I am sorry to hear you are going through so much. My first point of call would be back to your surgeon – as despite being an endometriosis and gynaeoncology surgeon – he is also an experienced gynaecologist. He will be able to evaluate your case based on pre and post op symptoms. This is not something a GP would be able to do, as gynaecology is complex and often requires an in-depth look.
1. Adenomyosis/Fibroid – unlikely a small fibroid causes symptoms, but it depends on where it is in the uterus and what part of the wall it is in. Adenomyosis is a known cause of profuse bleeding (which may be regular) and also the low “bowling ball” pressure feeling in the pelvis, lower back pain etc. It may be worth investigating this and looking at temporary suppression to see if this helps regulate the cycle once stopped. Did you have PSN to address adenomyosis pain?
2. You could be perimeopausal – would you have a family history of early menopause? Have you had your FSH, LH, AMH, Oestradiol, Progesterone levels checked? It is unlikely as you are not having other symptoms, but not beyond possibility and should be checked. Endometriosis does not appear to have any effect on menopause, the oestrogen produced by endometriosis lesions is fairly local to those lesions and is unlikely to contribute to the overall systemic level.
2a. Thyroid – definitely get checked – it changes so much and often I see people go from normal to abnormal in 6 months. It is a quick and easy blood test and does not need to be fasting or timed to your cycle. It can be done with hormone levels above.
3. Ask for a CA125 level, Vitamin D, Vitamin B12, Coagulation Profile and hormone levels from your GP. If it was infection you would have a lot of other symptoms. If bleeding is the main symptom, it is more likely not endometriosis. Bleeding is most likely adenomyosis – but all other causes should be ruled out.
Suppression (Pill, Mirena, GnRHa) may be of help to alleviate the bleeding and you could see if this would help the cycle. It is not for everyone but might be with discussing with your doctor. Regardless of where you had your surgery – and this goes for any type of surgery – your doctor cannot refuse to treat you or refer you. People are referred for surgery all over Ireland for many different conditions and while some do find their local doctors are a bit huffy afterwards – change doctors – unfortunately this is the shape of the HSE at the moment, we are sending more and more people abroad for treatment as they are past capacity. I always ask if they were willing to let their loved one (or themselves) sit on a 3 year waiting list for XXXX procedure?
Perimenopause may be an issue – stary tracking your cycle with BBT so that you can have your levels done on Day 3 and day 21, that way you would have a better idea.
PCOS – blood work will give an indication – have you had PCOS in the past? There is another post with links on PCOS which would be of help in terms of diagnosis (blood tests and scan).
Weight gain can be down to so many factors, and often the shift from pain to no pain (and meds) an make a change in the body. Have you looked at a food diary? Some women find that their appetite was suppressed with the pain meds and pain and once this suppression was gone their weight naturally rose as they were eating more.
Hope this makes some sense, typing here on the go, but please come back with more questions. First stop would be with GP if they will oblige for blood work, and a follow up Skype appt/Email appt with your previous surgeon.