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Kelly asked...

I have had abdominal discomfort and back pain for the last 3 months. It started after my period and lasts 2 weeks. This month though I have missed my period. I know I am not pregnant. I have had routine blood tests and an abdominal kidney ultrasound which were normal. I am getting quite worried now as I have never missed a period before. I am not on any contraceptive. I'm just looking for advice and where to go from here? Thanks

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The Answer

Many women suffer from pre- menstrual syndrome but it is rarely known that there is also a condition could post- menstrual syndrome too. The symptoms of this syndrome are very similar to pre-menstrual syndrome but start instead as the menses cease and can last up to the time of ovulation. The main symptoms being that of abdominal pain and cramping, back pain , fluid retention and mood changes. These syndromes are often a result of hormone imbalance particularly in relation to the oestrogen and progesterone levels.

Symptoms can be reduced by implementing changes to your lifestyle such as reducing caffeine and nicotine intake, exercising, taking analgesia and also making changes to your diet. Dietary changes can include ensuring you drink plenty of water and increasing the amount of pulses and wholegrains, green vegetables, foods rich in Omega 3 and 6, calcium, magnesium and vitamins in the B and E complexes. These foods, minerals and vitamins are known to help reduce some of the physical ailments as well as help balance hormone levels – particularly oestrogen. Also making sure you have a good sleep pattern too can help. Other possible causes of your abdominal and back pain can be related to conditions related to the ovaries and uterus such as endometriosis, polycystic ovaries syndrome or adhesions as a result of infection, inflammation or surgery.

You say that you have missed a period which is not normal for you and you say that you are not on any contraceptive but are sure that you are not pregnant this could be due to stress factors, extreme weight loss or hormone imbalance. We would bear in mind that if you have been on any type of hormone based contraceptives that it can take up to 6 – 9 months for the hormones to re balance and menses to regulate. Stress is known to cause changes to the body and coping mechanisms and menses can often be affected in this way. If you have had sexual intercourse at any point even if you used protective measures we would also suggest repeating a pregnancy test in case you had been given a false negative result.

We know you say that you have had blood tests and an abdominal kidney ultrasound which were normal did you have a pelvic ultrasound which focuses on the uterus, ovaries and fallopian tubes. It may be worth asking your GP to refer you for this type of investigation to rule out endometriosis and polycystic ovaries syndrome and the presence of fibroids. Blood tests to check hormone levels would also be useful. A referral to a gynaecologist might be relevant too.

Otherwise the other thing that could be causing the abdominal discomfort and back pain may be due to irritable bowel syndrome or dietary intolerances. It may be worth looking at having this investigated further.

Without seeing you it is difficult to expand further but we would suggest that you make an appointment with your GP to discuss your symptoms particularly now that you are also becoming irregular in your menstrual cycle. It may be a good idea to ask for further investigations to be performed such as pelvic ultrasound and specific blood tests for hormone and inflammatory markers. It may also be a good idea to ask for a referral to a specialist if your GP is unsure of diagnosis.

Answered by the Health at Hand nurses  

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