Is It Urethritis or Menstruation? Symptoms and Treatment

Is it urethritis or menstruation?

Hello, doctor! My menstrual cycle is irregular, but I started experiencing breast tenderness a few days ago, and I noticed a small amount of blood after using the restroom a couple of days ago, which I thought indicated that my period was approaching.
Last night, I felt pain in my lower abdomen while urinating, and this morning I suddenly experienced increased urinary frequency and hematuria, along with significant pain during urination.
The doctor diagnosed me with urethritis and prescribed Levofloxacin, Famotidine, and Pyridium.
After taking the medication once (in the afternoon), the pain significantly decreased, and there was no more blood in my urine (it turned orange).
However, later in the evening, I noticed blood on the toilet paper after using the restroom, although my urine remained orange.
This situation is quite distressing for me.
Should the blood be attributed to my menstrual cycle or hematuria? Thank you for your response.

Xiao Pang, 20~29 year old female. Ask Date: 2017/11/27

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Irregular menstruation has been accompanied by breast tenderness a few days prior, and I noticed a small amount of blood after using the restroom two days ago, indicating that my period might be approaching.
Last night, I experienced pelvic discomfort while urinating, and this morning I suddenly had frequent urination and hematuria, along with significant pain during urination.
The doctor diagnosed me with urethritis and prescribed Levofloxacin, Famotidine, and Pyridium.
After taking the medication once in the afternoon, the pain significantly decreased, and there was no more hematuria (it turned orange).
However, later in the evening, I noticed blood on the toilet paper after using the restroom, although the urine remained orange.
This situation is quite distressing.
Should I consider the blood to be from my menstrual cycle or from hematuria? Answer: To determine whether the blood is from menstruation or hematuria, a pelvic examination is necessary.

Reply Date: 2017/11/27

More Info

Based on the symptoms you've described, it seems that you are experiencing a combination of potential urinary tract issues and menstrual irregularities. Let's break down the symptoms and the possible underlying conditions.

1. Symptoms Overview:
- Breast tenderness: This can often be associated with hormonal changes in the menstrual cycle.

- Blood in urine (hematuria): This is a significant symptom that can indicate a urinary tract infection (UTI), kidney stones, or other urinary tract issues.

- Dysuria (painful urination): This is commonly associated with urinary tract infections, particularly urethritis or cystitis.

- Urinary frequency: This is also a common symptom of a UTI.

- Color changes in urine: The presence of orange urine can be a side effect of medications such as Pyridium (phenazopyridine), which is used to relieve urinary pain.

2. Differentiating Between Urethritis and Menstrual Blood:
- Urethritis: This is an inflammation of the urethra, often caused by infections. Symptoms typically include burning during urination, increased frequency of urination, and sometimes blood in the urine. The blood you are experiencing could be due to irritation or inflammation of the urethra.

- Menstrual Blood: If your menstrual cycle is irregular, it can be difficult to determine whether the blood is from menstruation or from a urinary issue. Menstrual blood typically has a different consistency and may be accompanied by other symptoms such as cramping or changes in vaginal discharge.

3. Treatment and Recommendations:
- Antibiotics: You have been prescribed Levofloxacin, which is an appropriate antibiotic for treating urinary tract infections. It's important to complete the full course of antibiotics as prescribed, even if symptoms improve.

- Pyridium: This medication can help alleviate the pain associated with urinary tract infections but does not treat the infection itself. The orange color of your urine is a common side effect of this medication.

- Famotidine: This medication is typically used to reduce stomach acid and may not be directly related to your urinary symptoms.

4. Monitoring Symptoms:
- Keep track of your symptoms, including any changes in the color of your urine, the presence of blood, and any pain or discomfort. If the blood persists or worsens, or if you develop additional symptoms such as fever, chills, or severe pain, seek medical attention promptly.

- If you notice that the blood is consistently present and not resolving, it may be necessary to undergo further evaluation, such as a urinalysis or imaging studies, to rule out other potential causes.

5. When to Seek Further Medical Attention:
- If you continue to experience blood in your urine after completing the antibiotic course, or if you have significant pain, fever, or other concerning symptoms, it is crucial to follow up with your healthcare provider. They may recommend additional tests to determine the cause of your symptoms.

In conclusion, while your symptoms may suggest a urinary tract infection, the presence of blood and the timing in relation to your menstrual cycle complicate the picture. It is essential to monitor your symptoms closely and maintain communication with your healthcare provider to ensure appropriate management and treatment.

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