Post-Sexual Discomfort: Symptoms and Seeking Help - Obstetrics and Gynecology

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Post-sexual discomfort can be a concerning experience, especially when accompanied by symptoms such as bleeding, unusual discharge, and itching. It's important to understand that these symptoms can arise from various causes, and seeking medical advice is crucial for proper diagnosis and treatment.

From your description, it seems that you experienced bleeding after sexual intercourse, which has persisted for some time, along with the presence of brownish, thick discharge and occasional blood streaks. The itching sensation in the genital area adds to the discomfort. You mentioned that you have already consulted a gynecologist, who performed an ultrasound and urinalysis but did not provide a definitive diagnosis. Instead, you were prescribed medications to manage unexplained bleeding.

The medications you were given, such as Estarde (a form of estrogen), Norina (which may be a progestin), and Tranexamic acid (used to reduce bleeding), suggest that your doctor is trying to manage the symptoms while they investigate the underlying cause. It's not uncommon for gynecologists to prescribe these medications when the cause of bleeding is not immediately clear, as they can help regulate hormonal imbalances or reduce excessive bleeding.

There are several potential causes for the symptoms you are experiencing:
1. Hormonal Imbalance: Fluctuations in hormone levels can lead to irregular bleeding and discharge. This can be due to various factors, including stress, changes in weight, or underlying health conditions.

2. Infections: Vaginal infections, such as bacterial vaginosis or yeast infections, can cause unusual discharge and itching. Sexually transmitted infections (STIs) can also lead to similar symptoms, so it's essential to rule these out.

3. Cervical or Uterine Issues: Conditions such as cervical polyps, fibroids, or endometriosis can cause bleeding and discomfort during or after sex. These conditions may not always be visible on an ultrasound, so further investigation may be necessary.

4. Trauma or Injury: Sometimes, physical trauma during intercourse can lead to bleeding, especially if there is insufficient lubrication or if the intercourse is particularly vigorous.

Given that your symptoms have persisted and you are still experiencing discomfort, it may be beneficial to follow up with your gynecologist or seek a second opinion. You might want to ask for additional tests, such as a pelvic exam, Pap smear, or STI screening, to rule out infections or other underlying conditions.

Regarding your question about bladder stone surgery (膀胱截石術), it is essential to communicate your medical history and any ongoing symptoms to the urologist or gynecologist performing the procedure. They will need to know about your current symptoms, including the bleeding and discharge, as this information could affect the surgical approach or the timing of the procedure. It is always best to have a thorough discussion with your healthcare provider about any concerns you have before undergoing any surgical intervention.

In summary, while your symptoms may be distressing, they can often be managed effectively with the right medical care. Don't hesitate to advocate for yourself and seek further evaluation if your symptoms do not improve or if you have additional concerns. Your health and comfort are paramount, and understanding the root cause of your discomfort is the first step toward finding relief.