addressing the heavy bleeding.

The left lower abdominal pain you are experiencing could be related to several factors. Given that you have reported a sensation of pain radiating to the rectal area, this could suggest involvement of the pelvic organs or structures. Conditions such as endometriosis, which is characterized by the presence of endometrial tissue outside the uterus, can cause significant pain and discomfort, particularly during menstruation. Endometriosis can also lead to inflammation and scarring, which may explain the elevated inflammatory markers in your blood tests.

Additionally, the pain you are experiencing could be related to pelvic inflammatory disease (PID), which is an infection of the reproductive organs that can occur due to sexually transmitted infections or other bacterial infections. PID can lead to chronic pelvic pain and may also cause irregular bleeding. However, since your imaging studies (ultrasound, CT scan) did not reveal any abnormalities, PID may be less likely, but it cannot be entirely ruled out without further evaluation.

The rectal discomfort you mentioned could also be linked to gastrointestinal issues, particularly if there is any history of constipation or bowel irregularities. Sometimes, pelvic pain can be referred from gastrointestinal sources, especially if there is any underlying bowel condition, such as irritable bowel syndrome (IBS) or diverticulitis. The fact that you have undergone stool tests and imaging without significant findings suggests that this may not be the primary cause, but it is worth considering.

Given the complexity of your symptoms and the lack of definitive findings from your tests, it may be beneficial to consult with a specialist in both gynecology and gastroenterology. A gynecologist can further evaluate for conditions like endometriosis or fibroids that may not have been detected on initial imaging. A gastroenterologist can assess for any underlying bowel issues that may be contributing to your symptoms.

In terms of management, addressing the underlying hormonal imbalance associated with PCOS may help regulate your menstrual cycle and alleviate some of the associated symptoms. Hormonal treatments, such as birth control pills, can be effective in managing heavy menstrual bleeding and associated pain. Additionally, non-steroidal anti-inflammatory drugs (NSAIDs) may help alleviate pain, although you mentioned they have not been effective for you. It may be worth discussing alternative pain management strategies with your healthcare provider.

In conclusion, your symptoms of left lower abdominal pain and rectal discomfort are likely multifactorial, influenced by your PCOS and possibly other gynecological or gastrointestinal conditions. A multidisciplinary approach involving both gynecological and gastrointestinal evaluations may provide a clearer understanding of your symptoms and lead to more effective management strategies. It is essential to continue working closely with your healthcare providers to explore all potential avenues for diagnosis and treatment.