the week before my period starts, i have intense pain deep in my right hip socket and lower abdomen

by Harley
(Boise ID USA)

Hi there, 24 year old female. I have been experiencing pain in my lower abdomen for a few months now along with some other symptoms.

I was diagnosed with hip impingement in 2008 and i had surgery in 2009 on my right hip socket to clean up some labral tears caused by some bumps on my femoral head. I recovered well but still have hip pain.

I have noticed that the week before my period starts, i have intense pain, deep in my right hip socket and lower abdomen. This pain radiates down my leg and I feel it in my foot and buttocks. It is so painful i feel nauseated and dizzy, it hurts for me to sit down. I go between feeling constipated and having soft stools, I feel as if my cervix is pushing on my bowel.

I also get pain in my lower back and lower abdomen (the right side being most painful). It almost feels as if my round ligaments are being pulled or stretched and I am not pregnant, this hurts when i move and when i sit down at all times of the month. I have already had my appendix removed so I know it is not appendicitis.

My abdomen feels tender if i press it and sexual intercourse is very painful for me, like my insides are bruised and my cervix is really tender, I cant have intercourse without pain.(I am married and monogamous, STDs and UTI have been ruled out)
The day after I have been intimate with my husband I feel extremely tender and I have noticed I lose what looks like a mucus plug from my front passage(sorry for graphic information.

I have been to my primary doctor and he sent me for an ultrasound which looked normal, all the ultrasound technician told me was that my uterus liked to "hang out" further back than usual but nothing worrying. My doctor took a pap smear and that showed signs of bacterial vaginosis which has been treated but I still have no relief. He has referred me to a gynecologist and I am waiting for an appointment.

I am a mother of one 20 month old and have had one termination in my past.

Any ideas what this could be? do you think that the hip pain could be connected or related? Thank you!


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Dear Harley,

Your story does sound very much like that of endometriosis.

Have you been investigated for this?

Endometriosis is the presence of the tissue that normally lines the womb (the endometrium), in other places outside the womb. When this happens, those tissues still respond to normal stimulation by the female hormones, causing them to grow and shred as they would inside the womb during the menstrual cycle.

Around your period, or just before then, these normal womb tissues found outside the womb also bleed, trapping blood within the surface or cavity where they are.

Endometriosis tissues can be found in the ovaries, where they can cause a swelling of the ovaries or ovary (if on one of the ovaries only), causing lower abdominal pain on that side that can spread to the lower back, hip and upper thigh, around the time of your menstrual flow.

If the tissues are also present around the lower large bowels or colon, they could cause a sensation of heaviness around the rectum or anus, about the time of menstruation and even cause pain on defecation.

If you have the tissues around your cervix and or behind the vagina, they could cause severe deep seated pain during sexual intercourse.

Another very related condition is adenomyosis - this is like endometriosis embedded inside the womb muscles. It could also cause exactly the same symptoms as endometriosis and could co-exist with endometriosis.

A negative ultrasound scan result, does not exclude endometriosis. You would need a laparoscopy and sometimes a pelvic MRI to make a firm diagnosis.

I am really sorry, Harley, to hear of your pain.

I am glad to hear, though, that you have been referred to see a gynecologist. I trust things would be sorted out soon.

If the wait is too long for you, your family doctor could consider trying you on Naproxen 500mg TWICE daily if you are not allergic to anti-inflammatory medications and if you do not suffer with gastritis or stomach or duodenal ulcers, or are asthmatic.

If you are not trying to get pregnant soon, trial of an IUD like Mirena coil or even oral progesterone hormones could help control these symptoms you are currently experiencing. Use of the combined contraceptive pills is another option.

If you look at our main page on endometriosis, you would find detailed information on possible treatment options for this condition.

I am curious and would be pleased to know how your visit with your gynecologist went and what was eventually agreed upon.

Harley, it's a lot of information here. I hope you found this helpful. Please do not hesitate to contact me, should you have any further question (s) on this or related issue.

Thank you for stopping here at abdopain.com.

We wish you a quick resolution of this pain.

Good Health To You.

Dr Omatseye Edema MD MSc MRCGP CCFP DRCOG
Family Physician, Emergency Medicine Practitioner and WebMD
Abdopain.com.

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