What could be the reason for sudden abnormal spotting and dull ache in the upper right side of the abdomen?

Question

Hello doctor,

Firstly, I want to mention that I have never had any problems with my periods since I started middle school. I am 33 years old now. It was always on time, lasted for 5 to 7 days, and I always had normal flow and color. Last year, I completely skipped my periods for the first time. I started having this "dull feeling" in the upper right side of my abdomen. At the beginning of this year, I started spotting (something I had never experienced before) that lasted almost two weeks along with this "dull feeling." The spotting stopped, but it started again at the end of the month, which lasted for a month. It was bright red, and the flow was thin. I bled almost every single day in that month except four days. The dull feeling would give me some sharp pains here and there too.

The following month, I went to a gynecologist and had a Pap Smear, which came back normal. My doctor also ordered a transvaginal ultrasound, which showed a cyst on my left ovary, and my doctor said it was not alarming due to its size. However, the results also showed my endometriosis's thickness, around 16 mm. My doctor prescribed me Norethindrone to help with endometriosis and abnormal bleeding. I asked her about this "dull feeling" in my upper right side, and she said the area is separated from the lower abdomen, which includes the uterus, ovaries, etc., so that area has not been checked. I thought to try the medication first and see what it does. I started taking it the next month. Unfortunately, I started bleeding the following month again and finally stopped after fifteen days. I thought I was good, but four days later, I started bleeding again and am still bleeding to this day. I went hiking, noticed this abdominal pain and "dull feeling" in the upper right side, and started bleeding. I am not sure if hiking triggered the bleeding. Also, ever since I started bleeding after I consulted my doctor, I noticed I have been having more abdominal pains as well as lower back pains. What do you recommend? Do you have any idea or advise on what this may be?

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

There are two conditions. One is endometrial hyperplasia, in which only endometrial tissue gets thickened, leading to abdominal pain and bleeding. This is a benign condition and is treated successfully. Another is endometriosis in endometrial tissue present outside the uterus, like on the ovary, intestine, or the peritoneum. It is a very painful condition in which you will get pain on menstruation days. It is diagnosed by biopsy, ultrasound abdomen, and laparoscopic biopsy as your doctor did. But endometriosis is more painful and harmful, so first, you get a confirmation of the condition. A common cause of endometrial hyperplasia is stress, obesity, polycystic ovarian disease, hypothyroidism, hormonal imbalance, etc. Probably you are suffering from endometrial hyperplasia. Estrogen causes the proliferation of the endometrium, and this growth is inhibited by progesterone; that is why your doctor advised it. If there is no response to this, you need dilatation and endometrial curettage. For endometriosis treatment, Progesterone supplement or surgical resection can be performed. So avoid stress-related activities, exercise regularly, get your hemoglobin levels and thyroid status done, and check for vaginal polyps. Use tablet Tranexamic acid 500 mg with Mefenamic acid 250 mg twice daily for five days. Please review with reports. Take care.

What could be the reason for sudden abnormal spotting and dull ache in the upper right side of the abdomen?

Ask your health query to a doctor online

Company

Customer Care

Get iCliniq