QuestionHi,
I am an eighteen-year-old sexually active female and I have been having recurrent genital health issues for over a year now. About a year and a half ago I started having symptoms like burning while urinating, urgency, abdominal pain, pain in the vaginal area, etc. I didn't know what it was and I was embarrassed so it was left untreated for longer than it perhaps should have been and spread into my kidneys causing intense pain. I went to the doctor (a local walk-in clinic) and was prescribed antibiotics. The infection cleared up and I continued drinking water and cranberry juice. About a year ago I became sexually active (about five or six months after my first UTI). I again started having symptoms of a UTI. I would have these symptoms every couple weeks or in some cases every couple of days and would drink lots of water and cranberry and they would usually go away. I also had occurances of painful vaginal intercourse characterized by an unbearable burning sensation. This cleared up after a while and I enjoyed many months without painful intercourse (even during or before or after UTI symptoms, sometimes painful urination after intercourse but not painful intercourse). I had another incidence where a UTI became so bad that I went to the doctor (I have no medical insurance) and was again prescribed with antibiotics. I continued to have on-and-off UTI symptoms, which I usually self-treated with water, cranberry, and/or vitamin C. I also started to take probiotics because I was told that an imbalance of my bacteria might be leaving me vulnerable to infection. Throughout all this time I was having mild to severe abdominal pain intermittently, which I vaguely attributed to mittelschmerz. Several months ago, I had another UTI that landed me in the doctors office again. I was prescribed another antibiotic: six pills, two a day for three days. When this failed to clear up my infection I was prescribed a different antibiotic, ten pills, two a day for five days. This mostly cleared up the infection but I still had some painful symptoms. I went to a gynecologist who took a urine sample and did a pap/vaginal exam. She said the urine contained almost no bacteria (previously, when my infections had been severe, my urine was analyzed and was overrun with bacteria) but there were an excess number of white blood cells. I don't think she understood the chronic nature of my symptoms and just attributed my infections to the fact that I was recently sexually active. She literally said that my body would eventually "get used to it." She prescribed yet another antibiotic. She was supposed to do a culture on my urine sample, but one of her employees "lost" the sample and she didn't offer to take another without charge. Since then I have had UTI symptoms on-and-off and have, as before, treated them with drinking lots of water and cranberry. In between symptoms, I also drink water (bottled) and unsweetened cranberry juice and, in fact, drink nothing else except the occasional glass of orange juice. I wipe front-to-back and always have. I don't take baths anymore at all. I pee before and after intercourse and wash with betadine after intercourse. I avoid scented soaps and shampoos and actually shampoo and condition my hair bent over so that the solutions don't wash down my body. I take probiotics. I wear cotton underwear and none at night to allow myself to "breathe." All of this on the suggestion of many websites and doctors. Also, on a family member's advice, I make sure I orgasm every time my partner and I are sexually involved. My partner and I have literally abstained from sex for over a month and my symptoms persisted. He has been my only sexual partner ever and he was tested during our relationship for STDs, all the results were negative. When I had my pap, the doctor said these tests were run: Pap IG, Ct-Ng, rfx HPV ASCU. I am doing everything right, at least, everything anyone can think of, and I still have UTI symptoms every few days. In addition, now I am having vaginal and vulval (but especially inside, vaginal) burning and itching as well as painful vaginal intercourse. I read that this may be a yeast infection but I did not want to treat myself for a yeast infection without knowing. I do not have cottage-cheese like discharge or a "yeasty" odor. This is constant while I continue to have UTI symptoms every couple of days that don't last long if I drink an excessive amount of water. Yesterday, I had a urinalysis done again and had no sign of yeast, but only a larger number of white blood cells. There were also a lot of etiphelial (epithelial?) cells, which I was told is probably normal. Today, I have some very slight abdominal pain/pressure.
History:
First period: When I was 11 or 12, so about seven years ago.
Most recent period: November 1, 2007.
I used to have light periods and I would often go for months without having a period. I almost never had cramping or other PMS symptoms. Recently, in the last year, or possibly two years, I have had very heavy periods with extremely bad cramping that leaves me bed ridden with a heating pad for a couple of days. I have also had random abdominal pain all throughout my menstrual cycle.
I took birth control pills for several months before and after I was sexually active for the purpose of treating acne, which I have had since I was a young teenager. It has ranged from mild to extremely severe at times. I took first a generic form of ortho-tri-cylin and then actual ortho-tri-cyclin. I didn't like the way birth control made me feel (although I experienced no serious side effects) and I went off it. I went on it again for a little while a bit later but I again didn't like it and it caused vaginal dryness so I quit it altogether.
My partner and I use our own variation of natural family planning, a combination of the basal body temperature method and the standard days method. We also use condoms on "unsafe" days. Once, when I first became sexually active, I had an adverse reaction to a condom with spermicide and subsequently stopped using that condom and have not had any problems since that seemed to result from condom use. We actually don't use condoms very often and usually abstain from intercourse during "unsafe" days and practice other forms of sex. When we do (rarely) use condoms though we use "pleasure plus: lubricate latex" and "lifestyle: lubricated latex."
I don't know if all of these things are related or separate but I do know that there are many causes that may relate them. I have read about endometriosis, polycystic ovaries, vaginitis, bacterial vaginosis, vaginal candidiasis, certain cancers, and many more. Whether or not these symptoms add up to a bigger cause, I still need to find I way to stop this constant suffering from UTI symptoms, it is hindering my life severely.
My questions for you are:
What do these excess white blood cells in my urine mean? Obviously, they are fighting some sort of infection, but neither bacteria or yeast are present. Do you know of any other condition that these tests might indicate?
Thank you so much for your time, I know this is a long question but I wanted to provide all the information I had. I think it is wonderful that doctors and other experts like you take time out of what I am sure is a very busy schedule (and busy life) to answer the questions of people whose doctors perhaps don't listen as much as they could. Your time in reading and answering my question is greatly appreciated.
AnswerHi Grace, I'd be glad to try and answer your question. I understand your frustration. Noone should have to suffer with your symptoms for so long, and no doctors are able to tell you what's wrong. It sounds like you are doing everything you can to help your body to fight this problem, but yet it still sounds like you're suffering. White blood cells in urine means that there is infection or inflammation present. This doesn't always mean that there's a UTI. If there's just inflammation then that means that the walls of the bladder or ureters are swollen (or inflamed). The cause can be hard to pinpoint. You said that you've read up alot on other diseases. But have you heard of Interstitial cystitis? Try Googling it. It causes symptoms like you have and it's not caused by an infection. Here's my advice: Be persistant. If you're not getting answers from your doctor, tell him to send you to a specialist (maybe a kidney/bladder specialist). It sounds like you need further testing, you've suffered way too long. I hope I've answered your question, Grace. I wish you the best.
**Information contained is not intended nor implied to be a substitute for professional medical advice.**
