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Avatar universal

Is this much pain and bleeding typical?

This is very detailed because I'm quite concerned about the amount of pain I'm in and I want to give as accurate a picture as I can.

I was diagnosed with  2 two days ago after going to the ER because of excruciating and escalating vaginal and labial pain.  My original complaint was the tears, cuts, constant bleeding, and intense pain during urination.  The previous week, I'd had rough (protected) sex that got completely out of control.  Directly after sex, I urinated (to prevent UTI and also to check the damage).  There was bleeding and I was VERY sore, which I expected.  I went home, still sore and had relatively mild and normal bleeding throughout the day.  

I examined myself with a mirror and I was expectedly red and slightly swollen.  I noticed a tear on my labia majora.  It looked exactly like a friction tear I'd developed on the back of my calf when breaking in new boots, so I didn't think much of it.  (This was maybe two or three hours after the violent sex.)  I went googling on how to proceed with genital cuts and essentially, the message was to let it heal on its own.  So I tried that.  

The next day, I had PT and there was bike riding and chair squats where I came down directly into a chair and just a general lot of open legged stretching).  I mention this because I initially thought that I'd made the tear(s) - because I suspected at that point there were internal tears since I was still bleeding and quite sore - worse with so much pressure and pulling and sweat in the cuts.  I went to the store and bought diaper rash cream to soothe the cut on the outside of my labia.

Gradually, the pain got worse and worse and it become more uncomfortable to sit down.  When I went back to physical therapy a few days later, sitting on the bike was almost impossible.  Whereas before, urination was painful, it now felt like I was peeing razor blades.

The day I was diagnosed, I was in so much pain and so swollen that I called every clinic around the city and no one would see me, so I wound up at the ER.

I'd been continuously checking myself  because I worried when the (mild) bleeding hadn't stopped and because there was a clear discharge with the consistency of water.  Each day the swelling and redness seemed to get worse.  My labia minora looked abraded on the inside, as if someone had taken sandpaper to it.  My vagina was very swollen and red and urination was becoming consistently more painful. Everything I'd read said that vaginal cuts and tears heal by themselves and there was nothing to be done for them, but the pain was so severe and only getting worse and I hadn't stopped bleeding since directly after the sex, so I thought maybe I'd been injured more seriously internally or that the cuts had become infected.

Early that morning, I checked myself again, and I was even more swollen than before.  Everything looked even more abraded than before and the cut on the side looked deeper.  

And that is what landed me in the ER. When I made it the to back and explained my symptoms and spread my legs, the PA kept asking me if we'd used a toy or foreign object, which was unnerving, but upon spreading apart my labia, he then said that it looked herpetic.  At the time, I was confused (and of course, upset) because I'd used protection and I'd been examining myself every day and there were no lesions - only cuts and abrasions.  I'd also had no itching or any of the other symptoms of herpes that I'd come across in my searches regarding vaginal pain.

He then did a pelvic exam, which was horrific.  To communicate how severe the pain was, I want to point out that I have an extremely high pain tolerance, but when he pushed the speculum inside me, I screamed.  He again said that it looked as if I had herpetic lesions and took two swabs.  He also had a colleague come and examine me externally and she agreed.  Again, I was confused for the previous reasons and asked if they would be doing a swab test (they didn't swab any of the lesions on my labia, although I guess there could have been lesions inside of my vagina that were swabbed) and she said they'd be testing for "a bunch of things" and left.  No one would explain which tests they were doing, though.

I waited for half an hour before a nurse came in and told me that the PA had made a diagnosis of genital herpes and also that I had a UTI because "I guess they found some bacteria on the swabs."  This was confusing, as I had given them a urine sample, but she specifically referred to swabs from the pelvic exam.  I don't know if that matters.  During this conversation, she gave me eight pills - four pills of Flagyl and four pills of azithromycin,

I asked the nurse if they'd prescribed anything for pain (because that's why I was there) and she said that no.  At that point, I specifically told her I as not referring to anything narcotic, but a numbing or soothing cream.  She said she would check and left.  Finally, a nurse came back with RXs for me - one for acyclovir, one for doxycycline, and one for lortab.  I again specified that I was not asking for narcotics because they don't help at all.  I asked if there was any kind of cream or topical anesthetic that could be prescribed instead because I was in serious pain and she said there wasn't anything.  I asked about OTC products and again, she said there was nothing that would help and that the lesions needed to dry out and anything put on them would just make the pain worse.

When I got home, I was upset and doubtful of the diagnosis because during the examination, they kept insisting that I'd had symptoms I hadn't had and because no one would answer my questions about what tests were run, but when I examined myself, things looked completely different than they had earlier.  Where the cuts, abrasions, fissures, and torn skin were, blisters had also popped up. The diagnosis made much more sense.

The next day, I woke and tried to urinate, but once I started, I actually stopped because the pain was so intense.  It was the worst pain I have ever known.  I also started bleeding bright red blood.  I quit and for the three hours I held it, the bleeding never stopped.  It wasn't extremely heavy, but it was constant.  It was bright red for awhile until it tapered off into a watery looking pink.  When I finally urinated, there was blood everywhere and it felt as if I'd back flipped naked into a pool of rubbing alcohol and razor blades.  Also I've never messed with or scratched the sores. Every time I urinate, the blisters bleed bright red blood and continue bleeding for several hours until it tapers off.  

I'm not hoping for false reassurances.  With the amount of pain I'm in I just want to make sure I'm not prolonging it by being treated for the wrong condition.  Again, narcotics, NSAIDs, etc. are totally ineffective.

So, here is my question.  With everything I've detailed here, is there anything else it could be?  I'm not sure if there was a culture done and no one would give me specific answers.

Any help, advice, or insight would be greatly appreciated.
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Avatar universal
It seems kinda late for me to join the conversation right now but I am basically going through the same thing right now. I've recently started being sexually active and must admit I'd rather been too ignorant than being cautious about protecting myself from the absurdly obvious risks of such life-threatening(I mean mentally) sexual infections.
Starting from last Wednesday I had vaginal pain during having sex which felt like abrasion from friction, proceeding to unbearable soreness(like having slits/cuts) accompanied by the blood and then, the dignity-dumping pain on my vagina(with unidentified bumps and blisters on labia) at urination. I remember myself noticing this weird, gross, fishy smell as I urinated in the toilet from two weeks ago but I haven't paid as much attention as I'd surely had I had any idea what was following behind it.
I went to PPH today which is Saturday Oct 6 to get a testing and it's too terrifying that I will have to live with the overwhelming pain and stress until next week, not knowing what exactly is going on and therefore, not having any choice for myself but to leave it as is untreated for up to 6days from now.
I'm almost in a state of insanity+panic now because that I'm getting strange skin rashes on other areas of my body as well, such as chest, back of a thigh and a shoulder. Can't even consider looking at it through the mirror, it might cause me a serious mental disorder honestly...
I know I'd got the first cold core outbreak when I was really young supposedly from my mom. So I am quiet convinced, after all my research and googling, that I have got Herpes as a STD.
Am I still not allowed to take any action other than waiting for the result in pain to relieve myself from the symptoms? Is there any innocuous medicine or cream that I may use to reduce my pain and/or the sores? If yes, then do I need to get prescribed for them?
The suspected past sex partner of mine is not someone reliable and I cannot talk to him about any sexuality-concerned issues. I'm all alone in this painful situation and desperate for help, advice, any comments that might be related.
It's my first time writing on here but hopefully this will give a notice to the poster and all the other people with their comments above....
Helpful - 0
Avatar universal
okay.  thank you so much for letting me know.  i went ahead and made an appointment for next week to get everything rechecked.  it is a kind of a relief not having to worry about being poked and prodded since i'm still pretty sore.  

re: the partner, unfortunately not.  i actually forgot to ask them whether or not they did the type specific igg testing when i was making the appointment.  hopefully, they do, and if not, hopefully they can point me in the direction of someone who does.  

thanks so much for being so knowledgable and so kind and for pointing me in the direction of helpful resources.  just having some information really makes a difference and then, of course, the at-home pain relief suggestions were tremendously helpful (it was nice to know they existed, too, because i wouldn't have unless i came here because everyone at the hospital said there was nothing i or they could do, ugh)  at some point there, i was half convinced i was going to die and wouldn't that have been an awkward way to go out?  :)   as much as all of this still sucks, i feel so much better on all fronts.  
Helpful - 0
101028 tn?1419603004
it'll be too late for lesion cultures tuesday.  at this point I'd give this all another week, then follow up at PP and get retested for yeast and bacterial infections vaginally too to make sure nothing new is going on down yonder and to make sure the bv you were diagnosed with cleared up.   not unusual to develop a yeast infection after antibiotics and they will be able to get a better look at things down yonder since by then you won't be in so much pain too.  they also can call the ER you were seen at and get all your results faxed over to them so they are there for them to look at too.

any chance you can get the partner from the encounter before all this to get type specific herpes igg blood testing and share it with you?  Not all PP offer the type specific herpes igg blood testing and you'll need to wait until 3 months post encounter to follow up with the testing for yourself.

glad you are finding things that are making you feel better :)   When you get a humdinger of an ob, it really sucks :(



Helpful - 0
Avatar universal
i am honestly not sure if they swabbed lesions or not because everything that i could see was external and that's where the pain was concentrated.  it was just a normal pelvic exam without the breast examination.  they never said if there were lesions inside of my vagina and that's the only place they swabbed and now i'm really frustrated because things are starting to look better (though i'm also on an antibiotic, so if there was a chance it's something else that could be helping), so now i don't know how accurate a swab test will be at this point.  

they gave me the acyclovir and the antibiotic (and the narcotic that i told them didn't want because it didn't help, sigh.  i had knee surgery recently, so i had leftover pills from that and they were stronger than what they gave me and they didn't even help).  they flat out refused to give me a cream when i specifically asked for one and i just wanted to cry because i came in because of the pain.  

luckily, the azo tablets helped a lot and i tried the dermoplast, which didn't do a lot, but it helped a bit and i just gave in and started drinking a lot of water again, which did help dilute the urine.  

i was really upset that i wound up at the er, to be honest because i had a feeling something like this would happen.  the whole experience was just upsetting and and kind of gross.  i'm really hoping that planned parenthood will squeeze me in so i can get a swab test while everything is still good and gruesome down there.  i know they'll be thorough about everything and do the swab and blood tests, too, instead of just basing it on a visual exam.  

i think the not knowing for certain is the scariest part right now.  i've kind of put aside the emotional part of it because the physical part is so terrible right now.  for me, i think going into it expecting the worst will be the easiest way to deal with it.

i'm really glad i stumbled across this forum in my googling.  it's honestly made me feel so much better about everything.  so, you know, thank you so much.  i have absolutely zero support system, so this is the only place i've been able to talk about things, and if the worst is true, then at least i can come back here where people seem to be really knowledgeable and kind.  
Helpful - 0
Avatar universal
Hey so the same thing happened to me my initial time except the doctor didn't.even swab me she just sent me home with ascylovir and a topical prescription of lidocain.... It does hurt to initially put on but it does numb the area you put it on. That was the only was I could use the restroom... Or turn the shower on to warm water and stand up in the shower and pee... That one really helps to.

But I would say do what grace says and go  see your normal ob/gyn and see what she or he has to say because  they usually have more empathy than an ER doctor and they can explain to you better how to deal with it.

It's scary for the 6 weeks you have to wait till the result come back but once it clears you just have to live a normal life and try to watch for symptoms of another outbreak... and hope that the ER doctor was wrong and you just have something else
Helpful - 0
Avatar universal
thank you for the recommendation.  i read it and i found it very helpful, particularly in relation to testing methods.  i'm even more dissatisfied with the way this was handled at the er.  i was obviously already not pleased by the brush off and also the fact that they didn't even bother to take a sexual history (which, at the time, i thought was ridiculous, but i was in too much pain and feeling too upset about everything i said being dismissed to even bother), let alone ask more about this encounter than what i volunteered.

i've come to the conclusion that there's no way they could've typed this or, i think, even tested a culture (which they took from the pelvic exam) because of the timing.  i'm going to call planned parenthood and try to get them to see me on tuesday while everything is still there and horrifying to look at because i know from experience that they'll answer my questions and do the right tests, so i can actually be more informed about this.

re: the milk, honestly, i only meant it to be a one time thing (and it was; i just reached the point where i was willing to risk it because i was actually starting to grey out from the pain prior) so i could urinate until i was able to procure the things you suggested, which, oh god, they've helped SO much.  there's still blood and pain, but the pain isn't anywhere near as bad as it was.  it also gave me the courage to cross my fingers and start drinking tons of water again, which i imagined helped as well.  the neon orange urine is worth it.  

again, i cannot even communicate my thanks right now.  the azo tablets and the dermoplast have made such a difference.  and the handbook is great and it's given me a better idea of what questions to ask and what tests i should be requesting when i see someone.  i just feel so much better.  i'm actually a little teary about it just now, so you get this terribly long comment.  honestly, i was just sobbing from the pain and frustration before.  so, really, i don't have words enough to express my gratitude.  
Helpful - 0
101028 tn?1419603004
google the free herpes handbook by terri warren. we recommend it all the time here - it's up to date and accurate and written by our medhelp herpes expert Terri Warren.  it'll help you with the basics like treatments and difference between hsv1 and hsv2 genitally.  

I'm not sure if the sugars in the milk would be an issue or not genitally to be honest.  
Helpful - 0
Avatar universal
that's actually another thing i wanted to ask about - the different tests and whether one that gives results quickly (if they somehow managed a miracle and performed that in half an hour) actually differentiate between types.  the reason i was especially curious is because, ugh, i did perform unprotected oral sex on him and have had no problem at all.  i know for a fact that i have hsv 1 because i contracted it when i was a child from my parents in the form of cold sores.  i just thought it was strange that the riskier sex didn't trigger anything, which, of course, sometimes that's just the way it happens, but it still made me wonder and to be honest, aside from the absolutely excruciating pain et al, that's another reason i asked if i could be anything else.  i've read that having one type can offer you some minor protection just because you already have antibodies in your system, but even so, i just found it really odd that i haven't even had the hint of a cold sore.

even if it turns out to be hsv, is there a difference between types one and two as far as treatment, symptoms, etc when it presents on the genitals?  I'm sorry i'm bombarding you with questions, but you've honestly been more informative than the four medical professionals i saw in the ER.  but god, thank you so much again for being so informative.  i'm going to try and get in with planned parenthood on tuesday.  it's where i would've preferred to go anyway because i've honestly always been more comfortable talking to them about my sexual history and encounters.  when i was at the hospital, judging by the questions and how fast they got me out of the waiting room and into the back, i'm pretty sure they thought i'd been assaulted, and when they realized that wasn't the case, they made me feel really uncomfortable and maybe it's in my head, but i also felt like that's when they started being really vague with me and insisting on they symptoms i didn't have, etc.  

i actually, miracle of miracles, managed to urinate after nearly 24 hours.  i guess it's hard to break a habit of drinking tons of water every day because, even though i cut down, i still managed to unconsciously reach for my water bottle and keep drinking.  i've never been so glad for a side effect (dry mouth) in my life.  so, that did help to dilute the urine a bit.  something else i did, and god, it is the best thing i have done since this thing begun.  i mean, my pain, for the moment is almost gone, at least in terms of walking and just leaning back relaxing.  i've not taken anything at all, but i just tried this when i went into the bathroom knowing i absolutely had to urinate or something drastic and probably more painful would happen.  it occurred to me that if urine is acidic, well, then what about a base to counteract the acidity?  so i made a sort of compress out of milk and just held it against myself for about ten for fifteen minutes (the same thing i'd tried with sitting in the tub, which didn't really help).  then i split it down the middle and tried to cover all the blisters as best i could while kind of spreading things down there to keep as much skin as i could from touching my urethra and while it was still painful, it's been the least painful experience i've had since the day before i went to the hospital.  i also poured milk over myself after to rinse any urine off and then i cleaned everything off with mild soap and water and i honestly cannot believe how much better the pain is right now.  so now i can pee.  and start drinking lots of water again.  

again, god, thank you so so much.  you've been so helpful and informative.  
Helpful - 0
101028 tn?1419603004
there is some testing that will give results quickly but it's not the most accurate testing and we don't really recommend its use any more  ( and it won't type infection either - some providers still mistakenly assume if it's genital, it must be hsv2 but often it's hsv1 from unprotected oral sex ). if they didn't do a lesion culture or even better yet a herpes pcr swab of symptoms, I recommend a type specific herpes igg blood test now and then repeat it in 3 months.  

was the partner from the encounter a regular partner who you can trust to get type specific herpes igg blood testing done and share their results with you?

if you can't urinate on your own, you need to go and be seen and get catheterized. urine retention can occur with herpes and can last for a few days up to a few weeks even and can't be ignored.  You can also try putting water in the bathtub, sitting in it, peeing in there and then showering off. sometimes as an adult it's just hard to pee anywhere but in a toilet though.  

since you don't have a regular provider, give the hospital a call tuesday and see if you can get a copy of your records. With HIPAA laws they have to give you them ( really you just need lab results, not the full record) though they are allowed to charge a reasonable charge for them.  

it will get better and if this is herpes, recurrences won't be anywhere near as bad as this at least.  
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Avatar universal
no, i'm not getting any side effects from any of it.  i'm on a fair amount of other medication anyway, so my body mostly just shrugs off side effects.

i didn't think there was any culture that would come back so fast (that's kind of what i was getting at) and that's why i was asking.  i get diagnosing on the visual exam, but i really felt like they should've done more as far as testing.  there was already more than one problem - what if there's more than that and it's making everything worse.  i'm sorry.  i'm just so frustrated and in so much pain and everything is only getting worse and i actually cannot urinate now. i try and the pain is so severe from a tiny drop that i start shaking and crying and my body just won't.  it's severely painful for the next ten minutes, as well, at which point it tapers off into less agonizing pain.  but for those ten minutes, I'm clawing at any skin I can reach and i can't breathe.  i have honestly never known pain like this.

i did try squirting water over myself as i tried to urinate, but the water was too much and my body just quit.  i say that and i mean it literally.  it's like the pain is so overwhelming that my body just shuts down as a defense mechanism.  

the worst part is that i usually drink lots of water and up until today, i'd mostly maintained that, but after today, i was too terrified.  i haven't completely dehydrated myself because i've still been trying to drink a little. even so i still can't pee because of the pain, so i'm just holding it all in, which is just awful.  i honestly don't know if i have a uti because i've never had any symptoms at all and my urine was completely clear likely because of all the water i usually drink.  even if i don't have one, though, i'm probably going to get one now with the way things are going.

aside from all of this, i don't actually have a regular doctor or gyn because i have no health insurance.  i really don't know what to do now.

sorry, i think this is really rambly and unnecessarily detailed.  it's late and i'm exhausted, but ha, can't sleep because everything hurts.
Helpful - 0
101028 tn?1419603004
they gave you the shingles dose of acyclovir but that's ok. are you getting bad headaches, nausea or abdominal pain with them?  you really only needed 400mg 3x/day for 7-10 days.

there isn't any rapid culture that comes back in a half hour. not sure what testing they did but hopefully they also did a culture. Have your regular provider or gyn give the hospital a call tuesday to get all your test results for your records so we can find out for sure if you really had good testing done at all or not.  

also this sounds like the worst advice ever but drink lots of water. it will keep your urine from being acidic and stinging worse running over your skin as well as it keeps you from becoming constipated that also adds to pain in the genital area.
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Avatar universal
Oh, god, thank you so much.  I'm sure I'll be awake at stupid o'clock tomorrow anyway (another fun side effect - the pain keeps waking me up), so I'll be off to the drugstore first thing.  As far as the tablets turning my underwear orange, with all the blood, I figure they're a lost cause, so if it it might help in the slightest, I'll take them.  

I don't know if any of the cultures have come back or if they even cultured the lesions themselves.  I was never clear on that and they brushed me off when I asked about the swab test.  

Re: acyclovir dosage - I'm on 800mg 5x/day.

I forgot to mention in my original post that they also gave me an injection of Rocephin at the hospital.  I have a penicillin allergy, so they used Rocephin in place of that.  That's actually also why I got the doxycycline, I think.  I kind of felt like they were throwing everything at the wall until something stuck.  Like I said, I'm not even sure about the cultures.  They specified type 2 hsv on the little informational sheet they sent me home with, but I can't find enough information on the rapid hsv culture test to determine whether or not it can distinguish between types and also, how long it takes because I got the official diagnosis within half an hour after the initial examination.  I need to call the hospital and see if I can find something out, but honestly, for the past two days, I've been trying to lay perfectly still in the vain hope that the pain will let up.

Anyhow, thank you so much for the suggestions.  I really appreciate your help.  God knows I'll be grateful if I can just pee without crying again.  I can do without the ability to walk around for the time being.
Helpful - 0
101028 tn?1419603004
oh I just saw it was 2 days ago you were seen.

it will take a few more days yet until most of your medications are working to help you.  what dose of acyclovir were you given?
Helpful - 0
101028 tn?1419603004
have any of your lesion cultures come back yet?

having bv on top of it all just makes things worse too. how long ago was it you were given the antibiotics and the flagyl?'

dermoplast spray ( the blue can for the genital area, not the red can ) is a topical anesthetic you can find in most drug stores for under $10. you can spray it on several times a day for pain relief.

soaking in the tubby with epsom salts thrown in is also comforting.

you can also buy a sitz bath set up to urinate into or buy a squirt bottle and squirt lukewarm water over your genital area when you urinate to help dilute the urine too. sometimes the otc urinary pain relief tablets are helpful too with pain during urination but be aware they turn your urine bright orange and can stain your underwear if you've never used them before.

grace
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Avatar universal
What a horrible experience. I would say go to another doctor for sure!! I don't like the way this dr handled your situation.
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