[20F] Experiencing pelvic cramping and vaginal discharge

Patient Description

A 20-year-old female reports experiencing sharp, widespread pelvic cramping that comes and goes, rated 8 out of 10 in severity, for a duration of one week. Additionally, she has had creamy white vaginal discharge for two weeks, which has been significant enough to frequently necessitate changing underwear. She also reports fatigue and back pain. The patient has a history of Polycystic Ovary Syndrome (PCOS) diagnosed four years ago. She is not currently on any medications and does not have any known drug allergies. She has not experienced fever, vomiting, abnormal bleeding, dizziness, fainting, or severe pain unrelieved by over-the-counter medications. The patient has the same sexual partner and does not use protection. No family history of similar symptoms or gynecological conditions was reported.

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Arora's Assessment

What might be happening

Based on the symptoms you've provided, here are a few possibilities:

  • Pelvic Inflammatory Disease (PID): This is an infection of the female reproductive organs, often due to sexually transmitted bacteria. Symptoms can include pelvic pain, vaginal discharge with an odor, painful urination, pain during sex, and irregular menstrual bleeding.

    • Treatment typically involves antibiotics to clear the infection.
  • Polycystic Ovary Syndrome (PCOS): You've mentioned you have been diagnosed with PCOS. This condition can cause irregular periods, heavy bleeding, excess androgen leading to physical signs such as facial hair, and polycystic ovaries. Pelvic pain is not a common symptom of PCOS, but it can occur.

    • Treatment typically involves lifestyle changes and medication to manage symptoms and prevent complications.
  • Ovarian Cyst: These are fluid-filled sacs that can form in the ovaries. They are common and usually harmless, but can sometimes cause symptoms like pelvic pain, bloating, and lower back pain.

    • Treatment may involve monitoring the cyst, birth control pills to prevent new cysts, or surgery to remove the cyst.
  • Endometriosis: This is a condition where tissue similar to the lining of the uterus grows outside of the uterus, causing pain and potentially fertility problems. Symptoms can include pelvic pain, painful periods, pain with intercourse, and fatigue.

    • Treatment typically involves medication to manage pain and slow endometrial growth, and sometimes surgery.

Please note that these are possibilities based on the symptoms you've provided, and not a definitive diagnosis.

What you can do

  1. Schedule an appointment with your healthcare provider. They can perform a physical examination and may order tests such as blood tests, pelvic ultrasound, or laparoscopy to determine the cause of your symptoms.
  2. Keep track of your symptoms. Note when they occur, how long they last, and any factors that make them better or worse. This information can be helpful to your healthcare provider.
  3. In the meantime, over-the-counter pain relievers may help manage your pelvic pain. Warm baths or a heating pad applied to the lower abdomen may also provide some relief.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe or sudden pelvic pain
  • Pain with fever and vomiting
  • Signs of shock, such as fainting, rapid breathing, dizziness, or lightheadedness

Remember, I'm an AI and this advice is based on the symptoms you've told me. It's important to consult with a healthcare provider for an accurate diagnosis and treatment.

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9 mo ago


People Also Ask


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

Common symptoms of PID include pelvic pain, vaginal discharge with an odor, painful urination, pain during sex, and irregular menstrual bleeding. It is often caused by sexually transmitted bacteria.


Can Polycystic Ovary Syndrome (PCOS) cause pelvic pain?

While pelvic pain is not a common symptom of PCOS, it can occur. PCOS more typically causes irregular periods, heavy bleeding, and symptoms related to excess androgen, such as facial hair.


What are the treatment options for ovarian cysts?

Treatment for ovarian cysts may involve monitoring the cyst, using birth control pills to prevent new cysts, or surgery to remove the cyst if it causes significant symptoms or complications.


How is endometriosis diagnosed and treated?

Endometriosis is diagnosed through a combination of symptom evaluation, imaging tests like ultrasound, and sometimes laparoscopy. Treatment typically involves medication to manage pain and slow endometrial growth, and in some cases, surgery.

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