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Women's Health

Pelvic pain & abnormal bleeding

02/19/2008

Question:

For the last four menstrual cycles, I have been feeling a dull and achy pain on the right side of my pelvic area. The first two menstrual cycles I thought it was just a pulled muscle from exercising (I have a high tolerance for pain and did not really think anything of it) but the last two menstrual cycles, two days of my period it has been achier than previously to the point of not being able to move around comfortably. This fourth menstrual cycle, about 3 weeks ago, was the last time during a menstrual period I felt the pain and I have always felt it on my right side. I have been abstinent for a little over 3 years and all my Pap smears have been negative, even the most recent Pap smear two months ago. About two weeks ago, a week after my last menstrual cycle, I started having sexual intercourse with my boyfriend. We had sexual intercourse a few times in one day and during the fourth time I started bleeding during intercourse. After waiting about a week, before intercourse again I bled the next few times within two days again and the same thing happened 5 days later when we waited after that. I thought it could be because I have been abstinent for a long time and it was a tear that has not healed completely yet. My concern is the pain on my right side I usually only feel during my menstrual period but now it is evident right after sexual intercourse for up to three days and evident after exercising. My general physician put me on a low estrogen dosage birth control I started a week ago because she thinks it is probably ovarian cysts because of the pain. She did not take any test and did not examine me. She pressed on the outside of abdominal and pelvic area, asked a few questions and stated it sounded like ovarian cysts and to see how I feel during my next couple of menstrual cycles. She did not really answer my question though for the reason I would be bleeding during sexual intercourse and if it is related to ovarian cysts or if it is something else. Should I be concerned that it is something worse than ovarian cysts or is that seem like an accurate diagnosis?

Answer:

Pain during or around the time of a period is referred to as "dysmenorrhea".  Such pain can be associated with conditions such as:

Ovarian cysts would not necessarily cause pain during the period, since they are usually going away by the time your period comes.

With any of the above conditions, the birth control pill is usually helpful to diminish the period pain.  Pain relievers that are anti-inflammatory, such as ibuprofen or naproxen, are also helpful. 

Bleeding during or following intercourse is probably unrelated to this problem, and you can read about this problem on other responses on this page.  Pain in the same area triggered by intercourse ("dyspareunia") can still be a symptom of endometriosis, however.

For more information:

Go to the Women's Health health topic, where you can:

Response by:

The Ohio State University Jonathan A Schaffir, MD
Assistant Professor
Division of General Obstetrics and Gynecology
Department of Obstetrics and Gynecology
College of Medicine
The Ohio State University
Jonathan A Schaffir, MD