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I was prescribed medication but I think I was misdiagnosed

Doctor's Assistant: What medications do you take daily? Are you allergic to any medications?

I take the birth control chateal daily and am allergic to bactrim

Submitted: 7 months ago.Category: Medical
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Answered in 2 minutes by:
11/20/2017
Doctor: Richard Han, Board Certified MD replied 7 months ago
Richard Han
Richard Han, Board Certified MD
Category: Medical
Satisfied Customers: 1,123
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Hello my name is***** am a board-certified physician with 15 years of experience. How may I help you today?

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Customer reply replied 7 months ago
Currently after I engage in sexual intercourse with my partner the next day I become irritated down and hurt for several days. I went the doctor he diagnosed me with bacterial vaginosis. I was prescribed metronidazole and took those pills 2x a day for seven days. The next time I engaged in intercourse again all the same symptoms came back. I have irritation, redness and a pinching feeling in my vagina. I also have tore too. All the symptoms to me seem to be leading to herpes, which is terrifying. I was tested for all other stds and the tests were negative. What is your opinion?
Doctor: Richard Han, Board Certified MD replied 7 months ago

You are experiencing dyspareunia, the medical term for pain during or after sexual intercourse. There are many causes for dyspareunia. Bacterial vaginosis is not usually a cause, but should be treated anyway, as you have already been treated. STD's can be another reason, but since you have already been tested, and I assume for herpes as well, and found negative, please rest assured that those are not the cause. Just a few more questions. May I know how old you are? Do you take any other medications? Do you have any other chronic medical conditions? You also mentioned "irritation, redness." Is this more external around the labia or vulva where you can see it, or is it more internally at the introitus to the vagina, where you mentioned you also feel the "pinching" pain? Are you having any vaginal discharge, bleeding or pain with urination? Thank you in advance for your replies.

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Customer reply replied 7 months ago
The doctor only did a swab test for STDs, so I believe that tested for gonorrhea and chlaymedia. There was no blood test done to check for Herpes. I have redness and pain around the opening of the vagina, so In the inner part. I have discharge that is clear/ can have a slight white/ red tint. I believe the red is blood. The last time I engaged in sex I tore at the bottom and I believe the top of my vagina, it’s hard to tell, but from the pain that’s where it felt like.i also bled from there on and off the whole next day. I am 22 years old and currently only taking the chateal birth control pills. I have been sexually active for years and this is the first time I have ever experienced such difficulties and pain associated with intercourse. I still have such pain today and it has been almost 3 days since I last engaged in sex.
Customer reply replied 7 months ago
Also no chronic medical issues. And currently no pain during urination, but it has happened before. More so when it would touch the torn area
Doctor: Richard Han, Board Certified MD replied 7 months ago

I understand, thank you for that information. If the STD test was only a pelvic swab, then you are correct, it is limited to GC/chlamydia. Your description of the irritation, redness and pain, and location is not typical for herpes, but that being said I believe it would be thorough and wise to be tested for it via a blood test. If the physician examining you previously and diagnosing the bacterial vaginosis was not specifically a GYN, then I would also schedule an appointment with a GYN for a closer internal examination. There is also the possibility of more vigorous sexual intercourse or a large girth male partner having caused mechanical trauma to explain the cuts, bleeding and overall irritation. That can take some time to heal. Do you have any other questions I can answer for you?

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Customer reply replied 7 months ago
The doctor I went to see I believe was either a GYN or an OBGYN. I am just curious as to why it happens? When I first became sexually active with him there were no issues until about 2 months after. I am just wondering why that could happen?
Doctor: Richard Han, Board Certified MD replied 7 months ago

If you've been with the same partner for the past 2 months, then less likely mechanical trauma is the cause of your symptoms, unless your more recent activity has been significantly more vigorous than in the past. From the description of your white/red tinted vaginal discharge, a yeast infection is also another possibility. By chance do you douche at all or have you worn any newer fabric underwear or tighter jeans or other clothing? Pressure from constriction can sometimes cause some of the symptoms as well. I would schedule a return visit to your OB/GYN and inform him/her that your symptoms are persisting and not improving despite having been fully treated for the bacterial vaginosis. May I assist you with anything else this evening?

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Customer reply replied 7 months ago
I only have these issues after sexual intercourse, which is why it is alarming to me.
Doctor: Richard Han, Board Certified MD replied 7 months ago
I understand. Some underlying process is causing your vaginal tract to be inflamed and sensitive to touch/friction. What that cause is remains unclear to me based on your description and answers to my questions. But it does make sense that you only experience the symptoms after sex if the friction from intercourse exacerbates the sensitive, irritable tissue of the exposed layers of your vagina. Seeing your OB/GYN is the best thing to do both for further testing, an accurate diagnosis and peace of mind. Many things in medical practice are just as much art and science, and after one visit, diagnosis and treatment, when a patient continues to have the problematic symptoms, doctors need to see the patient again to better fine tune their investigations in terms of testing to hone in on the true diagnosis so as to provide the best, ***** ***** treatment. Please call your GYN in the morning for an appointment. Can I answer any other specific questions for you?
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Customer reply replied 7 months ago
Based on what I have mentioned what is your opinion on what it might be? I will be making an appointment I am just trying get a professional opinion also.
Doctor: Richard Han, Board Certified MD replied 7 months ago
To be perfectly honest, I do not know for sure what it is. However, in my professional opinion I do not think it is genital herpes. Many times in medicine, knowing what something isn’t is just as important and sometimes more important than knowing what it is. I hope that helps.
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Customer reply replied 7 months ago
Today I went to the ER and was tested for std infections again as well as BV, trich, & yeast. I also had a pelvic exam done and the doctor said there seemed to be no irritation to my vagina, but yet it has been burning. I wanted to get a blood test done, but they do not do blood tests for Herpes or HIV there. After he finished the exam he said he did not notice any signs of herpes, which what I have been worried it was. He and an other said they believe it is interstitial cystitis, due to have reacurrent leukocytes in my urine, but no bacteria. They prescribed me phenazopyridine 200mg tabs taken as needed for burning urination. Now I still feel really lost because I still have a burning in my vanginal area and what they suggested does not fit my current vaginal symptoms. At this point I don’t know what else to do. I have been told I have BV, UTIS, Cervicititis, and now interstitial cystitis. Nothing is adding up. What should I do?
Doctor: Richard Han, Board Certified MD replied 7 months ago

Hello again. I strongly recommend you see your gynecologist. Emergency room physicians are trained to handle life threatening and acute conditions and are often quite skilled with general medicine illnesses as well, however your specific symptom of dyspareunia would best be served by a specialist in vaginal tract anatomy and physiology, i.e. a gynecologist. He/she would definitely be able to order blood testing to rule out herpes and/or any other potential causes his/her expertise might call into question. I do not believe your symptoms are plausibly explained by BV or UTI. Since your GC/chlamydia was negative and I assume your GYN examined the cervix via pelvic exam, cervicitis also does not seem likely. Interstitial cystitis is a possibility, as it is often associated with vulvar pain, or vulvodynia and/or dyspareunia, but is usually associated with painful bladder filling and relieved by urination and bladder emptying. It is a difficult diagnosis to make and confirm. In my opinion, you would receive the best possible care by consolidating all your medical visits with one physician, your gynecologist, who should be able to methodically and over time hone in on an accurate diagnosis, or else coordinate your care by referring you to a specialist, such as a urologist, if interstitial cystitis is a possibility that needs looking into. I would avoid urgent care and ER visits, as you will see someone different every time, creating a "too many cooks in the kitchen" phenomenon, and likely receive many different ideas, answers and treatments, that will likely only frustrate you more and possibly make findings the correct diagnosis more difficult because of multiple, various uncoordinated tests and treatments.

Do you have any other questions I can help with?

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Doctor: Richard Han, Board Certified MD replied 7 months ago

If you have no further questions, please click the button to accept the answer and conclude our interaction. I would also appreciate the kindness of a 5 star positive review. Thank you.

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