Lower Abdominal Pain and Abnormal Discharge in Women

Lower abdominal pain with increased vaginal discharge?

Hello Dr.
Huang: Since early March this year, I have been experiencing a feeling of heaviness in my lower abdomen, occasionally accompanied by a sensation of pressure.
I have noticed an abnormal increase in vaginal discharge, and sometimes when I urinate or have a bowel movement, I expel a lump of discharge.
I also have constipation and occasionally experience dull pain in my lower back.
At least once or twice a week, I suddenly feel dizzy, my appetite is not very good, and sometimes I feel nauseous.
I have been passing gas frequently and have suddenly gained a significant amount of weight.
Should I see a gynecologist or a gastroenterologist? I have had three cesarean deliveries and have undergone tubal ligation.

Bu Bu, 20~29 year old female. Ask Date: 2018/03/31

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Since you are experiencing abnormal vaginal discharge accompanied by constipation, and if the discharge is not associated with any discomfort, it is advisable to first consult a gastroenterologist.

Reply Date: 2018/03/31

More Info

Understanding lower abdominal pain and abnormal discharge in women can be quite complex, as these symptoms can arise from various underlying conditions. Given your description of symptoms, including persistent lower abdominal discomfort, abnormal vaginal discharge, constipation, back pain, dizziness, nausea, and sudden weight gain, it is essential to consider a comprehensive approach to diagnosis and treatment.

Firstly, the lower abdominal pain you are experiencing could be attributed to several gynecological issues. Conditions such as pelvic inflammatory disease (PID), endometriosis, or ovarian cysts can cause significant discomfort and may also lead to abnormal discharge. PID, for instance, is an infection of the reproductive organs that can result from sexually transmitted infections and may present with pain, unusual discharge, and fever. Endometriosis, on the other hand, occurs when tissue similar to the lining inside the uterus grows outside it, leading to chronic pain and other symptoms, including heavy menstrual bleeding and abnormal discharge.

Your mention of increased vaginal discharge, particularly if it is accompanied by a foul odor or changes in color, could indicate a vaginal infection, such as bacterial vaginosis or a yeast infection. These infections can also lead to discomfort during urination or bowel movements, as the inflammation can affect surrounding tissues.

The gastrointestinal symptoms you describe, including constipation and nausea, could suggest a gastrointestinal issue such as irritable bowel syndrome (IBS) or even a more serious condition like an intestinal obstruction, especially considering your surgical history. The fact that you have had three cesarean sections and a tubal ligation may contribute to the development of adhesions, which can lead to bowel obstruction and associated symptoms.

Additionally, the sudden weight gain and dizziness you mentioned could be linked to hormonal changes, particularly if you are experiencing irregularities in your menstrual cycle. Hormonal imbalances can lead to fluid retention and weight fluctuations, which might explain the sudden increase in weight. Dizziness could also be a sign of dehydration or low blood pressure, which can occur with gastrointestinal disturbances.

Given the complexity of your symptoms, it is advisable to consult with a healthcare professional who specializes in gynecology. A gynecologist can perform a thorough evaluation, including a pelvic exam, ultrasound, and possibly lab tests to assess for infections or other conditions. If the gynecological evaluation does not reveal a clear cause, a referral to a gastroenterologist may be warranted to explore any potential gastrointestinal issues.

In summary, your symptoms warrant a comprehensive evaluation by a healthcare provider. It is crucial to address both the gynecological and gastrointestinal aspects of your health to determine the underlying cause of your discomfort. Early diagnosis and appropriate treatment can significantly improve your quality of life and alleviate the symptoms you are experiencing. Remember to provide your healthcare provider with a complete history of your symptoms, surgical history, and any other relevant information to aid in their assessment.

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