Aa
Painful Pelvic Exam
Hi, I had a question regarding pain during a routine pelvic exam. I had a yearly in May of last year and was also seen again about a month ago and during those appointments I did not have any pain. I am a little tender inside due to scar tissue from a surgery but it is bearable. I went yesterday for another check and this time when the doctor did the manual exam I almost hit the roof. I was literally backing away because I was in soooo much pain, it hurt all over like I was being stabbed, after the doctor apologized he suggested I get an ultrasound and after he left the pain was still there it was so bad that I left the office light headed and ready to vomit. I thought I was going to pass out in the parking garage it was just that bad. Has this happened to anyone before or does anyone have an idea of what could possibly cause this kind of pain? I have had cysts in the past and know that tender feeling that can be felt but this was a pain I have NEVER experienced before in my life. Any insight is appreciated.
MEDICAL PROFESSIONAL
Hello
Pain on deep penetration is due to pelvic inflammatory disease, endometriosis, pelvic tumors, cervical and uterine infections and tumors. Depending on the site of pain, diagnosis can be made. This can be further confirmed by clinical examination, ultrasound abdomen or CT scan, PAP smear and a STD panel as required.
It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.
Pain on deep penetration is due to pelvic inflammatory disease, endometriosis, pelvic tumors, cervical and uterine infections and tumors. Depending on the site of pain, diagnosis can be made. This can be further confirmed by clinical examination, ultrasound abdomen or CT scan, PAP smear and a STD panel as required.
It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.
I should add that pain sometimes associated with functional ovarian cysts, which begins during ovulation, can last until the end of the cycle or-- rarely-- longer. My pain is usually during ovulation only, but that's not the case for everyone or every cyst.
Hi, I've experienced pain like that a number of time after manual pelvic exams. The level of pain varies slightly at different appointments. In my case, I have other factors which contribute to the pain, but that particular pain seems to be associated/significantly worsened by my recurrent ovarian cysts. They're usually the functional cysts which appear during ovulation.
If your painful exam occurred during ovulation, perhaps that's the cause. I imagine that's the reason/part of the reason that your doctor ordered an ultrasound. I assume you don't have the results yet but, if there's a cyst, you might want to discuss with your doctor whether it was the cause of the pain and whether you should schedule future appointments during certain times in your cycle (provided they aren't needed sooner, which your doctor could address). He may think that taking some type of medication (such as aspirin) prior to appointments is a good idea-- but do ask before trying that, since anything which reduces pain may also make it more difficult for a doctor to determine whether you're ill.
Your doctor may also be using the ultrasound to explore other possibilities, such as Pelvic Inflammatory Disease (PID), particularly if you've been sexually active during a time frame that concerns him If your second-to-last appointment was prompted by symptoms or signs of infection, or resulted in a diagnosis of infection, your doctor may want to explore the possibility of PID. It can show up on ultrasound, but not always and not at all stages of the disease.
PID is usually caused by Chlamydia or Gonorrhea, but may also be caused by common bacterial infections which aren't necessarily sexually transmitted (such as Bacterial Vaginosis). It's possible (but unusual) to have negative Chlamydia and Gonorrhea tests but still have either infection, or the infection was vaginal in the past but has since caused Pelvic Inflammatory Disease. However, you would probably have had signs and symptoms of infection during at least the appointment a month prior to the very painful exam. You may want to check and write down your temperature a few times per day until this is figured out, since infection or PID would likely cause a fever. PID generally causes a low-grade fever, which would probably be 99.1-99.5 if your usual temperature is 98.6 or so.
In my personal opinion, based on far too many gynecological problems and appointments over the past 13 years or so, if your doctor is unable to determine the cause of your pain-- especially if you still have the pain, develop new signs or symptoms of illness, or think that he failed to evaluate your problem thoroughly-- discussing it with your primary care doctor might lead to a reason for the pain or appointment to see another gynecologist for a second opinion. While gynecological pain in the absence of other signs and symptoms is likely to be a cyst (or perhaps a fibroid, but I'm not sure about that), it's something that I take seriously following numerous delayed diagnoses.
I was lucky that the correct tests were Eventually done and led to diagnoses, as well as vindicating me when doctors apparently thought the symptoms and signs I'd described were exaggerated so that the pain I experience isn't so bad as it once was. Good luck!
If your painful exam occurred during ovulation, perhaps that's the cause. I imagine that's the reason/part of the reason that your doctor ordered an ultrasound. I assume you don't have the results yet but, if there's a cyst, you might want to discuss with your doctor whether it was the cause of the pain and whether you should schedule future appointments during certain times in your cycle (provided they aren't needed sooner, which your doctor could address). He may think that taking some type of medication (such as aspirin) prior to appointments is a good idea-- but do ask before trying that, since anything which reduces pain may also make it more difficult for a doctor to determine whether you're ill.
Your doctor may also be using the ultrasound to explore other possibilities, such as Pelvic Inflammatory Disease (PID), particularly if you've been sexually active during a time frame that concerns him If your second-to-last appointment was prompted by symptoms or signs of infection, or resulted in a diagnosis of infection, your doctor may want to explore the possibility of PID. It can show up on ultrasound, but not always and not at all stages of the disease.
PID is usually caused by Chlamydia or Gonorrhea, but may also be caused by common bacterial infections which aren't necessarily sexually transmitted (such as Bacterial Vaginosis). It's possible (but unusual) to have negative Chlamydia and Gonorrhea tests but still have either infection, or the infection was vaginal in the past but has since caused Pelvic Inflammatory Disease. However, you would probably have had signs and symptoms of infection during at least the appointment a month prior to the very painful exam. You may want to check and write down your temperature a few times per day until this is figured out, since infection or PID would likely cause a fever. PID generally causes a low-grade fever, which would probably be 99.1-99.5 if your usual temperature is 98.6 or so.
In my personal opinion, based on far too many gynecological problems and appointments over the past 13 years or so, if your doctor is unable to determine the cause of your pain-- especially if you still have the pain, develop new signs or symptoms of illness, or think that he failed to evaluate your problem thoroughly-- discussing it with your primary care doctor might lead to a reason for the pain or appointment to see another gynecologist for a second opinion. While gynecological pain in the absence of other signs and symptoms is likely to be a cyst (or perhaps a fibroid, but I'm not sure about that), it's something that I take seriously following numerous delayed diagnoses.
I was lucky that the correct tests were Eventually done and led to diagnoses, as well as vindicating me when doctors apparently thought the symptoms and signs I'd described were exaggerated so that the pain I experience isn't so bad as it once was. Good luck!
Have an Answer?
You are reading content posted in the Women's Health Community
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
Normal vaginal discharge varies in color, smell, texture and amount.
Bumps in the genital area might be STDs, but are usually not serious.
Chlamydia, an STI, often has no symptoms, but must be treated.
From skin changes to weight loss to unusual bleeding, here are 15 cancer warning signs that women tend to ignore.
