Abdominal Pain and Menstrual Irregularities in Women

Abdominal pain, menstrual irregularities, prolactinoma, polycystic ovary syndrome?

Hello doctor, I would like to ask about some symptoms I experienced after having unprotected intercourse with my boyfriend.
I felt pain in my right ovary during the night; could this be a sign that my period is coming, or is it possible that I could be pregnant? I have polycystic ovary syndrome and a prolactinoma, and I haven’t had my period for five months.
I have been on medication for the prolactinoma, and my prolactin level is 110.
I have also been taking traditional Chinese medicine for the past two months; would this affect the accuracy of a pregnancy test? Should I continue seeing a traditional Chinese medicine practitioner or consult a gynecologist? Does having elevated prolactin levels make it more difficult to conceive?

yuyu, 20~29 year old female. Ask Date: 2022/02/20

Dr. Chen Zhiyu reply Obstetrics and Gynecology

Regarding your concerns, it is true that general ovarian dysfunction combined with abnormal prolactin levels can make conception more difficult.
However, due to this, unexpected pregnancies may not be easily identified through menstrual symptoms.
It is recommended that if your period does not occur about 2 to 3 weeks after an unprotected intimate encounter, you should consider taking a home pregnancy test.
If you require further consultation or confirmation, it is advisable to visit a gynecologist.
Thank you for your inquiry, and I wish you health and happiness.

Reply Date: 2022/02/20

More Info

Understanding abdominal pain and menstrual irregularities in women can be complex, especially when considering various underlying conditions and recent sexual activity. In your case, the right-sided ovarian pain you experienced after unprotected intercourse could be attributed to several factors, including hormonal fluctuations, the presence of ovarian cysts, or even the onset of menstruation. Given your history of polycystic ovary syndrome (PCOS) and prolactinoma, it is essential to consider how these conditions may affect your menstrual cycle and overall reproductive health.

Polycystic ovary syndrome is a common endocrine disorder that can lead to irregular menstrual cycles, anovulation, and various symptoms such as abdominal pain, weight gain, and hirsutism. Women with PCOS often experience hormonal imbalances that can result in the formation of cysts on the ovaries, which may cause pain, particularly during ovulation or menstruation. The pain you felt could be related to an ovarian cyst or the hormonal changes associated with your menstrual cycle.

On the other hand, prolactinoma, a benign tumor of the pituitary gland that produces excess prolactin, can significantly impact menstrual regularity and fertility. Elevated prolactin levels can inhibit ovulation, leading to amenorrhea (absence of menstruation) and making it more challenging to conceive. If your prolactin levels have been consistently high, it is crucial to continue monitoring and managing this condition with your healthcare provider.

Regarding your concern about pregnancy, if you have not had a menstrual period for five months, it is possible that your body is not ovulating regularly, which could make conception less likely. However, it is still possible to become pregnant even with irregular cycles. If you suspect you might be pregnant, a home pregnancy test could provide some insight, but keep in mind that hormonal treatments and conditions like PCOS can sometimes lead to false negatives or positives.
As for your question about whether to continue seeing a traditional Chinese medicine (TCM) practitioner or consult a gynecologist, it may be beneficial to pursue both avenues. TCM can offer supportive care and may help with symptoms, but it is essential to have regular check-ups with a gynecologist, especially considering your medical history. A gynecologist can provide a comprehensive evaluation of your reproductive health, including hormone levels, and help you navigate your options for managing PCOS and prolactinoma.

In summary, the abdominal pain you experienced could be related to several factors, including hormonal changes, ovarian cysts, or the onset of menstruation. Given your medical history, it is crucial to maintain open communication with your healthcare providers, monitor your symptoms, and consider both conventional and alternative treatments to optimize your reproductive health. If you continue to experience pain or have concerns about your menstrual cycle or fertility, do not hesitate to seek further evaluation from a specialist.

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