u/08kbda17

Has anyone had severe cyclical pelvic/GI symptoms with normal tests? I’m confused and looking for shared experiences.

For context, I’ve been on the same low-dose combination birth control for 10 years with excellent symptom control — almost no issues until a few months ago.

Over the last few months, I’ve had recurrent episodes of severe right-sided pelvic/lower abdominal pain (sometimes radiating into my back), bad enough to be debilitating for hours. After particularly bad episodes, I have soreness for several days afterward.

This is usually accompanied by the following symptoms, but to varying degrees and not always consistently: intermittent diarrhea (sometimes with mucus), nausea / feeling like I might vomit, bloating/distention, frequent urination during flares and nocturia, occasional night sweats, sleep disruption from symptoms.

Some symptoms feel GI, some feel hormonal/pelvic, and that’s part of why I’m confused.

The only pattern that seems consistent is these episodes flare up the week prior to my period/placebo week and on random days in the late evening. I’ve had no withdrawal bleed for about 12 months, despite taking placebo pills regularly (new for me). 

That timing made me wonder about: endometriosis, ovarian cysts, breakthrough ovulation / hormone shifts and whether my pill may not be suppressing symptoms the way it used to. 

My PCP did a full workup and found nothing of note. 

CBC normal except platelets elevated at 513 (and have been trending upward for years), Mildly elevated lymphocytes, Urinalysis normal, Urine culture normal, A1C normal, normal lipase and amylase, normal abdominal ultrasound and normal abdominal ultrasound. No infections, no obvious cysts, no structural explanation found.

My GYN felt the symptoms varied too much to see a recognizable pattern. Normal pelvic examination, and has now referred me to a gastroenterologist. We did discuss endometriosis but he said that was highly unlikely since there is no blood coming out there wouldn’t be any endometrium to be infected…Correct me if I’mm wrong, but this doesn’t sound right to me. He said a laparoscopy could be in the cards if given the all clear from GI, but warned me that they don’t find anything in 60% of patients. 

I’m struggling to understand this approach because GI alone doesn’t explain several of the symptoms: the severe one-sided pain, the apparent hormonal timing, urinary symptoms during flares, ibuprofen helping more than GI meds, the change after 10 stable years on the same pill.

And I also don’t know what to make of normal tests when symptoms are very real.

At this point I’m trying to stay open-minded, but I’m losing hope. 

Would love to hear if anyone has been through something similar or what questions you’d ask next.