Pain and bleeding?
Doctor, I had my period in early March, and shortly after it ended, I had sexual intercourse twice in a row.
After that, I started bleeding again, and two days later, the bleeding returned, accompanied by abdominal pain.
I visited a gynecologist who performed an ultrasound and found nothing wrong, and the examination showed no issues either, but I am still in pain.
What could be the cause of this?
Xie xie, 20~29 year old female. Ask Date: 2016/01/15
Dr. Lin Wenbin reply Obstetrics and Gynecology
Continue to seek follow-up with a physician, as some conditions cannot be detected initially.
Reply Date: 2016/01/15
More Info
Understanding post-intercourse bleeding and abdominal pain in women can be quite complex, as there are multiple factors that could contribute to these symptoms. Based on your description, it seems that you experienced bleeding shortly after engaging in sexual intercourse, followed by abdominal pain. While you have already consulted with a gynecologist and undergone an ultrasound with no apparent issues detected, it is essential to consider various potential causes for your symptoms.
Firstly, post-coital bleeding can occur for several reasons. One common cause is cervical irritation or trauma, which can happen if the intercourse is vigorous or if there are underlying conditions affecting the cervix, such as cervical ectropion (where cells from the inside of the cervical canal are present on the outside of the cervix) or cervical polyps. These conditions can lead to bleeding, especially after sexual activity.
Another possibility is that the bleeding could be related to hormonal fluctuations, particularly if it occurs around the time of ovulation or shortly after your menstrual period. Hormonal changes can sometimes lead to spotting or light bleeding, which might be mistaken for menstrual bleeding.
In addition, conditions such as endometriosis or pelvic inflammatory disease (PID) could also lead to abdominal pain and bleeding. Endometriosis occurs when tissue similar to the lining of the uterus grows outside the uterus, which can cause significant pain, especially during or after intercourse. PID, an infection of the reproductive organs, can also result in pain and abnormal bleeding.
It is also worth considering the possibility of an ovarian cyst. Functional ovarian cysts are common and can sometimes rupture, leading to bleeding and abdominal pain. While your ultrasound may not have shown any cysts, it is important to note that some cysts can be small or not easily visible at the time of imaging.
Given that your symptoms persist despite normal ultrasound findings, it may be beneficial to follow up with your gynecologist for further evaluation. They may recommend additional tests, such as a pelvic exam, blood tests to check for infections, or even a hysteroscopy to directly visualize the inside of the uterus if they suspect an intrauterine issue.
In the meantime, managing your pain with over-the-counter medications like ibuprofen or acetaminophen may help alleviate discomfort. However, it is crucial to avoid self-medicating without consulting your healthcare provider, especially if you are experiencing significant pain or if the bleeding continues.
If you notice any worsening of symptoms, such as increased bleeding, severe pain, fever, or any other concerning signs, it is essential to seek immediate medical attention. Your health and well-being are paramount, and persistent symptoms warrant thorough investigation to rule out any serious underlying conditions.
In summary, while post-intercourse bleeding and abdominal pain can stem from various causes, it is essential to work closely with your healthcare provider to identify the underlying issue. Continued communication with your gynecologist and possibly seeking a second opinion or further diagnostic testing may provide clarity and help you find relief from your symptoms.
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