Seeking Guidance Amid Ongoing Symptoms
Greetings to all, I’m a 27-year-old woman, standing at 5’2” and weighing 115 pounds, I find myself facing ongoing issues with pelvic and urinary discomfort that have surfaced over the past few months, leaving me feeling quite frustrated. I’m reaching out in hopes that someone here might have experienced something similar or can offer some advice. In April, I went through a distressing incident of sexual assault, and shortly afterwards, I began to experience symptoms such as burning sensations, internal irritation, and a frequent urge to urinate. When I visited the emergency room, I was diagnosed with bacterial vaginosis (BV). At that moment, they didn’t perform tests for HSV but conducted a comprehensive STD panel, which returned negative results, apart from the BV. I was given antibiotics to address the issue. A few weeks later, my symptoms persisted, prompting me to consult my OB-GYN for further evaluation. She diagnosed me with a yeast infection and ordered another round of tests. Yet again, all STD tests returned negative. Some time later, after noticing a small red spot, I underwent a vaginal PCR swab, which came back negative for both HSV-1 and HSV-2. Other tests revealed I was also negative for ureaplasma and mycoplasma. To date, I’ve undergone multiple comprehensive STD panels that have included tests for HIV, gonorrhea, chlamydia, trichomoniasis, hepatitis, and syphilis, with all results being negative. Despite these findings, I continue to battle internal vaginal irritation—distinct from external symptoms—along with intermittent urgency and urinary pressure. The discomfort sometimes intensifies during my menstrual cycle or after sexual activity, only to subside later. There are no sores, abnormal discharges, or symptoms that resemble flu illness, yet I’m left with a persistent burning sensation and an urgent need to urinate that just won’t seem to resolve. During one of these flare-ups, I had a urinalysis conducted, which revealed several irregularities in the dipstick test: - Protein: 30 - Nitrite: Positive - Leukocytes: Large - Urobilinogen: 4 - Glucose: 100 - Bilirubin: Small - Ketones: Trace - Urine color: Orange - pH: 5.0 However, I did take Azo (phenazopyridine) prior to this test, which can potentially lead to false positives. My physician mentioned that since my urine culture indicated “normal urogenital flora isolated,” she doesn’t think a urinary tract infection (UTI) is present or that there’s cause for alarm. Nonetheless, I still feel unwell. My doctor suspects it could be linked to hormonal changes due to my premature ovarian insufficiency and ongoing hormone replacement therapy (HRT) or possibly residual trauma and stress from the assault. Yet, my urinary symptoms seem distinct from these factors. Has anyone experienced a mismatch of a normal culture with an abnormal dipstick test and yet still felt unwell? Would it be advisable to pursue more precise testing, request another urine culture, or seek a referral to a urologist? I’m making a concerted effort to stay grounded, but the prolonged duration of these issues without clear answers is wearing on me. Any thoughts or suggestions would be greatly appreciated. Thank you for taking the time to read my post.
Answers (1)
7/22/2025, 2:20:48 AM
OpenHealth AI
I'm truly sorry to hear about the ongoing challenges you're facing with pelvic and urinary discomfort. The symptoms you've described, especially following such a distressing incident, can be complex and frustrating. Here’s a summary of your situation and some suggestions that may help you find relief and clarity.
Summary of Your Situation:
- You have experienced pelvic and urinary discomfort for several months, with symptoms including burning sensations and a frequent urge to urinate.
- You dealt with bacterial vaginosis (treated with antibiotics), a yeast infection, and multiple negative STD tests.
- Recent urinalysis showed some irregularities, but your urine culture indicated normal flora, leading your physician to suspect other underlying issues, possibly linked to hormonal changes or residual stress from the trauma you experienced.
Understanding the Situation:
Your persistent symptoms, especially after a trauma, may indeed have a multifaceted origin. Hormonal changes from premature ovarian insufficiency (POI) and stress-related conditions can contribute to physical symptoms, including pelvic pain and urinary issues. The negative culture results interplay with the irregular dipstick findings, which can lead to confusion.
Next Steps:
Here are some prioritized steps you can consider taking:
-
Document Your Symptoms:
- Keep a detailed journal of your symptoms, including their intensity, timing (e.g., during your menstrual cycle), and any activities that worsen or alleviate them. This can help both you and your healthcare provider identify patterns.
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Follow Up with Your OB-GYN:
- Schedule a follow-up appointment with your OB-GYN to discuss your ongoing symptoms, the possibility of hormonal factors, and any other tests you may need. Be sure to share the findings from your recent urinalysis and your concerns about persistent symptoms.
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Consider a Urology Referral:
- Discuss the possibility of a referral to a urologist, who specializes in urinary tract and pelvic issues. They may conduct further testing to rule out urinary tract infections or bladder-related conditions that were not covered in your initial assessments.
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Explore Pain Management and Pelvic Floor Therapy:
- Investigate options such as pelvic floor physical therapy. A specialized therapist can help you with techniques to relieve pelvic pain and improve bladder function.
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Seek Support for Trauma Recovery:
- If you haven’t already, consider connecting with a mental health professional experienced in trauma recovery. Addressing emotional scars can sometimes alleviate physical symptoms related to stress and trauma.
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Monitor Lifestyle Factors:
- Evaluate your hydration, diet, and hygiene practices. Staying well-hydrated can help urinary symptoms, and maintaining a balanced diet may alleviate some discomfort. Avoid known irritants such as caffeine, alcohol, and spicy foods that could worsen bladder irritation.
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Ask About Further Testing:
- If symptoms persist, discuss with your physician the possibility of another urine culture or tests to examine bladder function more closely.
Remember, it’s important to advocate for your health. Clear communication with your healthcare providers about your symptoms and concerns can help lead you to the right path for relief. You're not alone in this, and maintaining connections with supportive friends or groups might also help you cope with the emotional aspects of your journey. Please feel free to ask if you need further guidance or details!
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