Dr. Frank Tu (NorthShore)
Hi Vicky, You might be having some ovulatory pain, or "mittelschmerz" related to the ovary normally producing follicles at this time of the month. The swelling can be uncomfortable for some women but is itself not dangerous. Simple treatments like NSAIDs are tried by many women. If its intense, and you aren't trying to get pregnant, trying a birth control pill to suppress the cyclical changes and ovarian stimulation is also an option.

Dr. Frank Tu (NorthShore)
Hi Joanne, We hear a number of women describe changes with their body after having a baby, and perhaps more if they had a c-section. The heavy periods could be due to a condition where the c-section incision might have some residual areas that haven't perfectly healed. These minor defects are called "isthmoceles" and can potentially be treated through a minor ablative procedure through the cervix. An saline infusion ultrasound can sometimes help diagnose this. It sometimes can explain the pain with sex as well. However, many women do have painful sex separately from tight pelvic floor muscles related to childbearing. It might be good to have those examined by an ob/gyn and then have a pelvic floor PT help with some basic strengthening and coordination exercises. A lot of our patients do really well with just a little touch of rehab. NorthShore has several of these women's health PT specialists that work with our doctors.

Dr. Frank Tu (NorthShore)
Hi Tati, Sorry to hear about this side effect after the IUD. Its a good birth control choice for many women, but some women find it irritating. It might be wise to have the position checked by an ob/gyn, which may include an ultrasound also to make sure it isn't sticking partly into the uterine muscle. Sometimes if it is a little misplaced, a gyne can adjust it slightly. One option if it turns out to otherwise be in the right place, would be to remove it, which can be done as a brief clinic procedure. You then could either try another smaller IUD (Skyla comes to mind), or a different form of birth control. Also, have you tried a brief trial of anti-inflammatories?

Dr. Frank Tu (NorthShore)
Hi Stephanie, We expect about 1 in 4 women with a fibroid removed to have a future recurrence. Some fibroids are removed to actually improve a woman's chances of getting pregnant. This is especially true if the fibroid is inside the uterine cavity, and distorting the normal endometrial lining. On the other hand, if you are having trouble getting pregnant after a myomectomy (removal of a fibroid), it might be good to have a quick diagnostic procedure to make sure no scar has built up inside the cavity.

Dr. Frank Tu (NorthShore)
Hi Dania, Fibromyalgia involves complex changes in how men and women's brains and nervous systems recognize and interpret pain throughout the body. So muscle and skin pain in the pelvic floor and vulvar areas are more common in women with fibromyalgia. This doesn't affect all fibromyalgia sufferers fortunately. Use of oral nerve medications (tricyclic antidepressants or gabapentinoids) and physical therapy can be a big help for many women with pelvic floor or vulvar pain issues. Start with those, but there are other approaches too, like topical therapies or even vaginal muscle relaxant suppositories.

Dr. Frank Tu (NorthShore)
Hi Melissa, Great question. First, is the underwear plain cotton material? Some women are irritated by non cotton undergarments. Secondly, if they are really tight, compression of some of the branches of the pudendal nerve where the seams or elastic of your underwear is might be causing subtle nerve irritation. It might be good to check for any compression sites and find more comfortable underwear. Also some of our PT colleagues here at NorthShore will advise women who sit a lot to take regular breaks and move around to maximize blood flow to the pelvic area.

Dr. Frank Tu (NorthShore)
Hi Natalya, Congratulations! Pain in early pregnancy may be related to some stretch on the growing uterus. I assume that you've already had an early scan and they've seen the pregnancy is growing in the uterus? You may hear some women describe this as round ligament stretch. I do think that for some women there may be some early changes that could be related to elevated relaxin levels (those help the pelvic girdle "loosen" to help with delivery at the end of pregnancy. And those tend to peak around 3 mths into pregnancy. You might have this checked out to see if any of your pain is related to changes in pelvic stability. A good PT can really help many women with the aches of pregnancy and prevent post delivery issues. Good luck!

Dr. Frank Tu (NorthShore)
Hi Nicole, It sounds like you had an endometrial ablation. Sorry to hear it's led to some new cramps. The symptoms sound like you may have some trapped pockets of still hormonally sensitive tissue inside the "ablated" uterine cavity. Many women with ablation don't experience this, but a portion-- maybe 5-10% will have some symptoms like this. When these islands of tissue are activated and swell, then break down with bleeding, just as they normally would be by surges in sex hormones, the small menstrual fluid that is trapped causes painful pressure inside the trapped pockets. Two approaches can help - either shut down the cycle with hormones (birth control pills), or have an additional treatment. At NorthShore for women who don't do well with the pill, we consider resecting those islands of tissue with a hysteroscope, or we offer a laparoscopic hysterectomy. Usually one of these treatments gets a good result.

Dr. Frank Tu (NorthShore)
Hi April, Did you just have surgery in the last few days? There might be temporary changes related to instruments used to move the uterus around during laparoscopy. But with big clots call and see if you need to be evaluated by your operating surgeon in the next day or so for a quick check, to make sure there isn't a small tear in the cervix. Hopefully its just a minor, temporary change. Also make sure and let them know if you have started any new hormonal medications.

Dr. Frank Tu (NorthShore)
Hi Krista, PCOS or polycystic ovarian syndrome is usually based on three criteria in the US. You need to have at least 2 of 3 key signs a) signs of excess testosterone effect (hair growth more than expected, like face, chin, or severe acne), b) problems with having regular periods every month or so, and c) presence of multiple small follicles on the ovary on ultrasound which reflects failed ovulation due to the hormone imbalances that cause PCOS. Its good to have this diagnosed early if you have signs of this, because it can lead to diabetes eventually in some women, which good diet and exercise might help prevent. The lack of regular ovulation also interferes with getting pregnant for many PCOS sufferers.