# "Female Trouble"



## Jes (Jan 28, 2011)

and I don't mean the John Waters film, though I DO love that one.

Anyway, I don't understand my menstrual cycle. I really don't. I don't know how many times I've watched that 4th-grade health class film strip in my mind, but I still don't get it.

What I'd like to solicit is anecdotal evidence from any woman who has had a transvaginal (read: in the vag) ultrasound. How's the wand? Any pain? How long did the internal portion of the exam take? Was it done by a tech? Was the tech female?

And what I'm also curious about and can't seem to find out is: if you're looking for evidence of cystic activity, and you're still menstruating, does it matter when during your cycle you have the test done? Know what I mean? If you're looking for regular cysts (around eggs), can you see evidence of that any day of the month? What if you're looking for other types of cysts? In other words, would it be likely that you'd go for the test, but b/c you're there at the 'wrong' time of the month/in your cycle, you wouldn't get anything diagnostic out of it?

Eventually, I'm going to get this test done (and by the breathtaking pain i'm feeling today, which isn't responding to hydromorphone btw, I wish it was today) and I'll certainly be able to ask questions then, but I'm just curious. I find it very helpful to ask other women of different ages and backgrounds for their experiences.


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## olwen (Jan 28, 2011)

That internal ultrasound thingy isn't painful at all. It just feels like someone is rootin around in your junk with a lipstick vibrator that is preheated. The last time I had one it was fine. There was a female tech and I wasn't on my period. Whether or not it matters for your check up is a question for your doctor tho. I don't think it does tho.


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## AmazingAmy (Jan 28, 2011)

What Owlen said - it's not painful, the wand in thin and the head not very big at all, and they don't push deep. They just go in a certain distance and gently move about to achieve different images on the scan.

In regards to your cylce, I was due to start my period on the day I had my internal scan - they were looking for cysts too. It didn't effect the results, though it did bring on my period a little heavier than I usually have for the first few days. However, I was also a virgin when I had an internal scan (they didn't know), so some of the blood may have been from my hymen breaking... but you shouldn't worry, Jes. It's no different to a vibrator, minus the fun.


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## Jes (Jan 28, 2011)

olwen said:


> It just feels like someone is rootin around in your junk with a lipstick vibrator that is preheated. .



Now, see, this, THIS, is what we women need. Or at least what *I* need, when I'm looking for information on this stuff. Everything is always so euphemistic or vague ('a wand is used internally to blahblahblah') and really, while I'm not afraid of stuff, I just kinda want to know what gives! And the info above is exactly what I wanted to know, in language I could understand it! And thanks for your tips, too, Amy.

the one thing I will say is that I don't want a male tech. I just plan to state that on the phone when making the appt. That said, it's not like they rearrange a tech's schedule just to make me happy, so it might be a 'you get who you get' thing. Still, maybe I can request a woman while on site. It's a big practice at one of the top 10 hospitals in the country; they can't just have 1 lone guy working that day! right?

In terms of one's cycle...cysts naturally form during ovulation and all that, but I do wonder, if they're growing over time, then bursting, if test results are dependent on when you go in. It's not like I want the wand up there every 3 days for a month. 

I see a nurse practitioner (as my regular GP) and she's like: Oh yeah--you're gonna get the dildo, all right! And I was like: Oh, Kate, I don't want the dildo...

(and yes, i call her kate. it's weird but what else can I call her??)


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## penguin (Jan 28, 2011)

I've only had the dildo cam used on me during pregnancy ultrasounds, but like the others said, it didn't hurt.

For one of the scans, it was a male tech, and he had a female tech in the room to chaperone, which I found kinda weird, but understandable. Otherwise it was a female tech. I'm personally not bothered about the gender of the person who's looking up there, only that they're competent. 

I use femilia to keep track of my cycle, which you might find useful. It lets you record all sorts of details about your cycle and keeps records of them so you can see how they change or stay the same, which can be useful when you need to talk to your doctor about it.


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## Saoirse (Jan 28, 2011)

penguin said:


> I use femilia to keep track of my cycle, which you might find useful. It lets you record all sorts of details about your cycle and keeps records of them so you can see how they change or stay the same, which can be useful when you need to talk to your doctor about it.



I use Femilia too! Its been very helpful to me.


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## olwen (Jan 28, 2011)

Jes said:


> Now, see, this, THIS, is what we women need. Or at least what *I* need, when I'm looking for information on this stuff. Everything is always so euphemistic or vague ('a wand is used internally to blahblahblah') and really, while I'm not afraid of stuff, I just kinda want to know what gives! And the info above is exactly what I wanted to know, in language I could understand it! And thanks for your tips, too, Amy.
> 
> the one thing I will say is that I don't want a male tech. I just plan to state that on the phone when making the appt. That said, it's not like they rearrange a tech's schedule just to make me happy, so it might be a 'you get who you get' thing. Still, maybe I can request a woman while on site. It's a big practice at one of the top 10 hospitals in the country; they can't just have 1 lone guy working that day! right?
> 
> ...



Hahahahaha! Plain language about our vajayjays from our doctors. Yes. I'm sure you can request a female tech. They are probably sensitive to that and might ask you what you prefer. I used to put a little "P" on a calandar on the first day of my period. I did this for years, and one day I decided to count the days from one period to the next and discovered my cycle is 33-35 days long, which explains why the first day starts to move around the month after a while. All those years I thought it was irregular but it wasn't. Regular exercise is making it shorter now actually. It's more like 29-31 days now. I can feel when I ovulate and it's usually right in the middle of my cycle.


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## penguin (Jan 28, 2011)

olwen said:


> I can feel when I ovulate and it's usually right in the middle of my cycle.



Since having my daughter I can usually feel it too! I don't know if I'm just more aware of it now, or if things changed or what, but it's very interesting. I'm also on the 33-35 day cycle, and have always been regular, no matter what weight I've been at. The only time I've ever missed a period (from the very beginning, back when I was 12), was when I was pregnant.


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## olwen (Jan 28, 2011)

penguin said:


> Since having my daughter I can usually feel it too! I don't know if I'm just more aware of it now, or if things changed or what, but it's very interesting. I'm also on the 33-35 day cycle, and have always been regular, no matter what weight I've been at. The only time I've ever missed a period (from the very beginning, back when I was 12), was when I was pregnant.



When I was a teenager my cycle started the fourth thursday of every month like clockwork. As I got older that stopped happening and it started to become erratic. Like I wouldn't get it for two months, then when I did it would last for two sometimes three weeks. I thought it was still erratic year and years later but it wasn't, it just stabilized and got longer. I've only started noticing when I ovulate a year or so ago. I was getting a sharp pain every once in a while and I wondered if it was some weird gas or a period thing so I started counting the days from that pain and after a few months I realized that my period would start about two weeks after getting that pain and so I realized it def wasn't gas. LOL


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## Jes (Jan 29, 2011)

I'm pretty regular. When I was on the pill, it was clockwork. Now that I'm off, it's still a 25 day, then 28 day, cycle. Weird, eh? 25 days one period, then 28, then 25. Now that I'm a certain age (sigh) it'll probably start to change, and it's certainly very heavy all of a sudden in the last year. So I definitely need some exploratory tests just to see what's going on.


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## BigCutieMeg (Jan 29, 2011)

The wand was lubed up with the same gel the use for a baby ultrasound and my tech was actually a guy but he was really nice... its almost warm and slides right in... its smaller than it seems.. at first I was like that isnt fitting here, sorry pal! But if you just totally relax all your muscles and let them do their job it will be fine.. harmless... 
I mean there can be pain if you have cysts and they are pushing against them, but its just pressure and will soon be alleviated. 

Also mine was done during the cycle and its fine as well... they put a cloth under you and keep it nice and clean... 
It isnt a long test at all... 
Less than 10 minutes in there... most of its the prep, and then the clean up afterwards!
Hope this helps hun, goodluck :kiss2:



Jes said:


> and I don't mean the John Waters film, though I DO love that one.
> 
> Anyway, I don't understand my menstrual cycle. I really don't. I don't know how many times I've watched that 4th-grade health class film strip in my mind, but I still don't get it.
> 
> ...


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## olwen (Jan 29, 2011)

Jes said:


> I'm pretty regular. When I was on the pill, it was clockwork. Now that I'm off, it's still a 25 day, then 28 day, cycle. Weird, eh? 25 days one period, then 28, then 25. Now that I'm a certain age (sigh) it'll probably start to change, and it's certainly very heavy all of a sudden in the last year. So I definitely need some exploratory tests just to see what's going on.



Hopefully it's nothing serious.


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## Jes (Jan 29, 2011)

Let me clarify what I mean by cycle: I mean the entire thing. Any day of the month. Not during my period. Or not during my period. Any day. I know that cysts grow over time, monthly, for many women. So I'm wondering if there are days that a test on a woman WITH cysts will come back as: we don't see anything.

Has anyone who has undergone this been told that? Just curious.


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## Miss Vickie (Jan 29, 2011)

Jes said:


> Let me clarify what I mean by cycle: I mean the entire thing. Any day of the month. Not during my period. Or not during my period. Any day. I know that cysts grow over time, monthly, for many women. So I'm wondering if there are days that a test on a woman WITH cysts will come back as: we don't see anything.
> 
> Has anyone who has undergone this been told that? Just curious.



Jes, all during a woman's cycle there are visible cysts (follicles) waiting their chance to be "the one" this month. The difference is that right before ovulation you will see one follicle which contains the egg getting bigger and becoming dominant, and then after ovulation you'll see the corpus luteum, which held the egg, hanging out and providing hormonal support during a possible pregnancy. 

So yes, if you are truly cycling, you'll see differences in your ovary over the course of your cycle. For women who aren't cycling, you'll see a bunch of cysts, who aren't dominant usually, and who don't mature and break free of the ovary.

Does that help?

Also, as far as a transvaginal ultrasound, it really feels like a loose baggie covered dildo going into your vajayjay. It's pretty slippery, which is the worst part, in my opinion. Some techs will make you place it yourself (with their guidance) and some will do it themselves. You're usually covered with a blanket, as a desperate attempt to provide modesty. And you can absolutely ask for a female tech, and you should, if you feel more comfortable.

Let me know if you have more questions. I'm happy to help!

Edited to add a cool pic of what happens during ovulation and the different structures of the ovary.


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## Jes (Jan 31, 2011)

Miss Vickie said:


> Does that help?
> ]



*sigh*

No. I mean, it should, and I thank you, but for some reason, this doesn't make any concrete sense to me. You always do such a good job explaining, but it's greek to me. I was certainly hoping you'd chime in, but I didn't want to outright ask! 

Are you saying that if I have probs with cysts (causing pain over and above what they should/can) that problem will be evident every single day of the year? So I don't need to 'time' a test for it to be diagnostic?

Here's the weird thing--it's Monday, and I can feel my period coming on right now. And the terrible right (what I suspect is ovarian)-sided pain was all day Friday. 

Clearly, that's no ovulation. What the hell? Also, I think I had similar pains right after my period ended, last month.

My bleeding has been much heavier in the last year. Thyroid checked out fine. I don't seem to be in menopause (or even peri-). So we're thinking maybe fibroids? Fibroids would not have a pain component such as I'm describing (lower right side of pelvis), right?

I know a Dr. (pediatrician) from my alumni newsgroup and we post crap to one another all day long. And I asked him to please explain my menstrual cycle to me (jokingly) and he came back with: Can I pass?

hahaha. I feel so stupid.


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## Miss Vickie (Feb 1, 2011)

Jes said:


> *sigh*
> 
> No. I mean, it should, and I thank you, but for some reason, this doesn't make any concrete sense to me. You always do such a good job explaining, but it's greek to me. I was certainly hoping you'd chime in, but I didn't want to outright ask!



Honey, you can always ask. It might take me a few days to respond because I'm trying to do both school/work/life full time but if you PM me (or I'll get you my email) I'm happy to help.



> Are you saying that if I have probs with cysts (causing pain over and above what they should/can) that problem will be evident every single day of the year? So I don't need to 'time' a test for it to be diagnostic?



Oh no, I'm not saying that. I'm saying that ovaries are dynamic, and that the way to really tell what's going on is optimally not just one ultrasound but perhaps a series to tell what your ovaries do over time; also, it's helpful to have hormonal levels if you're thinking there is some sort of hormonal thing going on, but again, you may need several to get the clearest picture.

It's like taking a picture of a bicyclist riding the Tour de France. One picture tells you what's going on at that time, but does it mean he won the race? Or who the other riders were? Or if he had to switch bikes along the way? When I've had issues with painful cysts and it was unclear what was going on, I had several ultrasounds which told my gynie that I didn't have a dermoid cyst (thank GOD!) but rather a hemorrhagic (bleeding) cyst that was actually a corpus luteum (remember, the follicle that holds the egg until it's released, at which point they bleed and start to shrink back into the ovary). It resolved over time but the first ultrasound showed a hot spot which looked solid and freaked us ALL out. It wasn't until the next ultrasound showed it as less solid and smaller that we could relax, since dermoid cysts (ew) don't resolve on their own.

If you're having pain when the egg is released (mittelschmerz) then if you can time the ultrasound to be done when you have the pain, that's optimal. But if you're concerned about PCOS or other cystic problems that are ongoing, serial ultrasounds can also provide a more comprehensive picture of what's going on.

But an ultrasound of your ovary today will look different than one in a week's time.



> Here's the weird thing--it's Monday, and I can feel my period coming on right now. And the terrible right (what I suspect is ovarian)-sided pain was all day Friday.
> 
> Clearly, that's no ovulation. What the hell? Also, I think I had similar pains right after my period ended, last month.



That doesn't sound like ovulation, unless you ovulate very late in your cycle, which happens sometime. Is it usually on one side or another? Does the pain go away after a few hours? Can you describe the pain?



> My bleeding has been much heavier in the last year. Thyroid checked out fine. I don't seem to be in menopause (or even peri-). So we're thinking maybe fibroids? Fibroids would not have a pain component such as I'm describing (lower right side of pelvis), right?



If a fibroid or other kind of mass was on the side of your uterus, yes. Yes, it could, and they can attach anywhere. I took care of a lady recently whose fibroid was on the top right of her uterus, on the outside (as opposed to being on the inside). No doubt when she wasn't pregnant the pain could have been more on the side, rather than dead center. Fibroids can also account for heavier bleeding. But so could endometriosis, which wouldn't be picked up on ultrasound, so it's good they're doing an ultrasound because a fibroid would be evident, and a ruptured, resolving cyst would also show, so you can rule those in or out and then go from there.

Does this pain happen EVERY cycle? And in the same spot?



> I know a Dr. (pediatrician) from my alumni newsgroup and we post crap to one another all day long. And I asked him to please explain my menstrual cycle to me (jokingly) and he came back with: Can I pass?
> 
> hahaha. I feel so stupid.



LOL. Fortunately, pediatricians don't have to deal with menstrual cycles too much. It's one reason to go into pediatrics!

So is this all clear as mud?


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## Jes (Feb 1, 2011)

Miss Vickie said:


> But an ultrasound of your ovary today will look different than one in a week's time.
> 
> 
> 
> ...



Ok... The first sentence I quote above is key, for me. I understand that ovaries are dynamic, but I did wonder if there are certain 'problem structures' that will allways show on a film. (they're not even films anymore, are they? haha). It sounds to me like some will (fibroid) and some may not (cysts).

Now, you've really asked the unanswerable above, and this is where I frustrate myself. I should've been plotting this all along and I haven't. that leaves me practically helpless to give accurate responses. 

When I get the pain, it's usually for a big part of the day, and sometimes a day and a half, or maybe 2. It does resolve on its own. I think that Ibuprofen does provide some relief (I don't always take it). While I recognize that strong pain isn't necessarily 'normal,' I have grown so used to it that it never became a case of 'you should really do something about this ALL OF A SUDDEN' since I hadn't done so in years! It's a weird kind of complacency. the pain can be so strong that I think if it started tomorrow, and I'd never had it, I'd be much more motivated to attend to it. 

Anyway, I have a new gyne who, being African American (not my choice, it was just the good luck of the draw!) is certainly familiar with fibroids, etc. Anyway, she said I could plot my cycle for a few months, to see if I thought it was ovulation and b/c it's not an emergency, but either way, she'd like me to have the tests. I'm going for a biopsy this week (different bodypart!) so, I mean, I don't want to go to the hospital every damned week. And good lord, my mammogram is due too. Getting old is seriously not for weaklings. You hit 40 and everything goes in the crapper! But, I digress.

How to describe the pain? It's generally localized (I think more on the right than the left) to a fairly small spot I can, if I manipulate under my panus, put my fingers on (the pain--not a mass, I mean). It's strong, constant and ... like a burning ball. I don't know, really. And not burning during urination or anything. I just imagine it feeling hot and angry to the touch ... so, inflammed probably right?

Now today, I'm still not having my period and I feel some pain on the left.

Nurse, I think you should probably just put me down.


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## Miss Vickie (Feb 5, 2011)

Jes said:


> Ok... The first sentence I quote above is key, for me. I understand that ovaries are dynamic, but I did wonder if there are certain 'problem structures' that will allways show on a film. (they're not even films anymore, are they? haha). It sounds to me like some will (fibroid) and some may not (cysts).



Hey, sorry about the delay. It's been a busy week. 

Yes, you're right. Some structures (the wall, stroma, and ligaments that support the ovaries and uterus which can also cause pain) are always there, but cysts do change and grow, develop, release the egg and degrade, over time. Fibroids are muscle and are on/in the uterus, not the ovaries. They can cause a lot of pain, and are often (not always) palpable during a bimanual exam and usually able to be seen on ultrasound.



> Now, you've really asked the unanswerable above, and this is where I frustrate myself. I should've been plotting this all along and I haven't. that leaves me practically helpless to give accurate responses.



Well, it's never too late to start charting. You can document when your first day of bleeding is (your period) which is day one of your cycle. You can start then to figure out how long your periods are and then hopefully when you ovulate. 



> When I get the pain, it's usually for a big part of the day, and sometimes a day and a half, or maybe 2. It does resolve on its own. I think that Ibuprofen does provide some relief (I don't always take it). While I recognize that strong pain isn't necessarily 'normal,' I have grown so used to it that it never became a case of 'you should really do something about this ALL OF A SUDDEN' since I hadn't done so in years! It's a weird kind of complacency. the pain can be so strong that I think if it started tomorrow, and I'd never had it, I'd be much more motivated to attend to it.



That's a little atypical for ovulatory "mittelschmerz" pain, but you just never know. You could be particularly sensitive to the fluids released by the ovary into the abdomen after ovulation happens. You usually ovulate 14 days before the start of your period, and the worst pain is usually then with ovulatory pain. When you hurt right before or during your period it's usually related to the endometrium (like endometriosis) or fibroids. Notice I said usually. Nothing is ever 100% and the variations in normal are pretty significant.

I understand what you mean about becoming accustomed to pain, though; I did the same thing with my gall bladder pain, which was atypical (not worse after meals but rather when my stomach was empty). I went quite a long time in agony, and then each time it stopped I thought that was "it". And yet it kept coming back. :roll:

But again, this is a good opportunity for you to tune in to what's going on with your body. Since you don't need it fixed nownownownownow, you've got time to plot things and try to figure out what's going on.



> Getting old is seriously not for weaklings. You hit 40 and everything goes in the crapper! But, I digress.



No joke. But when you consider the alternative (death) it's not too bad.  I know what you mean though about all the damn tests. On my few days off, I'm usually seeing some doctor or another. It's so NOT how I want to spend my time.



> How to describe the pain? It's generally localized (I think more on the right than the left) to a fairly small spot I can, if I manipulate under my panus, put my fingers on (the pain--not a mass, I mean). It's strong, constant and ... like a burning ball. I don't know, really. And not burning during urination or anything. I just imagine it feeling hot and angry to the touch ... so, inflammed probably right?



Hmmm. Hard to say. It's not typical "this" kind of pain or "that" kind of pain. if it lasted a handful of hours I'd say you were ovulating. If it happened with your period and you had heavy periods I'd say it was fibroids. Hell, it could even be bowel pain, constipation or adhesion (have you had abdominal surgeries?) although that would be less related to your menstrual cycle. 



> Nurse, I think you should probably just put me down.



You poor thing. But I think you'll live. Keep track of everything, though, even seemingly unrelated symptoms like diarrhea or constipation. Hopefully when they do the ultrasound they'll be able to find something easily fixable. It could be they think about putting you on birth control pills to suppress things, see if that helps.

Let me know what they end up finding, ok?


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