What to test for/look back pain-period issues

[Soror]

Daughter has had horrible periods. Cramping that knocked her flat and very, very heavy bleeding. Finally last Dec we went and she got on the pill. It has been much better (when she takes it regularly - which she has been lately). In the last few months she's started to have back pain. It is now nearly constant. OTC meds are not touching it. She feels faint at times. I've got her an appointment with the ped on Thursday. The gyn can get her in on Monday. 

What do we need to look for?

I'm concerned about cysts/endometriosis. 

What else? Tests you would have done?

We had blood work before she went on the pill and nothing showed up then. 

[Katy]

Cysts & endo are what I’d be concerned about too. I can’t remember the name of the organization that has endo-friendly OBGYN’s, but I’d google and see if there is one near you for a second opinion if need be. 

The other thing you could talk to her about is trying a low fat vegan diet. This lowers both estrogen and histamine. Eating more cruciferous vegetables (broccoli, kale, cabbage) also lowers estrogen.  When I’ve had painful periods I’ve found following a plan like the PCRM one I’ll link below for even a month helps for months or even years.

https://www.pcrm.org/good-nutrition/nutrition-information/using-foods-against-menstrual-pain

[MooCow]

Meanwhile heating pads and those icey Hot pads that don't have to be plugged in, work as well. 

[ktgrok]

Any chance of a UTI? I'd check that at urgent care or even get one of those home tests. 

[kbutton]

8 hours ago, Katy said:

Eating more cruciferous vegetables (broccoli, kale, cabbage) also lowers estrogen.

DIM supplements can also do this. Thorne has one my women's health nurse practitioner likes. It's the stuff that makes the cruciferous veggies good for metabolizing estrogen. 

[prairiewindmomma]

Besides endometriosis rule out, and fibroid ruleout, I'd also look at SI joint dysfunction and ankylosis spondylitis which would explain back pain but not the menorrhagia. Odds are it's straight up dysmenorrhea and menorrhagia unless you have a history of endo in the family---is she taking a really good quality magnesium? Also, if you don't have her on something like Floradix, the super heavy bleeding can become cyclical.  Being anemic makes you more likely to have heavy bleeding, and heavy bleeding fuels the anemia. It's super stupid.

 

[BronzeTurtle]

kidney stones

[GoodGrief3]

My 17 year old just had surgery for endometriosis. It is relatively common, debilitating and horribly under/inadequately treated. The average GYN does not know how to deal with endo and will put women on BCP/IUDs as a bandaid while the disease continues to progress.

Go to the Nancy's Nook website for years of research and a list of excision specialists. If it's endo, excision is your daughter's best bet (not ablation, which is much more commonly practiced.)

Unfortunately, surgery is the only way to definitively diagnose it. I 100% suggest getting that surgery with an endometriosis specialist. not just a GYN.

Here's a link to an excellent NYT article from this past spring: https://www.nytimes.com/2021/04/27/health/endometriosis-griffith-uterus.html

Nancy's Nook: https://nancysnookendo.com/

Nancy's Nook has a Facebook group as well.

[mathnerd]

PCOS and cysts - take her to an OB/Gyn and have her evaluated and perform some scans to rule those out. I have a family member who tried to live with it for 8 years and eventually, a scan revealed a cyst/tumor which was 7 pounds in size. It is treatable when caught early. 

[Soror]

Thank you ladies- I'm checking all of this out before our appointments.

[BusyMom5]

Endo is so hard to get diagnosed!  I hope you get answers- I'd probably skip the pediatrician and just go to the gynecologist.

[Terabith]

Not a practical solution, but I went from having debilitating pain and gastro symptoms with my periods to virtually none after having kids.  I had fewer issues as a young adult pre-kids than I did as a teen.  I never had terrible bleeding.  If I had a kid with similar issues, I would have advocated for birth control pills to prevent periods.  

[Soror]

3 hours ago, BusyMom5 said:

Endo is so hard to get diagnosed!  I hope you get answers- I'd probably skip the pediatrician and just go to the gynecologist.

Ya, I think he's probably not much help but we were due for a visit. Maybe he can check for any basic things.

Fingers crossed the gyn is good

[GoodGrief3]

1 hour ago, Soror said:

Ya, I think he's probably not much help but we were due for a visit. Maybe he can check for any basic things.

Fingers crossed the gyn is good

I don't want to be a downer, but three different gyns later, and no relief for my daughter. Birth control pills or IUD are the typical default, and it is fine to try that. But if she doesn't get relief though, definitely try to get her in with someone who specializes in excision of endometriosis. We travled out of state to find the right person. I hope your daughter's path is simpler than that, but it's such a common story that I feel like I want to repeat my earlier advice. 🙂

[MercyA]

On 10/19/2021 at 11:58 AM, Katy said:

The other thing you could talk to her about is trying a low fat vegan diet. This lowers both estrogen and histamine. Eating more cruciferous vegetables (broccoli, kale, cabbage) also lowers estrogen.  When I’ve had painful periods I’ve found following a plan like the PCRM one I’ll link below for even a month helps for months or even years.

https://www.pcrm.org/good-nutrition/nutrition-information/using-foods-against-menstrual-pain

Yes. I have moderate endo which caused absolutely debilitating pain before I had a baby. A strictly followed almost vegan diet (I still ate eggs) lessened the pain to an extent that I didn't think was possible. It was amazing and I wasn't even looking for that effect.

As someone else noted, endo cannot be diagnosed definitively without exploratory surgery. It won't show up on a ultrasound. The surgery can be done laparoscopically. Mine was diagnosed and laser excised at the same time. However, the gyn might be able to make a good guess with an exam. Sometimes the internal organs are pulled out of place by the endometrial tissue and that can sometimes be felt.  

I have also had some fairly large ovarian cysts. Those can be seen on an ultrasound. Mine would come and go on their own. The pain was very distinctive--in the area of the ovaries and sharp like a knife. 

The faintness sounds like anemia. 

For me, back pain usually means a kidney stone or (once) a kidney infection. 

Hope you get it all sorted out! Poor girl. Thank God for modern medicine.

Edited October 21, 2021 by MercyA

[GoodGrief3]

1 hour ago, MercyA said:

 

As someone else noted, endo cannot be diagnosed definitively without exploratory surgery. It won't show up on a ultrasound. The surgery can be done laparoscopically. Mine was diagnosed and laser excised at the same time. However, the gyn might be able to make a good guess with an exam. Sometimes the internal organs are pulled out of place by the endometrial tissue and that can sometimes be felt.  

 

The laser procedure is ablation, which burns the endo lesions on the surface, but does not completely remove anything deeper in the tissue. Wanted to clarify that. It's simpler to find providers who perform ablation, and the procedure is generally easier on the body, but the risk of recurrence is much higher than if excision is performed. It sounds like you had long term success with it though, and that's fantastic! :-)

[MercyA]

6 hours ago, GoodGrief3 said:

The laser procedure is ablation, which burns the endo lesions on the surface, but does not completely remove anything deeper in the tissue. Wanted to clarify that. It's simpler to find providers who perform ablation, and the procedure is generally easier on the body, but the risk of recurrence is much higher than if excision is performed. It sounds like you had long term success with it though, and that's fantastic! 🙂

No, I didn't really. It didn't solve my infertility and I still had some pain. The thing that helped the most getting pregnant about two years after the procedure.  🙂