Recent Gynecological Symptoms: When to Seek Medical Attention

Recently, it has been inconvenient to seek medical care. I would like to understand the possible conditions and then assess the severity to determine if urgent medical attention is needed?

In August 2018, after taking emergency contraception for two years, I unfortunately became pregnant.
At that time, I was about a month along and experienced frequent sharp pains in my lower abdomen that caused cold sweats.
When I sought medical attention, the doctor said it was normal implantation pain and prescribed medication to stabilize the situation.
However, due to financial and emotional crises, I chose to end the pregnancy with RU-486 despite the pain.
A follow-up examination confirmed that the abortion was complete.
At that time, being young, I didn't take care of myself.
After the medical abortion, I often complied with my partner's requests to clean and scrub the floors, neglecting my recovery.
Subsequently, I experienced severe lower abdominal pain for nearly a month, which prompted me to return for a check-up that revealed a 1.5 times enlargement of one ovary.
After three months of medication, the pain mostly subsided.
After breaking up with my ex and taking time to recover, my menstrual cycle became more regular, and I hadn't returned for a check-up in a long time.
I thought everything was behind me, but unexpectedly, after becoming intimate with my current partner over the past six months, I began to experience occasional sharp pains in my lower abdomen again.
Last week (around my non-menstrual period), I noticed a clear liquid without clots on my panty liner, which had previously occurred occasionally the day before my period.
The next day, I expelled a significant amount of brown, egg-white-like mucus with an unusual odor, but then it seemed to return to normal.
A few days ago, while squatting, I noticed an unusual odor from my urinary tract (there were no visible secretions, just a feeling of wetness on the panty liner, and the discharge seemed to be clear and watery with an odor).
Given my history of frequent infections, my gynecologist had previously warned me that I have a short and shallow vagina, making me susceptible to Candida/viral infections, so I have been diligent about hygiene.
A mild itching sensation and the unusual odor I experienced lasted only two to three days before stopping.
However, in the past two days, despite not engaging in vigorous exercise or intimacy, I have been experiencing intermittent severe sharp pains in my lower abdomen.
Currently, I suspect my partner may have acute scrotal eczema (due to prolonged sitting at work, and our private life is quite simple, with symptoms aligning with clinical descriptions and conditions), and I fear it may be due to an infection.
I also have a severe allergy condition and a weaker immune system.
Today, I am scheduled to receive the BNT vaccine, and I would prefer not to take unnecessary risks with medical visits in the near future.
Therefore, I would like to ask for your professional opinion (whether you lean towards a recurrence of an old issue, a recent infection, or if it’s not a significant concern) and any recommendations you may have.
I appreciate your understanding of my relatively complex medical history and symptoms, and I sincerely thank you for taking the time to clarify my concerns.

Dan You de Nü Zi, 20~29 year old female. Ask Date: 2021/10/31

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, based on your symptom description, it is recommended to maintain a light diet, have a regular daily routine, and keep the perineal area clean and dry.
Avoid wearing tight clothing.
You may soak in a bath to alleviate symptoms.
If symptoms persist, please consult a physician for diagnosis and treatment.
Thank you! Wishing you peace and health, Dr.
Chang.

Reply Date: 2021/10/31

More Info

When it comes to gynecological symptoms, particularly those that arise after a history of pregnancy and subsequent medical interventions, it is crucial to approach the situation with a comprehensive understanding of the potential underlying issues. Based on your detailed account, it seems you are experiencing a range of symptoms that could be indicative of several conditions, including hormonal imbalances, infections, or even complications related to your previous pregnancy and medical procedures.

Firstly, the abdominal pain you are experiencing could be attributed to several factors. Given your history of ovarian enlargement and the recent symptoms of severe abdominal cramping, it is essential to consider the possibility of ovarian cysts or other ovarian issues. Ovarian cysts can cause pain, especially if they rupture or if there is torsion. Additionally, the presence of brown discharge and unusual odors could suggest an infection, such as bacterial vaginosis or a yeast infection, particularly since you have a history of recurrent infections.

The brown discharge you described, especially if it is accompanied by a foul odor, is often a sign of old blood being expelled from the body, which can occur after menstruation or due to other gynecological issues. It is important to monitor this symptom closely. If the discharge persists, changes in color, or is accompanied by itching or irritation, it would be prudent to seek medical attention.

Regarding your concerns about the potential for a recurrence of previous issues versus a new infection, it is essential to consider your overall health and any recent changes in your lifestyle or sexual activity. The fact that you have experienced a change in your symptoms after becoming sexually active again could indicate that your body is reacting to new factors, including potential infections or hormonal changes.

Given your history of allergies and a weakened immune system, it is also possible that you are more susceptible to infections, which could explain the recent symptoms. The mention of acute scrotal dermatitis suggests that there may be a broader issue related to skin sensitivity or irritation, which could also be contributing to your discomfort.

In terms of seeking medical attention, it is advisable to consult a healthcare provider if you experience any of the following:
1. Persistent or worsening abdominal pain.

2. Unusual discharge that continues or worsens, especially if it has a foul odor.

3. Symptoms of infection, such as fever, chills, or significant changes in your overall health.

4. Any new or unusual symptoms that cause concern, especially given your medical history.

While it is understandable to want to avoid unnecessary medical visits, it is crucial to prioritize your health, especially when experiencing symptoms that could indicate a more serious issue. If you are hesitant to seek in-person care due to concerns about exposure to infections (especially with the ongoing pandemic), consider telehealth options where you can discuss your symptoms with a healthcare provider remotely.

In summary, your symptoms warrant careful monitoring and potentially further evaluation. While some symptoms may resolve on their own, others may require medical intervention to prevent complications. It is always better to err on the side of caution when it comes to your health, particularly with a complex medical history.

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