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:
Do you know of any reason why these symptoms might persist?
Can you recommend and actions or tests I might request a doctor or gynecologist to perform?
Could this be endometriosis or polycystic ovaries or another serious condition?
Is there any other helpful advice you might offer, medically or in terms of lifestyle, holistic treatments, diet, etc?
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 dont mind answering long questions. However, I am going to start by saying that I am not a Doctor, and my suggestions are based on personal experience/opinion rather than sound medical advice from a physician.
First I am going to address the UTI symptoms.
You might ask your Dr about prescribing a round of antibiotics to both you and your partner because some bacteria can be passed back and forth and the man has no symptoms.
Its possible to be allergic to the latex in condoms- Try using lambskin or another type of condom that is latex-free. Your history of skipped and heavy periods can indicate PCOS, but I dont know of a relation between UTI symptoms and PCOS. Another thing you might try, tho a bit embarrassing- ask your partner what type of soap he washes with and ask him to use something hypoallergenic on his private parts before you have intercourse. Let me throw another one out here- make sure you are well lubricated when you have sex because lack of lubrication can irritate you too. Be careful to choose a lubricant that doesnt have any fragrances or flavors added to it. And last but not least- ask your Dr about information on Vulvodynia. The National Vulvodynia website is http://www.nva.org/ Alot of the symptoms you are describing are listed on their website describing vulvodynia. However, only your Dr can make a diagnosis. I sympathize with you because its so expensive trying to get a diagnosis without insurance. You might call around and see if you can find a clinic in your area that will treat you on a sliding scale based on income. If I can be of further assistance please let me know, and do let me know what you find out.
