Ouch and ouch.
September 20, 2015 3:13 PM Subscribe
I'm a woman and I have occasional pain in the area of my lower left back and what might be my left ovary and reproductive areas in general. I haven't gone to my doctor about it because the symptoms seem kind of vague, but darnit, it hurts. What information should I give her? (And do you have any ideas about what's going on?)
Here's the information that I have so far: It hurts in the general vicinity of my kidney. I have had kidney stones in my left kidney. I have also had a history of terrible back cramps in that area (I guess due to my retroverted uterus). I have a Mirena IUD and no period these days, so I can't tell if the pain is connected to anything reproductive.
The lower back pain is also accompanied by extremely uncomfortable but hard to pin down pain that is basically all over everywhere that your underwear covers. Ovaries? Ureter? Bladder? Urethra? I dunno. I have no idea how to pin it down.
Also: The pain didn't start with the IUD. I'm on my second one and I'm fairly sure it predated the first one, which was 6 years ago. The time frame also makes me anxious about asking questions because I can't say for sure when it started, both because it's been so long and because it overlaps with times when I had the kidney stone pain and when I still definitely had menstrual cramps.
I often just fail at answering my doctor's questions because I'm not so great on the spot and I'm terrible at translating physical sensations into words. I dread questions like "what kind of pain is it?" I don't know! The painful kind! Sigh. So I'm not necessarily asking you for a diagnosis (although if you've had a similar situation and gotten a diagnosis, please share!). What information should I think of in order to answer questions that will help my doctor eliminate or pursue diagnoses?
(I do expect that she'll ask "What makes it better?" Answer: I don't know. It sticks around for a while and then it goes.)
Here's the information that I have so far: It hurts in the general vicinity of my kidney. I have had kidney stones in my left kidney. I have also had a history of terrible back cramps in that area (I guess due to my retroverted uterus). I have a Mirena IUD and no period these days, so I can't tell if the pain is connected to anything reproductive.
The lower back pain is also accompanied by extremely uncomfortable but hard to pin down pain that is basically all over everywhere that your underwear covers. Ovaries? Ureter? Bladder? Urethra? I dunno. I have no idea how to pin it down.
Also: The pain didn't start with the IUD. I'm on my second one and I'm fairly sure it predated the first one, which was 6 years ago. The time frame also makes me anxious about asking questions because I can't say for sure when it started, both because it's been so long and because it overlaps with times when I had the kidney stone pain and when I still definitely had menstrual cramps.
I often just fail at answering my doctor's questions because I'm not so great on the spot and I'm terrible at translating physical sensations into words. I dread questions like "what kind of pain is it?" I don't know! The painful kind! Sigh. So I'm not necessarily asking you for a diagnosis (although if you've had a similar situation and gotten a diagnosis, please share!). What information should I think of in order to answer questions that will help my doctor eliminate or pursue diagnoses?
(I do expect that she'll ask "What makes it better?" Answer: I don't know. It sticks around for a while and then it goes.)
Best answer: I would print this out (or at least, the part where you describe your symptoms to us) and hand it to her. Doesn't matter if they seem vague, many ailments have symptoms that are hard to pin down, and as a doctor she will be experienced in dealing with them. She will probably ask you to make different movements and/or press down on your back to try to pin down what hurts a bit better.
I will say that I had something that sounds very similar last year, and I had the same concerns when I went to my doctor. By having me move around, she was able to exclude a slipped disk as a cause, and to tell me that it was likely a muscle or joint problem. I had concerns about ovarian cysts, so she sent me for a scan; but she also sent me to a physio, who was able to diagnose the cause as sacroiliac joint inflammation.
Good luck!
posted by jlibera at 3:35 PM on September 20, 2015
I will say that I had something that sounds very similar last year, and I had the same concerns when I went to my doctor. By having me move around, she was able to exclude a slipped disk as a cause, and to tell me that it was likely a muscle or joint problem. I had concerns about ovarian cysts, so she sent me for a scan; but she also sent me to a physio, who was able to diagnose the cause as sacroiliac joint inflammation.
Good luck!
posted by jlibera at 3:35 PM on September 20, 2015
I had pain like this that was due to an ovarian cyst. I described it at the time as "tings" on the right side just above the groin. It felt like a painful, irregular tapping. You should definitely write it down as you experience it. Ob/gyns in particular are good on this stuff and will check it out even if your description is vague.
posted by thetortoise at 3:38 PM on September 20, 2015 [1 favorite]
posted by thetortoise at 3:38 PM on September 20, 2015 [1 favorite]
Don't want to man up the thread or anything but my team leader at work had exactly the difficulties you describe only within the past month and it has been diagnosed as ovarian cysts (yeah, plural).
posted by turbid dahlia at 5:01 PM on September 20, 2015 [1 favorite]
posted by turbid dahlia at 5:01 PM on September 20, 2015 [1 favorite]
Best answer: It sticks around for a while and then it goes.
Main questions your doctor is likely to ask, which don't seem to be covered here: How long does it last? How long does it go away for?
Don't worry about being precise! The trouble is that until you tell her, she won't know whether this is basically constant pain that you sometimes manage to ignore for half an hour to get some work done, or a sudden intense pain that lasts for several seconds and comes at random a few times a day, or a gradual but excruciating pain that lasts for 20 minutes and then doesn't come again for a few weeks or so.
For "describing the pain," I've found it helpful to describe in the same sorts of terms that a "healthy cardiovascular workout" is described:
- would you be able to talk during this pain?
- would you be able to sing?
Also:
- are you making those weird pain-faces because it hurts?
- do you get shock-like symptoms (feverish, clammy, nauseous)?
- are you surprised when it hurts, or could you kind of tell because it was getting uncomfortable?
But Nthing the advice that your doctor should be able to deal with a vague description. In particular, it is completely normal that you can't tell where the pain is coming from. This is not some sort of moral failing, it's that in general humans have no idea about internal sources of pain and even when they're certain they're often wrong. Your brain is doing the best it can.
posted by cogitron at 5:18 PM on September 20, 2015 [3 favorites]
Main questions your doctor is likely to ask, which don't seem to be covered here: How long does it last? How long does it go away for?
Don't worry about being precise! The trouble is that until you tell her, she won't know whether this is basically constant pain that you sometimes manage to ignore for half an hour to get some work done, or a sudden intense pain that lasts for several seconds and comes at random a few times a day, or a gradual but excruciating pain that lasts for 20 minutes and then doesn't come again for a few weeks or so.
For "describing the pain," I've found it helpful to describe in the same sorts of terms that a "healthy cardiovascular workout" is described:
- would you be able to talk during this pain?
- would you be able to sing?
Also:
- are you making those weird pain-faces because it hurts?
- do you get shock-like symptoms (feverish, clammy, nauseous)?
- are you surprised when it hurts, or could you kind of tell because it was getting uncomfortable?
But Nthing the advice that your doctor should be able to deal with a vague description. In particular, it is completely normal that you can't tell where the pain is coming from. This is not some sort of moral failing, it's that in general humans have no idea about internal sources of pain and even when they're certain they're often wrong. Your brain is doing the best it can.
posted by cogitron at 5:18 PM on September 20, 2015 [3 favorites]
Response by poster: This is all SUPER helpful.
posted by kutsushita nyanko at 6:09 PM on September 20, 2015
posted by kutsushita nyanko at 6:09 PM on September 20, 2015
Response by poster: There was a mention of a small "fundal uterine leiomyoma" on an ultrasound from 7 years ago when they were looking for kidney stones. That was with my previous doctor, so I'll mention that I had an ultrasound way back then when I talk to my current one this week.
posted by kutsushita nyanko at 6:11 PM on September 20, 2015
posted by kutsushita nyanko at 6:11 PM on September 20, 2015
Omg. I had this same thing last week and I did go to the doctor. My doctor basically brushed me off, mansplained my reproductive system, and offered me xanax. I hope your doctor takes it more seriously. Five days later, pain gone, back go normal.
posted by Marinara at 8:13 PM on September 20, 2015
posted by Marinara at 8:13 PM on September 20, 2015
Best answer: small "fundal uterine leiomyoma" on an ultrasound from 7 years ago when they
There's your fibroid. Did your gyn check in with you about that periodically to ensure it didn't cause problems for you? They can grow, cause unspeakable menstrual problems. Though they're usually, if not too big, treated with Mirena (just the excessive bleeding that accompanies fibroids). But go check in with your gyn and remind her of this. You may need another ultrasound to see if it has gotten bigger, and have them tell you if it's on top or within the uterine muscle, or if it has impacted the shape of your uterus.
They usually say fibroids resolve themselves usually after 40. But shrug. I know someone who had a full hysterectomy for it after they didn't resolve themselves.
posted by discopolo at 8:15 PM on September 20, 2015 [1 favorite]
There's your fibroid. Did your gyn check in with you about that periodically to ensure it didn't cause problems for you? They can grow, cause unspeakable menstrual problems. Though they're usually, if not too big, treated with Mirena (just the excessive bleeding that accompanies fibroids). But go check in with your gyn and remind her of this. You may need another ultrasound to see if it has gotten bigger, and have them tell you if it's on top or within the uterine muscle, or if it has impacted the shape of your uterus.
They usually say fibroids resolve themselves usually after 40. But shrug. I know someone who had a full hysterectomy for it after they didn't resolve themselves.
posted by discopolo at 8:15 PM on September 20, 2015 [1 favorite]
(My friend with the hysterectomy was over 40 but not menopausal yet and I think they offhand say 40 when they mean menopausal. Shrug.)
posted by discopolo at 8:22 PM on September 20, 2015
posted by discopolo at 8:22 PM on September 20, 2015
Seconding that the fibroid you were diagnosed with on the ultrasound 7 years ago could have grown and could be causing or contributing to these issues. I had a massive fibroid that caused all manner of pain and heavy periods until it was surgically removed. So, aside from all the ways people have suggested for describing the pain, definitely bring up that prior ultrasound and ask the doctor to check to make sure it's not contributing to your issues.
posted by bedhead at 9:37 PM on September 20, 2015 [1 favorite]
posted by bedhead at 9:37 PM on September 20, 2015 [1 favorite]
Since you're not great when you've been put on the spot, maybe write some things down in advance of your appointment? Here's a list of pain words you might find helpful. In addition to the questions you've already mentioned, and the ones cogitron mentioned, your doctor might want to know how frequent the pain is and whether that's changed at any point, whether anything makes it worse, whether there are times of day it's worse, whether any medications help, whether you can sleep through it, and whether it affects your mood, social life, family life, or work.
There are a lot of possible causes of pelvic pain in reproductive-aged women. Mostly, pain descriptions aren't as central to diagnosis as imaging and examination are, so don't get too worried about being precise - the important thing is to tell your doctor that you have pain. (And, unfortunately, in our sexist world, many women find that reporting their pain once or twice isn't enough to get it addressed - it can require considerable persistence to have pelvic pain taken seriously and diagnosed. Hang in there, though - you deserve to be cared for, and you are your own best advocate.)
posted by gingerest at 12:39 AM on September 21, 2015 [1 favorite]
There are a lot of possible causes of pelvic pain in reproductive-aged women. Mostly, pain descriptions aren't as central to diagnosis as imaging and examination are, so don't get too worried about being precise - the important thing is to tell your doctor that you have pain. (And, unfortunately, in our sexist world, many women find that reporting their pain once or twice isn't enough to get it addressed - it can require considerable persistence to have pelvic pain taken seriously and diagnosed. Hang in there, though - you deserve to be cared for, and you are your own best advocate.)
posted by gingerest at 12:39 AM on September 21, 2015 [1 favorite]
Best answer: Chiming in with the consensus, although I am NOT saying this is true for you. I had the same thing go on FOR YEARS and it was pretty bad. Those ZAPs or tings and just general pain in that area.
A few years ago, my regular gyn was out and I saw the covering doctor for my annual. I was explaining the pain to her and she booked a scan that, of course, showed some tumors (which are always fruit-sized for some reason; mine were grape sized, one was almost a plum. I don't know WHY doctors assume putting tumors in terms of fruit is helpful, but I now look at grapes and plums and get skeeved out).
Anyway. She then booked me in with a gyn surgeon and within 2 months I ended up having laproscopic surgery to remove them. They also took out my appendix, and the reasons were explained to me at the time but I honestly can't remember why now.
Pain never returned. But if I didn't meet a doctor who was like, "Yeah, nobody needs to live in constant discomfort; let's get that taken care of," I probably wouldn't have advocated on my own for more testing and surgery.
posted by kinetic at 2:35 AM on September 21, 2015 [2 favorites]
A few years ago, my regular gyn was out and I saw the covering doctor for my annual. I was explaining the pain to her and she booked a scan that, of course, showed some tumors (which are always fruit-sized for some reason; mine were grape sized, one was almost a plum. I don't know WHY doctors assume putting tumors in terms of fruit is helpful, but I now look at grapes and plums and get skeeved out).
Anyway. She then booked me in with a gyn surgeon and within 2 months I ended up having laproscopic surgery to remove them. They also took out my appendix, and the reasons were explained to me at the time but I honestly can't remember why now.
Pain never returned. But if I didn't meet a doctor who was like, "Yeah, nobody needs to live in constant discomfort; let's get that taken care of," I probably wouldn't have advocated on my own for more testing and surgery.
posted by kinetic at 2:35 AM on September 21, 2015 [2 favorites]
Best answer: Your doctor should refer you to get an ultrasound to check for cysts, no question. You will need BOTH the pelvic and the transvaginal. Also request to your doctor that the ultrasound tech checks for femoral hernias in the area. The pain is very similar to what you are describing. They are easily treated with surgery, like cysts. Definitely get it checked out, though. I had two cysts rupture on me last year, it's not fun.
posted by ananci at 4:15 PM on September 21, 2015 [1 favorite]
posted by ananci at 4:15 PM on September 21, 2015 [1 favorite]
Response by poster: update: so they found some simple cysts on both sides, and I'm supposed to get another ultrasound in 2 months. Not sure what they're looking for in the followup...but that's all I know so far!
posted by kutsushita nyanko at 10:21 PM on October 31, 2015
posted by kutsushita nyanko at 10:21 PM on October 31, 2015
They are probably looking to see if the cysts are going away naturally, which is very common, or if they are increasing in size and may need surgical intervention, which is far less common. They may also be monitoring you for PCOS, though that has some bloodwork tests as well, so maybe not.
If you want to be proactive and this doesn't sound too woo, I have had good results with chaste tree berry tincture to help with reducing cyst pain, and it seems to prevent recurrence if you take it regularly.
posted by ananci at 12:44 PM on November 10, 2015
If you want to be proactive and this doesn't sound too woo, I have had good results with chaste tree berry tincture to help with reducing cyst pain, and it seems to prevent recurrence if you take it regularly.
posted by ananci at 12:44 PM on November 10, 2015
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Also, definitely write stuff down as it's happening, make a little journal of it to note location and how long it lasts. See if you can compare it to other pains to put it in context. Does it hurt like when you stub your toe? whap your funny bone? have a bruise? have a stomach ache? pull a muscle? etc.
Your answer to "what makes it better?" is "I have to just wait it out."
posted by phunniemee at 3:28 PM on September 20, 2015 [2 favorites]