Abnormal Bleeding: When to Seek Medical Attention - Obstetrics and Gynecology

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Abnormal bleeding can be a concerning symptom that warrants medical attention, especially when it occurs in conjunction with other symptoms or after certain medical events. Based on the details you've provided, it seems you are experiencing a series of symptoms that could be interconnected, and it is essential to address them appropriately.

1. Understanding Your Symptoms: You mentioned that you took RU486 (Mifepristone) in early August, which is often used for medical abortion. Following that, you had a health check-up that revealed protein in your urine (proteinuria). While proteinuria can sometimes resolve on its own, it can also indicate underlying kidney issues, especially if it persists. It is advisable to consult a nephrologist (kidney specialist) to evaluate the cause of the proteinuria and determine if any further action is necessary.

2. Post-Sexual Activity Bleeding: The significant bleeding after sexual intercourse, along with the diagnosis of bladder inflammation, raises concerns. While bladder infections can cause bleeding, the persistence of bleeding and the presence of discharge suggest that there may be other underlying issues, such as cervical or vaginal irritation, or even more serious conditions like cervical polyps or infections. It is crucial to follow up with a gynecologist to rule out any serious conditions and to receive appropriate treatment.

3. Pain in the Right Thigh: The pain you are experiencing in your right thigh and buttock, especially if it is severe enough to impede your ability to walk, should not be ignored. This pain could be related to various factors, including musculoskeletal issues, nerve compression, or even vascular problems. Given that this pain occurs after sexual activity and is accompanied by bleeding, it is essential to have a thorough evaluation by a healthcare provider. They may recommend imaging studies or other diagnostic tests to determine the cause of your pain.

4. When to Seek Medical Attention: You should seek medical attention immediately if you experience any of the following:
- Heavy bleeding that soaks through one or more pads or tampons in an hour for several hours.

- Severe abdominal or pelvic pain.

- Fever or chills, which could indicate an infection.

- Any new or worsening symptoms, such as dizziness or fainting, which could indicate significant blood loss.

5. Next Steps: Given your symptoms, I recommend scheduling appointments with both a nephrologist and a gynecologist as soon as possible. They can provide targeted evaluations and treatments based on your specific symptoms and medical history. It is also important to keep a detailed record of your symptoms, including when they occur, their severity, and any associated factors, as this information can be very helpful for your healthcare providers.

In summary, while some symptoms may resolve on their own, the combination of proteinuria, abnormal bleeding, and pain warrants a thorough medical evaluation. Do not hesitate to seek care, as early intervention can often lead to better outcomes and peace of mind.