[18F] Experiencing abnormal vaginal bleeding and abdominal pain

Patient Description

An 18-year-old female reports abnormal vaginal bleeding that is bright red and clotted, differing from her normal menstrual cycle, and began 2 days ago with a history of spotting over the past month. The patient has taken Plan B recently, which may be relevant. She describes feeling general weakness and soreness, with a severity of 4 out of 10, and lightheadedness with a severity of 4-5 out of 10, both of which started 2 days ago and are exacerbated by physical activity. The patient also experiences pain during sex, rated 3-4 out of 10, with a stinging or aching sensation in the abdomen, particularly on the left lower side, where she also feels soreness. Sleep patterns are irregular, with spontaneous awakenings and a total of 4-6 hours of sleep. Additionally, the patient noted an unusual vaginal discharge that is creamier and thicker with a sweet but unpleasant odor. No known allergies, no current medications, and no recent prescriptions. The patient's medical history is otherwise unremarkable.

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Arora's Assessment

What might be happening

Based on the information you provided, possible explanations for your symptoms include:

  • Pelvic Inflammatory Disease (PID): This is an infection of the female reproductive organs, often due to sexually transmitted bacteria. Symptoms can include pain in your lower abdomen, fever, unusual discharge, pain during sex, and irregular menstrual bleeding.

    • Treatment typically involves antibiotics to clear the infection.
  • Ovarian Cysts: These are fluid-filled sacs that can form in the ovaries. They can cause abdominal pain, bloating, and irregular periods. Some women may also experience pain during sex.

    • Treatment can range from monitoring the cysts to surgical removal, depending on their size and whether they're causing symptoms.
  • Side effects of Plan B: Plan B can sometimes cause changes in your menstrual cycle, including spotting or heavier bleeding. It can also cause nausea, abdominal pain, fatigue, and dizziness.

    • These side effects should resolve on their own within a few days to a week. If they persist, you should see a healthcare provider.
  • Sexually Transmitted Infections (STIs): Certain STIs, like chlamydia or gonorrhea, can cause abnormal vaginal discharge and pain during sex.

    • Treatment typically involves antibiotics.

What you can do

  1. Schedule an appointment with a healthcare provider as soon as possible to discuss your symptoms. They may want to perform a pelvic exam or other tests to determine the cause of your symptoms.
  2. In the meantime, avoid sexual activity until you've been evaluated by a healthcare provider, especially if you're experiencing pain during sex.
  3. Keep track of your symptoms and any changes, as this can be helpful information for your healthcare provider.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe abdominal pain
  • High fever (temperature over 100.4°F)
  • Fainting or severe dizziness
  • Heavy vaginal bleeding (soaking through one or more pads or tampons every hour)

Remember, while I strive to provide accurate information, I'm not a doctor and this advice should not replace a consultation with a healthcare provider.

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10 mo ago

People Also Ask


Can Plan B cause changes in menstrual bleeding patterns?

Yes, Plan B can cause changes in menstrual bleeding patterns, including spotting, heavier bleeding, or changes in the timing of your period. These side effects are usually temporary and should resolve within a few days to a week.


What are the common symptoms of Pelvic Inflammatory Disease (PID)?

Common symptoms of Pelvic Inflammatory Disease (PID) include lower abdominal pain, fever, unusual vaginal discharge, pain during intercourse, and irregular menstrual bleeding. It is important to seek medical attention for proper diagnosis and treatment.


How can ovarian cysts affect menstrual cycles and cause pain?

Ovarian cysts can cause irregular menstrual cycles, abdominal pain, bloating, and pain during intercourse. Depending on their size and symptoms, treatment may involve monitoring or surgical removal.


What should I do if I suspect I have a sexually transmitted infection (STI)?

If you suspect you have a sexually transmitted infection (STI), it is important to see a healthcare provider for testing and treatment. Avoid sexual activity until you have been evaluated and treated to prevent spreading the infection.


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