Post-Ovarian Surgery: Left-Side Pain During Menstruation - Obstetrics and Gynecology

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Post-ovarian surgery pain, particularly during menstruation, can be a complex issue that may stem from various underlying causes. Given your history of left ovarian surgery due to a large tumor, it is understandable that you are experiencing these unusual symptoms. The pain you describe—sharp, nerve-like, and radiating to your left leg—suggests that there may be several factors at play.

One potential cause of your pain could be adhesions, which are bands of scar tissue that can form after surgery. These adhesions can cause organs to stick together or to the abdominal wall, leading to pain, especially during menstruation when the uterus contracts. This is particularly relevant in your case, as you have undergone a significant surgical procedure that could lead to such complications.

Another possibility is endometriosis or adenomyosis. You mentioned that some doctors noted mild adenomyosis, which is a condition where the tissue that normally lines the uterus grows into the muscular wall of the uterus. This can lead to painful menstruation and may also cause pain in the lower abdomen and pelvic area. Endometriosis can sometimes cause nerve pain, which could explain the sensations you are experiencing in your leg.

Pelvic inflammatory disease (PID) is another consideration, although your ultrasound results have been normal. PID can cause chronic pelvic pain and is often associated with infections. If there is any suspicion of PID, further testing, such as a pelvic exam or cultures, may be warranted.

In terms of diagnostic tests beyond ultrasound, you might consider a pelvic MRI, which can provide a more detailed view of the pelvic organs and help identify any abnormalities that an ultrasound might miss. A laparoscopy could also be performed if there is a strong suspicion of endometriosis or adhesions, allowing for direct visualization and potential treatment.

For pain management, since over-the-counter pain medications have not been effective, you might explore other options. Prescription medications, such as stronger analgesics or hormonal treatments, may help manage your symptoms. Hormonal therapies can sometimes reduce the severity of menstrual pain by regulating or suppressing the menstrual cycle. Additionally, physical therapy focused on pelvic floor dysfunction may provide relief by addressing any muscular or nerve-related issues contributing to your pain.

Lastly, considering the psychological aspect of chronic pain is crucial. Pain can have a significant emotional impact, and therapies such as cognitive-behavioral therapy (CBT) or mindfulness-based stress reduction may help you cope with the pain and improve your quality of life.

In summary, your left-sided pain during menstruation could be due to a combination of factors, including adhesions, endometriosis, or other pelvic conditions. It is essential to continue working closely with your healthcare providers to explore these possibilities and find an effective management strategy tailored to your needs. Regular follow-ups and open communication about your symptoms will be key in addressing this ongoing issue.