HomeAnswersObstetrics and GynecologyendometriosisMy girlfriend has intense period pains. Please help.

I have severe period pain. Is it because of endometriosis? What is the treatment?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At December 8, 2017
Reviewed AtFebruary 8, 2024

Patient's Query

Hi doctor,

My girlfriend has severe period pains that are certainly endometriosis. Her recent scan showed endometrium was 16 mm thick. She has crippling pains, and she is completely immobile during her period and sometimes in between. It is getting worse month by month. She is infertile. It is painful going to the toilet when on her period. She often has migraines. She has huge agonizing pain that does not feel better with Ibuprofen or Paracetamol. The pain starts two days before her period, and the majority of it ends 1 to 2 days after she starts bleeding. She describes the pain as an extremely heavy weight pushing down on her abdomen, vagina, and bottom.

This has been happening for the past 6 to 7 years, but it has worsened over the past 6 to 7 months. A local doctor prescribed Clotrimazole and Tinidazole. I personally think a Progesterone cream is the best course of action, yet it interferes with the Clotrimazole, so I do not know what course of action to take. We did try the Minidril pill, but it messed up her hormones pretty bad, and she started feeling suicidal, so we stopped. The pain has started happening midway through her cycle now and is getting worse and worse. She becomes completely immobile, not even able to get herself to the toilet, and I have to carry her. I will attach the ultrasound scans so you can see them for yourself. Unfortunately, the imagery is the best we have. Please let me know what you think is the best course of treatment we should try without having to see a gynecologist.

Hello,

Welcome to icliniq.com.

I did go through the ultrasound report (attachment removed to protect patient identity).

Although it reads normal, endometriosis is a laparoscopic or operative finding. The symptoms she has correlates with the condition. She may be helped with hormonal medicines. However, in cases that do not respond, surgery is needed. A laparoscopy-guided surgery, which includes removal of the endometriotic nodule and breakage of adhesions, may help, followed by oral contraception pills for a few months.

Regards.

Patient's Query

Hello doctor,

Thank you for your answer.

If possible, we would like to avoid surgery at first, so can you recommend what would be best to do out of the two options I listed previously, please? Should we stop the Clotrimazole and Tinidazole and start with the Progesterone cream? Or should we use them both together or stick with Clotrimazole and Tinidazole?

Hello,

Welcome back to icliniq.com.

Try using Progesterone cream first, under medical guidance, for three to six months.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Vidya Muralidhar
Dr. Vidya Muralidhar

Obstetrics and Gynecology

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