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Trying to conceive. Getting infection and pelvic pain. Could it be bacterial vaginosis?

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Practicing since : 1999
Answered : 1583 Questions
I'm starting to get very frustrated. I am just starting to try to conceive with my partner. Both of us are free of STD's. On 2 occasions now, the first in July and again this week we have tried and I ended up in emergency room with infection and terrible pelvic pain both times. Could it be that I am susceptible to Bacterial vaginosis? Could taking Flagyl during period of trying to conceive be preventive against infection? I think I will try to find a specialist. No one so far can give me a diagnosis with something happening only after sperm has been introduced into my body.
Posted Mon, 12 Nov 2012 in Women's Health
Answered by Dr. Timothy Raichle 3 hours later
Hello, I would be happy to help you with your question.

I have a couple of questions:
1. We're you diagnosed with BV on both occasions?
2. Do you/did you ever have this problem when you used condoms?
3. Please describe the symptoms for which you were seen the ER.

Please answer and I will get right back to you!
Above answer was peer-reviewed by
Follow-up: Trying to conceive. Getting infection and pelvic pain. Could it be bacterial vaginosis? 4 hours later

1. The first time the PA in the ER thought it was chlamydia or gonnorhea after doing my pelvic and there was discharge. I had my partner get tested for all STD's and he was negative for everything. The ER did not send out any cultures. They just gave me antibiotics. That was in July.
My discharge papers said I had bacterial vaginosis, but I think they really didn't
know for sure.
This second time in ER my diagnosis was pelvic pain only. I told the doctor about the symptoms of the cramping pain being the same as the last time and so they gave me IM Rocephin and sent me home with Doxycycline and Flagyl. This time there wasn't discharge with the pelvic exam. The doctor this time did cultures
just to be sure, for chlamydia, gonorrhea and Trich.
#2 No. I have never had this problem when have used condoms.

#3. The symptoms in July: I had tried to conceive with my partner and maybe about 5 days later started having this strange kind of cramping. I had never felt anything like this before. Nothing like cramping during period. On the 7th day the strange pelvic cramping was getting worse and progressed into pain. I work as a nurse and and the job is a very physical job. at the end of my work day I was very uncomfortable. I went home and rested and felt better. Then later that night I ended up having sex. A little while after the pain and discomfort was so bad. I also felt dizzy. Immediately went to ER. I ended up being out of work for a couple of weeks because of the pain. Activity would make it worse.
I followed up witih my GYN and told him that I had Pelvic inflammatory disease. He himself seemed hesitant about making any kind of diagnosis. He said it has only happpened one time. These things happen. You will be fine. Don't worry.

The symptoms this week: Well, we decided to try again to start our family. 9 days later: the horrible cramping started again. It hadn't yet progressed to being pain. But it was the same kind of strange cramping sensation. So I went to ER again thinking, maybe I can get this treated a little earlier than last time so I am not out of work again for 2 or 3 weeks. So the symptoms were not as bad this time when I presented to ER. And it was unfortunately a Friday night or would have gone to my GYN. When I went in I thought I was having an episode of pelvic inflammatory disease. But no one really wants to make a definitive diagnosis yet. So anyway, this time the pain is not so bad. I went to work yesterday. Not as physical of a day because worked as charge nurse. More time at the desk. At end of the work day I was having pain. I was really uncomfortable. When I got home took a Hydrocodone.
So, this has happened the only 2 times in my life that I have had ejaculate inside of me. I'm not sure what to make of it.
Answered by Dr. Timothy Raichle 4 hours later
Wow, thank you for the amazing detail. And what a miserable story. There are certainly clues, and a lot of people involved not really getting to the bottom of the story. I guess the only thing you left out was whether or not someone, at some point, did an ultrasound to look at the uterus, tubes and ovaries. You can comment on this in your followup. Here are some thoughts:

1. If you had PID, they certainly treated to adequately for it, but you really did not respond well from what you are saying. Or certainly, it does not sound like the antibiotics really made a difference in terms of symptom resolution.
2. BV perhaps was diagnosed, but consider that this is common, and not really associated with severe pelvic pain. I believe that this is an incidental finding.
3. The pain is reproducible with unprotected intercourse. Semen contains prostaglandins that cause cramping / contractions of the uterus. There is something about this part of the story that makes me think that there is something more anatomical going on - that is why I ask about the ultrasound.

Did they do an ultrasound?
Is the pain worse at a certain point in your cycle? (thinking about endometriosis)

Let me know and I will try to get back to you soon.
Above answer was peer-reviewed by
Follow-up: Trying to conceive. Getting infection and pelvic pain. Could it be bacterial vaginosis? 9 hours later

Dr. Raichle,

Thank-you. I really appreciate your thoughts and insight on what could be causing my problem.

I had 2 ultrasounds in July. The ultrasound in ER was normal. The 2nd one done at GYN follow up was normal and the doc said I have 1 very small fibroid.

My cycles: In July the cramping started 9 days before my period. The episode this week was 3 days before I got my period.

The first episode I know was a true infection. I wasn't having any discharge but apparently there was alot of discharge at my cervix.

Do you think it would take 7-9 days to have this effect from prostaglandins??

Something else to mention. With this episode I had a very strenuous workout, spin class then work out with personal trainer. This was 5-6 hours before the very uncomfortable cramping started, the night I went to ER.
Answered by Dr. Timothy Raichle 5 hours later
My final thoughts are:

1. The is a recurrent problem
2. That it is GYN related
3. That it is associated with your cycle
4. That infection may have made things worse
5. That you should talk with your doctor about a laparoscopy to evaluate for endometriosis, tubal disease, or pelvic adhesions.

Let me know what you think! Please remember to eventually leave feedback!
Above answer was peer-reviewed by
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