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Ask the Medical Expert Archives 2000-2004

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Bleeding and Abdominal Pain

January 2000

Q. Several months ago, I began experiencing heavy vaginal bleeding and abdominal pain. I have been seen by my primary physician, my gynecologist and a gastroenterologist. One of the tests showed several polyps located in the large intestine and stomach. These were removed, but I still have some abdominal pain. My gynecologist has checked for cancer, but found none. She put me on birth control, which has slowed the bleeding, but now my periods are more frequent (about every 16-19 days) and last longer (about 8-9 days). My gynecologist has recommended a hysterectomy. I'm not sure I want a hysterectomy, but I don't think I can tolerate the stomach pain and the frequent bleeding much longer. Do you have any suggestions?

A. You have several symptoms including fatigue, Abdominal pain, and heavy/frequent periods. You mentioned no evidence of cancer which is great, but might you have uterine fibroids with resulting anemia? I don't think the colon and gastric polyps would cause these symptoms. Other things to rule out would be thyroid disease, Vit B12 deficiency, and endometriosis. If not done yet, I would suggest labs including: a CBC, lytes, SMA-12, B12 level, TSH, FTI and urine analysis.

Your gynecologist may want to consider a laparoscopy (scope to look in the pelvic cavity). I assume you at least had a pelvic and abdominal ultrasound already, if not, I would suggest it. I would ask your gynecologist if depot Lupron injections (a different type of hormone therapy) may be worth a try instead of the birth control pills. I can understand your reservations about having a hysterectomy and would consider the above first. Hope you feel better soon.

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