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Not getting periods on weaning from breastfeeding, scarred cervix.

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I got pregnant in December of 2011. I'm still breastfeeding but have started to wean since September. I have not had a period since pre pregnancy. I had cold knife conization in February 2014. In January 2012 before I knew I was pregnant I had a pap which showed high risk hpv cin3. After birth my post birth pap December 2012 came back normal and my dr said it was likley my cells came off during the birth of my son hadn't tested for hpv since I wasn't over. 30 even with history of it. Had pap in December 2013 which showed high risk hpv and con3 again and my dr told me my pap from 2012 was a false negative.. Had ckc feb 2014 with clear margins. Re paped in April 2014, ever thing clear and normal, repealed in October 2014 a gain clear and normal. Since starting to wean in November December January and February I've had menstraul pain so severe I've gone to the er 2 times. Had ultrasound and ctscans only to find nothing. It is possible that since these are a month apart that my body is working my me starting my cycle back in but is it also possible that my cervix is scarred shut and I'm actually having my period but no blood is coming out? I usually have 2/3 days of pain followed by a couple days of extreme tenderness. I've been thinking this whole time it's bowel related because of the pressure but 4 months in a row almost a month a part each time has to be obgyn related . Thanks.


Category: OBGYN

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Category: Infertility Specialist
Dr. Aarti Vazirani is online now

Expert:  Dr. Aarti Vazirani replied 4 Days.

Hello,
Thank you for your query at DoctorSpring.com
I understand your concern.
If you had a scarred cervix, and the menstrual blood was getting pent up, that would clearly show up on the ultrasound and CT scans.
So I do not think it is likely.
Yes, it is possible that since you are weaning , the ovulatory cycles are resuming and hence the pain.
Again, it could be something totally unrelated, such as endometriosis, but that again would show up on imaging.
Did you have painful periods earlier ?
Is the pain spaced out exactly at a months' interval ?
Looking forward to hearing from you .
Take care.


Patient replied :

Thanks for your answer. My ultrasound I had was in September before the pain started checking for uterine fibroids as I was have bladder problems and my endometrium was fine. I know there is a lot in that area down there but this is 100 period related cramps. I had a ct scan but the didn't use contract that was in November. It first happened November 3 December 3 January 7 February 1st. It feels like I have my period like I did prior to pregnancy just with no blood. Absolutely none. I guess I could go to the er and ask for another. After 2 days of pain my abdomen has point tenderness for about 3 days. I would think that's from fluid? Where woul the blood go of it didn't come out? If my cervix was closed would I not have discharge either? Or vaginal secretions during intercourse? thanks


Expert:  Dr. Aarti Vazirani replied 3 Days.

Thank you for the update.
If the imaging was before this peculiar symptom began, then yes, you need a scan once again, most preferably while you are having one more bout of the acute pain.
The point tenderness could be from pooled up fluid.
If the blood was getting pent up, part of it would be gradually resorbed back into the system, or spill over into the pelvic cavity, and sometimes it might get infected too
It would certainly show up in a scan done while you are having this typical pain..
Cervical secretions might be intact because for blocking blood, only the area near the opening of the cervix needs to be scarred shut, and the rest of the cervical tissue ( that is not near the opening ) also can make secretions.
Vaginal lubrication during sex too is generally unaffected.
Let me know what the scan says.
Take care.


Patient replied :

I got another ultrasound. And it did in fact show fluid in my uterus. It looks as tho my ovaries are bigger than they were before compared to the previous ultrasound and why does it say irregular endometrium?
2/2105 uterus 8.4x4.0x5.0 16mm thickness and irregular endometrium ovaries 3.2x2.9x2.5 & 3.0x2.0x2.2 with sub centimeter follicular cysts.
9/2014 uterus 6.7x5.2x2.9 8mm thickness and normal endometrium ovaries 2.7x1.5x1.5 & 3.2x2.9x1.8 with sub capsular cyst
why such different sizes in thickness of endometrium as well as ovaries and why are the cysts called something different? Could you compare the two. Or tell me what you think. What are the cysts they mention.? I've uploaded them.


Expert:  Dr. Aarti Vazirani replied 2 Days.

Was this scan done during the time when you have the menstrual pain ?
I mean, when, if the cervix was alright, you would have had your period ?
Regards.


Patient replied :

Yes it was done during the pain


Expert:  Dr. Aarti Vazirani replied 1 Day.

Okay, the size of the uterus is more , because it is distended ( filled ) with the menstrual blood and the fluid.
You definitely need dilatation of the cervix, and drainage of the menstrual blood.
Regarding the ovaries, they are suggestive of polycystic ovaries.
This is when the ovaries get studded with small follicles, and they resemble small cysts.
It is not serious, and does not need any surgery.
It is basically a hormonal disturbance.
Are you overweight by any chance ?
Regards.


Dr. Aarti Vazirani
Category: Infertility Specialist
Experience: 
Residency: Obstetrics & Gynecolog, BJMC,Civil hospital, Ahmedabad, 2008
Post Graduate: MS (Obstetrics & Gynecology), B.J. Medical College, Ahmedabad, 2008
Medical School: MBBS, B.J. Medical College, Ahmedabad, 2004
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