Left Lower Abdominal Pain and Swelling in Women - Obstetrics and Gynecology

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Understanding left lower abdominal pain and swelling in women can be quite complex, especially when considering the various potential causes and the individual medical history. Based on your description, it seems that you are experiencing significant discomfort and swelling in the left lower abdomen, particularly during the mid-cycle of your menstrual period. This type of pain can be attributed to several factors, including hormonal changes, anatomical variations, or underlying medical conditions.

Firstly, it is important to consider the possibility of ovarian cysts. After the removal of one ovary, the remaining ovary may sometimes develop cysts, which can lead to pain and swelling. These cysts can fluctuate in size and may cause discomfort, especially during ovulation or menstruation. The fact that you have undergone multiple ultrasounds without any findings may suggest that the cysts are functional and transient, meaning they could resolve on their own.

Another potential cause of your symptoms could be related to adhesions or scar tissue from your previous surgeries. Adhesions can form after any abdominal or pelvic surgery and may lead to pain or discomfort, particularly if they affect the surrounding organs. This could explain the intermittent nature of your pain and swelling, as adhesions can sometimes cause organs to stick together or pull on each other during certain movements or activities.

Endometriosis is another condition that could be contributing to your symptoms. This occurs when tissue similar to the lining of the uterus grows outside of it, often causing pain, especially during menstruation. The presence of endometrial tissue on the ovaries or surrounding structures can lead to cyclical pain and swelling, which aligns with your experience of increased pain during your menstrual cycle.

Pelvic inflammatory disease (PID) is another consideration, particularly if there is a history of infections. PID can cause inflammation of the reproductive organs and may lead to pain and swelling. However, given that you have had multiple ultrasounds showing no abnormalities, this may be less likely.

In terms of diagnostic approaches, while ultrasounds are a common first step, other imaging techniques such as MRI or CT scans may provide additional insights, particularly if there is a concern for structural abnormalities. Additionally, a laparoscopy could be considered if there is a suspicion of endometriosis or adhesions that are not visible on imaging.

Regarding management, pain relief can be approached through various methods. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) may help alleviate pain during episodes. If the pain is severe and recurrent, discussing hormonal treatments with your healthcare provider may be beneficial, as they can help regulate your menstrual cycle and potentially reduce the occurrence of pain.

Lastly, it is crucial to maintain open communication with your healthcare provider. If your symptoms persist or worsen, or if you develop new symptoms such as fever, vomiting, or significant changes in bowel habits, it is essential to seek medical attention promptly. Your concerns about the swelling and pain are valid, and ensuring that you receive appropriate follow-up care is important for your overall health and well-being.