pelvic pain worse on lying down

[promethius]

Hi Doc - I've had pelvic pain for 4 mo. It's worse when lying down, radiates to the left ovary, and feels like someone is sitting on my pelvis. Also feels like organs have been skewered with everything stuck together from front to back. At first intermittant(few days at a time),now pain nearly every day. It it not relieved with bowel movements.

I had one abdom. sono. 3 weeks after pain started; does this rule out ovarian cancer? Nothing showed up, except a 1.3 cm dominant follicle on left ovary (note it was only day 4 of my cycle). I don't know what consistency of measurement is, but the size of left overy was slightly larger than 2 sonos 3 years ago (same office). Now: 2.8 x 2.2 x 2.8 cm, previously: 2.3, 1.4, 2.1. No free fluid in cul de sac, adnexa and myometrium within normal limits, endometrium 1 mm, anteverted uterus. It was performed just in a private GYNs office. Do I need another scan since it's gotten worse? Urinalysis normal.

I'm 45, periods regular (25-28 days), no birth control, no children. Recent thigh pain. History of mittleshmirtz. Pain began 3 weeks after a routine GYN visit, frequent bacterial vaginosis, but no sex in 2 years. I do not think its IBS. Laser ablation 13 years ago for high grade cervical dysplasia. Paps last 3 years show sq. atypia of unknown signficance, but HPV negative,so doc does not want to do further testing. I don't know if this is related to pain.

I'm in a new city- any specific doc recommendations in Philly? How fast must I pursue it? Any other suggestions for tests I should ask for, especially non-invasive ones? Thanks.

[kamylio]

A related discussion, Pain and pressure near blatter or cervics mostly when lying down on back was started.

[Annekathryn Goodman, M.D.]

Hi There,
thank you for your excellent health summary. If I understand correctly, prior to 4 months ago, you did not have pain. Your ultrasound report sounds normal to me. That is a normal size to the ovary. Ultrasounds are not a test for ovarian cancer. n Ultrasound tells you about the size and structure of the organs looked at.

I would suggest having a more global evaluation by a primary care doctor. Pelvic pain can be:
gynecologic such as secondary to a growth, infection, bad pain, endometriosis
bladder - interstitial cystitis, bladder infection,
bowel - irritable bowel, inflammatory bowel, obstruction, diverticulitis, constipation
musculoskeletal- trauma related, fracture, hip arthritis, hernia, muscle strain

With your present evaluation, there is no obvious gyn source (no cyst, mass) and the pain is not cyclical (so bad period, endometriosis unlikely).
best wishes to you

[promethius]

p.s. it does not fit an obvious pattern for endometriosis because the pain was never worse during my period. When pain was intermittant, it was not clearly related to day of cycle.