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Vaginal pain with discharge with blood after delivery, no infection, yeast

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General & Family Physician
Practicing since : 2000
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I had a baby in November and about a month ago, I started experiencing severe vaginal pain with discharge. It worsens when I am on my feet for long periods of time (at work). When the pain is at it's worse, the discharge has some blood in it. I have been checked for infections by my doctor and I don't have any, but the pain continues. I was given a cream to use because there were small amounts of yeast and the cream made the pain ten times worse. Any idea what the pain is from and how I can make it better?
Tue, 15 May 2012 in Women's Health
Answered by Dr. Jagdish 1 hour later

It would be good if you can elaborate on the vaginal pain and discharge.

1) Onset of pain - Sudden or gradual
2) Severity - On a scale of 1 to 10. What is its nature, spasm like / burning / dragging pain etc.
3) What increases and what does reduce it? Does the pain radiate to any other location?
4) Any relation of the pain with menstruation and / or defecation?
5) Do you have tenderness ( pain on pressing over the lower abdomen)
6) What is the color and consistency of the discharge? Does it have streaks of blood every time or only occasionally? Is it foul smelling? Does it itch?
7) How many pads do you require per day?
8) Do you have vulval pain and / or back pain along with vaginal pain?
9) Need the description of the latest child birth, vaginal or C/S? Any post child birth complications?
10) Sexual history - Do you have pain while having intercourse? Were STD ruled out?

What is your age?

Vaginal pain which increases on standing for long time is in favor of pelvic floor problems. Please ask your doctor to check for weakness of pelvic floor muscles.

Since vaginal infections are ruled out which is the first possibility with this description, I shall next examine for pelvic floor problems. Difficulty labor, prolonged labor will put pressure and weaken the pelvic floor muscles. Urinary bladder, rectum, will press on the pelvic floor and cause cystocoele and rectoceole. Gravitational pressure on the pelvic floor muscles can cause vaginal pain. So ask your doctor whether there is prolapse of bladder, or rectum. However, you will have symptoms like passing urine without your knowledge if you have cystocoele.

You also need abdominal ultrasound to detect any abnormalities in uterus, ovary and abdomen. Talk to your Gynaecologist.

In summary you need
Complete Vaginal examination
Vaginal sample for Gonorrhoea, chlamydia, KOH prep, saline microscopy
Ultrasound (abdomen & vaginal).

If there are causes are found and pain is located in labia, clitoris, and vaginal opening it is called vulvodynia. Vulvodynia is self limiting.

Here are a few things women can do to help relieve symptoms of vulvodynia or keep them under control.
1. Avoid Potential Irritants. It may help to avoid things that could be irritating the vulva. These might include certain soaps, medications, or douches. Wear loose-fitting pants and skirts; don't wear pantyhose. Keep the vulva clean and dry.

2. Soak in lukewarm or cool sitz baths. After intercourse, apply ice or a frozen gel pack wrapped inside a hand towel.

3. Local anesthetics, such as lidocaine cream, topical estrogen creams, tricyclic antidepressants will help relieve pain.

Hope it helps. I wish to know more information about your problem so that I can help you better.

Disclaimer: The information on this email and portal is provided for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, evaluation or care from your physician or other qualified healthcare provider as a complete assessment of an individual has not taken place. Nothing on this email and website should be used for treating or diagnosing a medical or health condition. This is not a replacement for Doctor - patient relationship and physical examination by other qualified healthcare provider.
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Follow-up: Vaginal pain with discharge with blood after delivery, no infection, yeast 34 hours later
1) The pain began gradually and has been steadily increasing in severity.
2) There is a constant soreness that I would rate a 4. When I'm on my feet, it becomes a throbbing pain with shots of stinging pain. Sometimes the pain is so bad that I can't stand any longer and have to sit down. When it is at its worst, it feels as though there are spasms as well. At that point, I would rate it a 10. 3) Being on my feet makes it worse and sitting down relieves some of the pain. However, sitting on the floor makes it worse and so does sitting on the toilet. I've also noticed that when I sneeze or cough, the pain increases. It doesn't radiate to any other location.
4) The pain did increase greatly during my period, but no relation to defecation. 5) I do not have any tenderness over the lower abdomen but I am bloated for no apparent reason.
6) The discharge has a yellow tinge to it and it ranges from watery to mucousy. Sometimes it has a brown tint to it and once in awhile its pink from a little bit of blood. It has a slight odor, but nothing strong and it doesn't itch.
7) I have to change a pantyliner everytime I go to the bathroom. Approximately once an hour or hour and half. I've noticed I have to urinate a lot.
8) I haven't noticed any irregular back pain but I think I have vulval pain (if I know the correct location). I've also been getting pain in my hips, if that is related in any way.
9)I had a vaginal delivery and it was difficult with a lot of tearing and stitches. I pushed for about 2.5 hours and needed a lot of lube because it was basically a dry birth. Afterwards, I needed blood transfusions afterwards due to low blood count.
10) Due to pain, soreness, and discharge, I haven't had any intercourse. However, I've checked myself to see if there is pain and any sort of stimulation makes the pain worse aftewards, not necessarily during stimulation. I have been screened and do not have any STD's.

I am 27 years old.

Answered by Dr. Jagdish 16 hours later

Since the delivery involved tearing of the vaginal wall and followed by suturing it , i would relate the pain you have to the same. If the injury was on the anterior vaginal wall the positional variation of the pain can be well explained . That in standing position due to the default relative position of the cervix and the anterior vaginal wall the cervix falls on anterior wall of the vagina giving you pain and opposite happens when you are supine (laying down ).

Meanwhile follow these recommendations:
1. Do cold water sitz baths
2. Get evaluated by Gynecologist for possible cystocele/rectocele/any bleeding from sutures
3. Stay on good pain medicines , Ibuprofen 800 3 times day
4. Take laxative
5. Avoid measures which increases abdominal pain like weight lifting , coughing

Disclaimer: The Expert’s advice is provided for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, as a complete assessment of an individual has not taken place. Please consult your nearest physician before acting on it. The advice is not valid for medico-legal purposes also.
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