Concerns About Irregular Menstrual Cycles and Abdominal Discomfort

Worry

Dear Doctor: I experienced brown discharge a few days before my period in February, and it was still not close to my expected menstrual date.
After examination, the doctor diagnosed me with irregular menstrual cycles and administered a menstrual induction injection along with medication.
However, my period was delayed by almost a week and finally started on February 17.
In March, my period was still not on time, and I also experienced bloating and pain on both sides of my abdomen, particularly discomfort in the lower area upon waking.
There was a time when pressing on the left side (lower abdomen) caused pain, and I felt that my abdomen seemed slightly larger in the past few days.
Since I had a cesarean section, I am unsure if this is a residual effect or if I might be pregnant, but given the limited frequency of intercourse with my husband, I am quite worried.
Could you please provide some clarification? Thank you.

Xiao Mama, 20~29 year old female. Ask Date: 2006/03/21

Dr. Chen Nengjin reply Obstetrics and Gynecology

Your issue requires an in-person examination at the hospital to confirm the diagnosis.
Please visit the nearest gynecology outpatient clinic for evaluation.
Thank you.

Reply Date: 2006/03/21

More Info

When it comes to selecting an appropriate internist for your mother's abdominal and navel pain, there are several factors to consider, especially given her age and existing health conditions such as diabetes, heart disease, and hypertension. At 73 years old, your mother is at a higher risk for various gastrointestinal and gynecological issues, and her symptoms warrant a thorough evaluation.

Firstly, the symptoms you described—pain in the lower abdomen, a feeling of tightness, and loss of appetite—could potentially be linked to several underlying conditions. Given the location of the pain, it is important to consider the organs involved, which include the intestines, bladder, uterus, and ovaries. Since your mother has a history of urinary tract infections and has undergone various imaging studies, it would be prudent to consult a gastroenterologist to rule out any gastrointestinal issues such as diverticulitis, bowel obstruction, or even colorectal cancer, especially considering her family history of colon cancer.

In addition to a gastroenterologist, a gynecologist should also be consulted to evaluate any potential gynecological issues, particularly since she is experiencing pain near the navel and has a history of abdominal surgeries. A pelvic ultrasound may be necessary to assess the ovaries and uterus for any abnormalities such as cysts or fibroids, which could be contributing to her symptoms.

Regarding the pain above the navel, it is essential to differentiate whether this is related to gastrointestinal issues or possibly cardiac concerns. While the pain could be referred pain from the abdomen, it is crucial to rule out any cardiac issues, especially given her history of heart disease. A visit to a cardiologist may be warranted if the pain persists or is accompanied by other symptoms such as shortness of breath, chest pain, or palpitations.

In summary, the best course of action would be to schedule appointments with both a gastroenterologist and a gynecologist. They can perform the necessary examinations and tests, such as blood tests, imaging studies, and possibly endoscopic procedures, to determine the cause of her symptoms. It is also important to keep her primary care physician informed of her symptoms and any new developments, as they can help coordinate her care among specialists.

In addition to seeking medical advice, it is crucial to monitor her symptoms closely. If she experiences any sudden changes, such as severe pain, fever, or changes in bowel habits, it is important to seek immediate medical attention. Given her complex medical history, a multidisciplinary approach will be the most effective way to address her health concerns and ensure she receives comprehensive care.

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