[19F] Experiencing burning genital pain and abdominal discomfort

Patient Description

A 19-year-old female presents with a burning pain in the urethra and clitoris, described as a sensation similar to road rash. The pain, rated 7/10 in severity, is constant, subsides during urination, and returns immediately after. She also reports abdominal discomfort akin to post-workout soreness combined with a sensation of bladder incontinence. The patient has been experiencing chills and a mix of drowsiness and insomnia. She has a history of frequent UTIs but indicates that the current pain differs from typical UTI pain. The patient suspects the pain may be due to a scratch from her sexual partner's pubic hair during unprotected intercourse approximately 7-8 hours prior to symptom onset. She has had a recent abnormal menstrual cycle, with a 13-day heavy period followed by a 10-day break and then a spotty, inconsistent period. The patient takes 5 mg of norethindrone for birth control and cranberry pills for UTI prevention, along with occasional use of an unspecified AZO product. There is no known history of allergies, adverse reactions to medications, or chronic illnesses.

Arora's Assessment

What might be happening

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

Urinary Tract Infection (UTI): Even though you mentioned that this doesn't feel like your typical UTI, the symptoms of burning and pain during urination, abdominal discomfort, and chills are common in UTIs. UTIs can vary in their presentation.
- Treatment usually involves antibiotics prescribed by a healthcare provider.
Sexually Transmitted Infections (STIs): Some STIs can cause burning or pain during urination, although you mentioned a recent negative test. Chlamydia and gonorrhea, for example, can cause these symptoms.
- Treatment involves specific antibiotics for the identified STI.
Vaginal Irritation or Inflammation: This could be due to a variety of causes, including chemical irritants or physical trauma. You mentioned the possibility of a scratch from your partner's pubic hair.
- Treatment involves identifying and removing the cause of irritation. Over-the-counter pain relievers may help with discomfort.
Interstitial Cystitis: This is a chronic condition causing bladder pressure and pain and occasional pain during urination. It's more common in women and can be associated with other disorders such as irritable bowel syndrome or fibromyalgia.
- Treatment can involve medications, physical therapy, and other methods to manage symptoms.

What you can do

Seek immediate medical attention: Given the severity of your pain and the presence of chills, it's important to get evaluated by a healthcare professional as soon as possible. They can perform tests to determine the cause of your symptoms and prescribe appropriate treatment.
Stay Hydrated: Drinking plenty of water can help dilute your urine and ensure regular urination, flushing bacteria out of your urinary system.
Avoid Irritants: Until you can see a doctor, avoid potential irritants such as harsh soaps or bubble baths.