[18F] With urinary urgency and dysuria post-intercourse

Patient Description

An 18-year-old female reports a constant urge to urinate and pain during urination since engaging in unprotected sexual activity today. She describes a numbness in the pelvic area and has experienced chills, though no fever is confirmed. There is no blood in the urine, nausea, or vomiting. She has not had any new sexual partners recently and has not been diagnosed with a urinary tract infection before. The patient experiences significant vaginal discharge and has noted minor vaginal bleeding after sex for the past two months, likely due to insufficient lubrication or roughness. She does not have a menstrual cycle due to birth control but has been feeling emotional, suggesting a possible cycle. There is a persistent itch in the genital area for over a year, with no recent STI testing. No sores or lesions are present, only redness from itching. She uses Lo Loestrin Fe birth control pills and has a Kyleena IUD. Saliva is used as lubrication during intercourse.

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Arora's Assessment

What might be happening

Based on your symptoms, here are some possible explanations:

  • Urinary Tract Infection (UTI): This is a common condition, especially after sexual activity, and can cause a frequent urge to urinate, pain during urination, and pelvic discomfort. UTIs are typically treated with antibiotics prescribed by a healthcare provider.

  • Irritation or Trauma: The bleeding after sex and itching could be due to irritation or minor trauma, especially if lubrication is insufficient. This can also contribute to discomfort during urination.

  • Vaginal Infection: The itching and discharge might suggest a yeast infection or bacterial vaginosis. These conditions can cause irritation and are treatable with over-the-counter or prescription medications.

  • Sexually Transmitted Infection (STI): Although you haven't been tested recently, some STIs can cause similar symptoms. It's important to get tested to rule this out.

What you can do

  1. Consult a Healthcare Provider: It's important to see a doctor for a proper diagnosis and treatment plan. They may recommend a urine test or other examinations.

  2. Stay Hydrated: Drink plenty of water to help flush out your urinary system.

  3. Use Proper Lubrication: Consider using a water-based lubricant during sex to reduce irritation and bleeding.

  4. Avoid Irritants: Wear loose-fitting, breathable underwear and avoid harsh soaps or douches.

  5. Track Symptoms: Use MDandMe to journal your symptoms, track progress, and share insights with your healthcare provider.

What you should look out for

Seek medical attention if you experience:

  • Increased pain or discomfort
  • Fever or worsening chills
  • Blood in your urine
  • Persistent or worsening symptoms

Remember, it's important to consult with a healthcare professional for a formal diagnosis and treatment.

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2 mo ago

People Also Ask

What are the common symptoms of a urinary tract infection (UTI)?

Common symptoms of a UTI include a frequent urge to urinate, pain or burning sensation during urination, cloudy or strong-smelling urine, and pelvic pain. Some people may also experience chills or fever.

How can insufficient lubrication during sex lead to vaginal bleeding?

Insufficient lubrication during sex can cause friction, leading to minor tears or irritation in the vaginal tissue. This can result in bleeding, especially if the intercourse is rough or prolonged.

What are the signs of a yeast infection or bacterial vaginosis?

Signs of a yeast infection include itching, redness, and a thick, white discharge that resembles cottage cheese. Bacterial vaginosis may cause a thin, grayish discharge with a fishy odor. Both conditions can cause discomfort and irritation.

Why is it important to get tested for sexually transmitted infections (STIs) even if there are no new sexual partners?

Testing for STIs is important because some infections can be asymptomatic or have mild symptoms that are easily overlooked. Early detection and treatment can prevent complications and reduce the risk of transmission to partners.

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