Vaginal Inflammation and Menstrual Irregularities: A Guide for Women

Menstrual issues

Hello doctor, I would like to ask about my situation.
I started having Pap smears at the age of 32, and all my annual tests have been normal, but I have consistently had inflammation.
I don't often experience itching in my vagina.
What is the definition of inflammation, and why does it occur? Last October, I had vaginal itching, so I saw a doctor and had another Pap smear, which was normal, but there was still inflammation.
The doctor said that if I experience itching, I should return for a follow-up, but since I didn't have itching, I didn't go back.
My menstrual cycle is regular every month, with heavier flow for the first three days and only a little left on the fourth day.
However, my periods usually last about nine days before completely stopping.
Is this normal? This month, my period started on the 19th and ended on the 28th.
Today, after having intercourse with my husband, I suddenly felt discomfort in my lower right abdomen for a brief moment; it was painful but not persistent.
I haven't experienced this before, so I'm quite worried.
Additionally, I sometimes feel a sudden cramping sensation in my lower abdomen, which feels like a brief spasm.
This has been happening for several years.
I would like to know what could be causing this, as I have had annual vaginal ultrasounds that have all been normal.

Wenwen, 40~49 year old female. Ask Date: 2018/03/30

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Starting at the age of 32, I have been getting Pap smears every year, all of which have been normal, but I have consistently had inflammation.
Since I do not often experience vaginal itching, I would like to ask what the definition of inflammation is and why it occurs.
Last October, I experienced vaginal itching again, saw a doctor, and had a Pap smear that came back normal, but there was still inflammation.
The doctor mentioned that if I experience itching, I should return for a follow-up, but since I wasn't itching, I didn't go back.
My menstrual cycle is regular every month, with heavier flow for the first three days and very light flow on the fourth day.
My period lasts about nine days before it completely stops; is this normal? This month, my period started on the 19th and ended on the 28th.
Today, after having intercourse with my husband, I suddenly felt discomfort in my lower right abdomen, which was brief and not persistent.
I have never experienced this before, so I am quite worried.
Additionally, sometimes I feel a sudden cramping sensation in my lower abdomen that lasts only a moment; this has been happening for several years.
I would like to know what the cause might be, as I have had vaginal ultrasounds every year that have all been normal.

Answer: Your questions are all valid, but each one requires a detailed examination to provide accurate answers.

Reply Date: 2018/03/30

More Info

Understanding vaginal inflammation and menstrual irregularities can be complex, but it's essential for women's health. Vaginal inflammation, often referred to as vaginitis, can be caused by various factors, including infections (bacterial, yeast, or sexually transmitted infections), irritants (such as soaps, detergents, or hygiene products), and hormonal changes. The inflammation can manifest as discomfort, itching, or abnormal discharge, even if you do not experience itching frequently.

In your case, you mentioned that you have had regular Pap smears since the age of 32, all returning normal results, which is a positive sign. However, the persistent inflammation noted during these exams indicates that there may be underlying factors contributing to your symptoms. It's important to understand that inflammation does not always correlate with the presence of an infection. It can also be a response to irritants or hormonal fluctuations.

Regarding your menstrual cycle, you mentioned that your periods last about nine days, with heavier flow in the first three days and lighter flow towards the end. While menstrual cycles can vary widely among women, a typical cycle lasts between 21 to 35 days, with bleeding lasting from 2 to 7 days. Your cycle appears to be within the normal range, but the length of your period may be on the longer side. If this has been consistent for you and does not cause significant discomfort, it may be normal for your body. However, if you notice any sudden changes in your cycle or experience increased pain, it would be prudent to consult your healthcare provider.

The discomfort you felt in your lower abdomen after intercourse could be related to several factors, including muscle tension, ovulation pain, or even pelvic floor dysfunction. The sensation of "pulling" or "cramping" in the lower abdomen, especially if it is brief and not severe, can sometimes occur due to normal physiological responses. However, if this discomfort persists or worsens, it is essential to seek medical advice to rule out any underlying conditions, such as ovarian cysts or endometriosis.

In summary, while your symptoms may not indicate a severe issue, they warrant further investigation, especially since you have experienced ongoing inflammation and recent discomfort. Regular check-ups with your gynecologist are crucial, especially if you notice any changes in your symptoms or menstrual cycle. Your healthcare provider can perform necessary tests, including cultures or ultrasounds, to determine the cause of your inflammation and discomfort. Additionally, they can provide guidance on managing your symptoms and maintaining your reproductive health. Remember, open communication with your healthcare provider is key to addressing any concerns you may have about your reproductive health.

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