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What Causes Chronic Vaginal Pain And Heaviness In Lower Abdomen After An IVF?

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Posted on Thu, 4 Aug 2016
Question: Hi,

Since april when I had an IVF, I have chronic vaginal pain and a feeling of heaviness in mu lower abdomen. The pain started during the last part of the treatment with Crinone gel, when a big clump of gel formed inside my vagina and was causing me severe pain until it came out at tge beginning of my period. Until then, I have constant discomfort, especially when sitting. In may, they found enterococcus in my cervical swab, but I have been under 2 rounds of antibiotics and they have only given me relief while I was on them. However, they haven't found the bacteria since, but the discomfort is still there. Now my gynecologist put me under another round of 2 different antibiotics (Flagyl and Cephalexin) for one week, and I'm mid treatment, but I cannot see significant improvement. I can't seem to get relief since the IVF.
What can be the cause and what therapy would you suggest? How can I get proper treatment if no bacteria is showing in the swab? Can anything else be causing this? Btw, my swab was negative for Chlamydia and Ureaplasma.
Thank you in advance!
doctor
Answered by Dr. Ramadevi Wani (46 minutes later)
Brief Answer:
Get urine c/s and pelvic ultrasound done.

Detailed Answer:
Hi,
Welcome to Health Care Magic.
I am Dr Ramadevi Wani. I appreciate your concerns.

I have read your notes carefully. You do not have any vaginal discharge and you are on your second round of antibiotics. Your swab tests are negative at present.

I am of the opinion that the Crinone gel might have caused some abrasion and inflammation in the vagina. Take anti inflammatory medicines like Ibuprofen 400mg twice daily for 7 days.
Do you have any urinary complaints? Get a urine c/s test done. Get an ultrasound of pelvis done to make sure that there are no ovarian cysts and everything is normal. Have you lifted any heavy objects? Have you done any heavy exercise? Muscle sprain can also mimic pelvic pressure.

Take multivitamins. Exercise regularly. Eat healthy food to boost your immunity. Do not use any scented soaps or douches to clean the vagina.

Wait for a week after completing the second course of antibiotics. By then you should feel okay. If pelvic pressure does not reduce you need a thorough internal examination again.
As a last resort, you may need laparoscopy to evaluate for endometriosis, infection etc.(although I am not expecting you to have this).

I hope this is helpful.
If you have any further concerns do contact me through Healthcare Magic.
Best wishes,
Dr Rama

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Ramadevi Wani (19 minutes later)
Hi and thanks for answering. I had large amounts of clear discgarge, when my symptoms beginned, and before starting this course of antibiotics, I had a bit of white discharge and for a couple of days it was yellowish.
I got an ultrasound of the pelvis done and everything looked normal, except a little amount of fluid in the pouch od XXXXXXX (before ovulation).
Is there a chance that the enterococcus bacteria is still there and causing my symptoms, even though it's not visible on swabs?
Thanks again!
doctor
Answered by Dr. Ramadevi Wani (6 hours later)
Brief Answer:
A very slim possibility that enterococcus may be still lingering.

Detailed Answer:
Hi,
Welcome back.

Good to know that ultrasound is normal.

A very slim possibility that enterococcus may be still lingering. Let us wait for a week or two after this course of antibiotics. Hopefully everything gets back to normal. If not you need a detailed examination again.

If you have further concerns, I will be happy to answer.

Best wishes,
Dr Rama
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Ramadevi Wani (3 hours later)
Thank you so much! Just one last question: the last swab I did was done 1 week after the end of antibiotic treatment. Is that enough for the bacteria to show in the result? Best regards
doctor
Answered by Dr. Ramadevi Wani (13 minutes later)
Brief Answer:
Probably repeating the swab test after two weeks would have been better.

Detailed Answer:
Hi,

Welcome back. Probably repeating the swab test after two weeks would have been better. Swab repeated after one week of treatment may not show correct result.

After you finish this course of antibiotics, wait for two weeks. Hopefully things will revert back to normal.

If you have further concerns, I will be happy to answer.

Best wishes,
Dr Rama
Above answer was peer-reviewed by : Dr. Sonia Raina
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Answered by
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Dr. Ramadevi Wani

OBGYN

Practicing since :1985

Answered : 1459 Questions

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What Causes Chronic Vaginal Pain And Heaviness In Lower Abdomen After An IVF?

Brief Answer: Get urine c/s and pelvic ultrasound done. Detailed Answer: Hi, Welcome to Health Care Magic. I am Dr Ramadevi Wani. I appreciate your concerns. I have read your notes carefully. You do not have any vaginal discharge and you are on your second round of antibiotics. Your swab tests are negative at present. I am of the opinion that the Crinone gel might have caused some abrasion and inflammation in the vagina. Take anti inflammatory medicines like Ibuprofen 400mg twice daily for 7 days. Do you have any urinary complaints? Get a urine c/s test done. Get an ultrasound of pelvis done to make sure that there are no ovarian cysts and everything is normal. Have you lifted any heavy objects? Have you done any heavy exercise? Muscle sprain can also mimic pelvic pressure. Take multivitamins. Exercise regularly. Eat healthy food to boost your immunity. Do not use any scented soaps or douches to clean the vagina. Wait for a week after completing the second course of antibiotics. By then you should feel okay. If pelvic pressure does not reduce you need a thorough internal examination again. As a last resort, you may need laparoscopy to evaluate for endometriosis, infection etc.(although I am not expecting you to have this). I hope this is helpful. If you have any further concerns do contact me through Healthcare Magic. Best wishes, Dr Rama