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Have pain during sex and started bleeding. Is there any risks of having chlamydia or ghonnera?

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HIV AIDS Specialist
Practicing since : 1974
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Two weeks ago today (5th Oct) (16 days after my last period began), i had sex in the "doggy position" (which I find goes quite deep) with a man who was quite well endowed, it was rather vigorus, but that is usual and we have had sex a number of times. I found sex painful this time, I have never experienced this before. On the Sunday (7th) (2 days later) in the afternoon I went to the toilet and I noticed I was bleeding bright red blood. I thought it must be my period, as my left ovary was hurting as well, despite realising it was very early (but I have been known to have 15-18 day cycles before) but what made me think it wasn't was that the blood was bright red, usually when i start my period it is brownish on the first day. I inserted a tampon and an hour later when I removed it there was very little blood on it, so I didn't insert another and didn't have any more bleeding.

The pain in my ovary got quite bad this night and into Monday. I still wasn't bleeding however, on Monday night I went to the toilet, and I placed my finger tip on the entrance of my vagina and a lump of dark brown paste, like a blood clot was there, I wiped this off and I haven't bled since. As it got into Tuesday the pain in my ovary was getting worse, and I was concerned about the bleeding so I booked an appointment with my GP for the Friday (17th) to have a smear and to talk to her about it. I was concerned about cervical erosion which I have had before many years ago now, and also cysts on my ovary as the doctor thought I may have polycystic ovaries a number of years ago (I have excess facial hair and was rather overweight then). The Ultra sound of my ovaries came back normal then.

When I saw her on the Friday, she said i should go and have my smear, and also for the nurse to look at my cervix, as if it was eroded she would be able to see erosion. She asked the nurse to take a swab of my cervix and also to test my for gohonnera and clamidyia - as if I had these the pain could be due to PID. The nurse looked at my cervix and said she didn't think there was any erosion at all. The only thing she could see which was different was I had a small red spot on it, which she described as like a blood blister. She said however it didn't look "sinister" and I shouldn't worry.

On the Saturday night (18th) the pain in my left ovary (and also I now had pain in my right as well) was REALLY bad and making me feel a little nauceous, I was really worried it was PID and I may become infertile so I went to A and E. The Dr I saw tested me for pregnancy and UTI - both of which I wasn't. He did a pelvic exam and said I had left adnexal tenderness, and it was likely it was due to PID, so he gave me intravenous anitbiotics (ceftriaxone) and a two week course of Doxycyline and Metronidazole. This reduced the pain a little, but over the last day or two it has got worse again.

I got my results from my swabs from the GP today (not the smear) and all came back as negative - so I don't have gohonnera or Clamydia. The other swab of my cervix came back normal. I am still having ovary pain however and at times it is bad - but I am aware technically I am due on my period now (so I don't know if that is the cause or not).

I am pretty much FREAKING out now about what else could be causing this pain? and what has caused this one red spot is on my cervix? and whether they are related.

I wondered if it could be caused by genital herpes? As I have had a sore anus the last few days - But I suffer for IBS which has been bad this last week (excreting up to 4 times a day), and thought I just had a haemorrhoid. But I also have lower back pain - but again I have a bulging disc and have had lower back pain on and off since February - so that could explain these two things. Also last Summer I have a tiny reoccuring cut on my perenium area, so when it was open, I went to the STI clinic and asked for it be swabbed as I thought it might be herpes, but the test came back negative for type 1 and type 2 herpes. So I think it unlikely - unless a spot on the cervix, painful sex, bleeding during sex, and a very painful ovary are also symptoms of Herpes. I should add I have not had any flu, fever symptoms at all.

My other concern if that the spot may be a genital wart - but I don't understand how I would just have one, on my cervix and not anywhere else? If they are spread by skin to skin contact, the penis would have touched other regions before getting inside me. Also I don't understand if this is a wart why it would cause painful sex, bleeding after sex and again most importantly my primary symptom - sharp ovary pain?

Is there a likelihood I could have chlamydia or ghonnera but the swap not be placed XXXXXXX enough inside my uterus to "catch" the bacteria on it?

I want to know what you think it is likely this ovary pain is due too? Could it be cysts? or is it likely to be another STI? Also what is this red spot due too? Cancer? Another STI? and are they linked?

I have booked in to a GUM clinic tomorrow, but I am so worried I wanted to ask your opinion now. To put things in context. Since my last STI test in XXXXXXX 2011 (where I was tested for Herpes with a swab and all the other STI and they all came back negative) I have had unprotected sex on four occasions with three men - two in February, one in May, one in end of August) and another man has put his penis inside me momentarily in early August and also on the 5th October. None of the men ejaculated inside me.

I am aware it takes three months for HIV to show up on a test - so the sex at the end of August and in October will not show up on this test. But would other STI's?

I am female, 28, 5 ft 5 and weigh 12 stone.
Posted Sat, 17 Nov 2012 in Sexually Transmitted Diseases
Answered by Dr. S. Murugan 8 hours later

Thank you for your very detailed query. I noted the details with diligence.

First, I am unhappy that you were examined by a nurse to rule out erosion. I would prefer a gynecologist examination. As the sexual intercourse was vigorous - XXXXXXX injury / erosion that could be responsible for left adnexal tenderness need to be ruled out. These would explain many of your symptoms.

Further pelvic inflammatory disease (PID) is still a possibility despite negative smear and swab report. The smear examination may have to be repeated as a single smear examination results are often not 100 % reliable. Besides that you also need culture from the swabs for Gonorrhea and Chlamydia.

As far as antibiotic, the treatment may have to be extended, preferably with Azithromycin in place of Doxycyclin.

In brief, my comments are as follows:

1. Localised injuries as erosion / infection needs to be ruled out by a competent gynecologist.
2. The possibility of PID is not yet ruled out. You will need a repeat smear examination with cultures.
3. I am pleased to know that ultrasounds did not reveal anything serious. Cysts may have been concerning.
4. The description is not indicative of genital warts. Genital herpes usually presents with prodromal symptoms - you do not have any.
5. Do plan a visit to the GUM clinic for thorough examination as to screen for other possible infections.
6. Most of your doubts should be clarified by an experienced gynecologist evaluation.

Hope I was able to clarify some of your doubts. Should you have any queries, I will be glad to assist you.

Get well soon.

Dr S.Murugan
Above answer was peer-reviewed by
Follow-up: Have pain during sex and started bleeding. Is there any risks of having chlamydia or ghonnera? 7 hours later

Thank you for your response. When I went to my GP I had the smear test and a swab of the cervix, they also did two other swabs for gonorrhea and Chlamydia. Are you saying these to be repeated too? Or did you not understand that I had already had these tests? As it was those tests which came back negative, along with the additional swab.

I am still waiting on the smear test.

I am visiting the GUM clinic today so will ask them to test for everything again. What are the prodromal symptoms of Herpes?

Also my ultrasounds was four years ago now, could things have changed? I also read that if the cysts were small then, that they may not be detected by ultrasound? I am assuming they could be bigger now?

I don't think I can take the Azithromycin as I am allergic to penecillin and erythromycin. So what should I take instead?

Kind regards

Answered by Dr. S. Murugan 7 hours later

Pleased to answer your questions.

Usually any smear tests, (whether sputum or stools or vaginal or cervical) need to be repeated thrice before to declare it is negative, especially cervical smear will be confusing and very difficult to trace the organism and express the results. So if you had the smear once and it comes negative, we cant rule out the infection.

Prodromal symptoms of Herpes will be either tingling, itchy or burning sensation, sometimes fever prior to onset of lesion. The lesions will tend to heal spontaneously, as it is self limiting.

Things may be changed in years as cysts tend to disappear or sometimes newer cysts likely to appear. This will reflect in ultrasound examination.

Penicillin allergy is common. Allergy to Azithromycin is very rare.

Your physician will guide you better for further treatment.
Get well soon.
Dr S.Murugan
Above answer was peer-reviewed by
Follow-up: Have pain during sex and started bleeding. Is there any risks of having chlamydia or ghonnera? 6 days later
I have had my test results back today, but now have more questions. So to summarise:

On the 12/10 - I had a swab of my cervix, a smear test and a bacterial test of the cervix (which included gonorrhea and chalmydia but they tested for all bacteria) - My smear came back normal showing no abnormal cells and all the other tests came back normal.

On the 20/10 - I was examined by a gynaecologist, and had STI tests for HIV, Syphilis, Trachiomas, Gonorrhea, Chlamydia, BV, Thrush. All these tests came back negative. The only note was that the swab from behind my cervix as opposed to the endocervical swab had an over growth of proteus on it. The notes said to redo the swab is Gonorrhea was suspected. My Clinic called me in this morning, and said I don't need to have the swab done again as Gonorrhea is not suspected because the other test for it was negative (apparently that was a NATS test and is more accurate) so they asked me to give a urine sample as proteus often causes UTI, and they think the swab may have been contaminated with my urine.

I get the results of this in a week - firstly I am unsure why they couldn't do a UTI test then and there? Like the GP normal does?

Secondly when I went to A& E on the 13/10 they did a test for UTI and it was negative so I think it unlikely I would have got a UTI in the week from the 13th - 20th.

So if this bacteria isn't in my urine, where did it come from? Could it be in my vagina?

Could proteus in my vagina be causing me all this pain in my ovaries? Also is proteus an STI?

When I saw the gynaecologist last week, he said that he was pretty certain I had PCO as I have so many symptoms of it - excess hair growth on my face and chest, irregular periods (14-35 day cycles), my mother had cysts and I used to be very over weight until this year. He has booked me in for hormone blood tests and an ultrasound scan.

I am now just concerned about this bacterium.....

Many thanks


Answered by Dr. S. Murugan 26 hours later
Thanks for writing back.
I am very much satisfied to see the tests for Syphilis, Gonorrhea, Chlamydia, BV and HIV were negative for you. So you are not having any STD.
Proteus organism is not transmitted by sexual route. So it is not a STD.
As your urine is negative for Proteus you are not having UTI also.
Proteus may be from your vagina. It may sometimes be present as a normal flora of Vagina and may not be pathological one.
So ignore the same.
As your Gynecologist told you, now your problem is only PCOD and you may go for other investigations and treatment for the same.
You will be alright. Forget about other things.
Get well soon.
Dr S.Murugan

Above answer was peer-reviewed by
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