Left Lower Abdominal Pain and Vaginal Discomfort: When to See a Gynecologist?

Left lower abdominal pain with vaginal cramping?

Hello doctor, initially I only had pain in the lower left abdomen, but starting the next day, I began to experience pain in the pelvic area as well.
The pain feels like cramping, and the area in the lower left abdomen feels warm to the touch.
The pain is irregular and sometimes radiates to a location that feels like the bladder and very much like the vagina.
There was even an instance where the pain extended to the clitoral area, and I felt unable to walk.
There hasn't been a significant increase in discharge, but the frequency of pain increases when I exert myself or after using the restroom, although it tends to ease afterward.
Recently, I noticed that my lower left abdomen appears larger than my right, but due to obesity, I'm unsure if this is simply a matter of asymmetry.
I went to the emergency room, and the doctor suggested I see a gastroenterologist, indicating that it might be early-stage gastroenteritis (blood and urine tests showed no significant signs of infection, and I did not have a fever).
Although I had an ultrasound, I am concerned that due to my obesity, the results may not be clear.
Should I consider seeing a gynecologist as well?

Ms. Chen, 20~29 year old female. Ask Date: 2021/12/17

Dr. Huang Yuande reply Obstetrics and Gynecology

It is recommended that if the pain persists, you should consider consulting a gynecologist.
Before your appointment, please drink water to fill your bladder, as this will make it easier for ultrasound diagnosis.

Reply Date: 2021/12/17

More Info

Based on your description of left lower abdominal pain accompanied by vaginal discomfort, it is indeed advisable to consult a gynecologist. Your symptoms, including the cramping pain in the left lower abdomen, the sensation of heat in that area, and the discomfort radiating towards the vaginal area, could indicate several potential gynecological issues that need to be evaluated.

Firstly, the pain you are experiencing could be related to conditions such as ovarian cysts, endometriosis, or pelvic inflammatory disease (PID). Ovarian cysts can cause significant discomfort, especially if they rupture or become large. Endometriosis, which involves the growth of endometrial tissue outside the uterus, can lead to severe pain during menstruation and even at other times in the cycle. PID, often caused by sexually transmitted infections, can result in pain and discomfort in the pelvic region and may also lead to complications if not treated promptly.

The fact that your pain worsens with physical activity, such as lifting heavy objects or after using the restroom, suggests that it may be related to the pelvic organs. Additionally, the observation that your left lower abdomen appears larger than the right could indicate an underlying issue that may require further investigation.

While the emergency department has suggested a gastrointestinal issue, such as early-stage gastroenteritis, it is crucial to consider that gynecological conditions can present with similar symptoms. The absence of fever and the normal results from blood and urine tests are reassuring but do not rule out gynecological problems.
Given your symptoms, it would be prudent to schedule an appointment with a gynecologist. They can perform a thorough examination, which may include a pelvic exam, transvaginal ultrasound, or other imaging studies to assess the reproductive organs more clearly. These tests can help identify any abnormalities such as cysts, fibroids, or signs of endometriosis.

In addition to imaging studies, the gynecologist may also consider laboratory tests to check for infections or hormonal imbalances that could be contributing to your symptoms. If endometriosis or another condition is diagnosed, treatment options may include pain management strategies, hormonal therapies, or surgical interventions, depending on the severity of the condition and your personal health goals.

In summary, your symptoms warrant a thorough evaluation by a gynecologist. While gastrointestinal issues are a possibility, the nature of your pain and its location suggest that a gynecological cause should not be overlooked. Early diagnosis and treatment can help alleviate your discomfort and prevent potential complications. Please do not hesitate to seek specialized care to address your concerns comprehensively.

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