Ectopic Pregnancy vs. Pelvic Inflammatory Disease Symptoms

Is it an ectopic pregnancy?

On February 25, I took emergency contraception.
On March 5, I experienced heavy bleeding.
On March 25, I had uncertain menstrual flow.
On April 6, I also had bleeding (similar to menstrual flow) and I'm unsure if it's my period.
I went to the gynecologist for a pregnancy test, which came back negative (one line), and I have tested multiple times with the same result.
An ultrasound was performed, and the doctor indicated signs of uterine inflammation.
Symptoms include left lower abdominal pain, breast tenderness, and pain near the anus, but there is no vaginal bleeding.
Could this be an ectopic pregnancy or pelvic inflammatory disease?

At sign, 10~19 year old female. Ask Date: 2022/04/20

Dr. Huang Yuande reply Obstetrics and Gynecology

It may be an inflammation of the uterus, as an ectopic pregnancy can definitely be detected through a pregnancy test.
However, it is still recommended that you see a doctor for an examination.

Reply Date: 2022/04/20

More Info

Ectopic pregnancy and pelvic inflammatory disease (PID) are two distinct medical conditions that can present with overlapping symptoms, making it crucial to differentiate between them for appropriate management.
Ectopic pregnancy occurs when a fertilized egg implants outside the uterus, most commonly in the fallopian tubes. Symptoms of ectopic pregnancy can include unilateral abdominal pain, vaginal bleeding, and signs of internal bleeding such as shoulder pain or dizziness if the ectopic pregnancy ruptures. The pain is often sharp and localized to one side, which aligns with your experience of left-sided lower abdominal pain. Additionally, ectopic pregnancies can sometimes present with breast tenderness or changes in breast tissue, which you described as "breast fullness."
On the other hand, pelvic inflammatory disease is an infection of the female reproductive organs, often caused by sexually transmitted infections like chlamydia or gonorrhea. Symptoms of PID can include lower abdominal pain, fever, unusual vaginal discharge, and pain during intercourse. The pain associated with PID may be more diffuse and can be accompanied by systemic symptoms like fever or malaise.
In your case, the timeline of events is significant. You mentioned taking emergency contraception on February 25 and experiencing heavy bleeding on March 5, which could be a side effect of the medication or an early menstrual period. The uncertainty regarding the bleeding on March 25 and April 6, along with the negative pregnancy tests, suggests that you may not be pregnant. The ultrasound indicating uterine inflammation could point towards PID, especially given your symptoms of left-sided abdominal pain and discomfort near the rectum.

It is essential to consider that while ectopic pregnancy can occur, the negative pregnancy tests and ultrasound findings may lean more towards a diagnosis of PID rather than ectopic pregnancy. However, the presence of unilateral pain and the history of potential pregnancy necessitate careful evaluation.
Given your symptoms and the findings from your ultrasound, it is advisable to follow up with your healthcare provider for further evaluation. They may recommend additional tests, such as blood tests to check for infection or inflammation markers, and possibly a repeat ultrasound to monitor any changes. If PID is confirmed, treatment typically involves antibiotics, and in some cases, hospitalization may be necessary if the infection is severe.

In summary, while both ectopic pregnancy and PID can present with abdominal pain and bleeding, the context of your symptoms, negative pregnancy tests, and ultrasound findings suggest that PID may be the more likely diagnosis. Nonetheless, it is crucial to continue monitoring your symptoms and seek medical advice to ensure proper treatment and management. If you experience worsening pain, fever, or any other concerning symptoms, do not hesitate to seek immediate medical attention.

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