Discomfort and Urgency in the Genital Area: Causes and Solutions

Perineal tightness

Sometimes I experience discomfort in my lower abdomen (during non-menstrual periods), accompanied by frequent urination, but only a small amount each time.
It feels particularly uncomfortable and tense when I urinate.
This morning, I had the same situation, but my menstrual period has started now.
However, there is no blood on the sanitary pad.
I still have frequent urination, but the urine is blood-tinged.
It is also very uncomfortable when I urinate, to the point of breaking out in a cold sweat.
I'm not sure what this condition could be.

Huang, 10~19 year old female. Ask Date: 2023/11/08

Dr. Lin Wufu reply Internal Medicine

Hello, it is recommended to schedule an appointment with the obstetrics and gynecology department for diagnosis and treatment.
The symptoms sound very much like a urinary tract infection, but during menstruation, it is common to experience discomfort similar to that of a urinary tract infection, making it difficult to differentiate.
If it is confirmed that the blood in the urine is true hematuria and not mixed with menstrual blood, then it is likely a urinary tract infection.

Reply Date: 2023/11/08

More Info

Experiencing discomfort and urgency in the genital area, especially when accompanied by symptoms such as frequent urination, a tight feeling, and blood in the urine, can be concerning and warrants a thorough evaluation. There are several potential causes for these symptoms, and understanding them can help guide appropriate management.

Possible Causes
1. Urinary Tract Infection (UTI): One of the most common causes of discomfort and urgency in the genital area is a urinary tract infection. UTIs can cause symptoms such as frequent urination, a burning sensation during urination, and sometimes blood in the urine. The tight feeling you describe could be due to bladder irritation.

2. Interstitial Cystitis: This is a chronic condition characterized by bladder pressure, bladder pain, and sometimes pelvic pain. It can lead to frequent urination and discomfort, especially during periods of stress or hormonal changes.

3. Kidney Stones: The presence of kidney stones can cause significant discomfort and urgency. If a stone is passing through the urinary tract, it can lead to sharp pain, blood in the urine, and a feeling of urgency.

4. Hormonal Changes: Since you mentioned that your symptoms are occurring around your menstrual cycle, hormonal fluctuations could also play a role. Conditions such as endometriosis or pelvic inflammatory disease can cause discomfort in the pelvic area and may be exacerbated during menstruation.

5. Vulvodynia or Vaginal Infections: Discomfort in the genital area can also arise from vulvodynia, which is chronic pain in the vulva, or from infections such as yeast infections or bacterial vaginosis. These conditions can cause irritation and discomfort, leading to a feeling of urgency.

6. Bladder or Kidney Issues: Conditions affecting the bladder or kidneys, such as bladder inflammation or pyelonephritis (kidney infection), can also present with similar symptoms.

Recommended Actions
1. Seek Medical Attention: Given the presence of blood in your urine and significant discomfort, it is crucial to consult a healthcare provider as soon as possible. They may perform a urinalysis, urine culture, and possibly imaging studies to determine the underlying cause.

2. Hydration: Drink plenty of fluids to help flush out your urinary system. However, avoid irritants such as caffeine, alcohol, and spicy foods, which can exacerbate bladder irritation.

3. Pain Management: Over-the-counter pain relievers may help alleviate discomfort temporarily, but they do not address the underlying cause.

4. Monitor Symptoms: Keep track of your symptoms, including when they occur, their severity, and any other associated symptoms. This information can be helpful for your healthcare provider.

5. Consider a Gynecological Evaluation: Since your symptoms are occurring in relation to your menstrual cycle, a gynecological evaluation may also be warranted to rule out any reproductive system issues.

Conclusion
The symptoms you are experiencing—discomfort in the genital area, urgency, and blood in the urine—can be indicative of several conditions, some of which require prompt medical attention. It is essential to consult with a healthcare provider who can perform a thorough evaluation and provide appropriate treatment based on the underlying cause. Early intervention can help prevent complications and improve your overall well-being.

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