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What causes lower abdominal pain and spotting after sex?

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Dr. Madhuri N Bagde

OBGYN

Practicing since :2001

Answered : 1390 Questions

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Posted on Wed, 6 Aug 2014 in Women's Health
Question: I am 24 years old and just.recently started seeing a gynecologist. I know. I am late to stary but anxiety stopped me from.doing a lot of.things. pap was normal but I feel like there is.so much more I need to know but am.afraid to ask. Is it normal to sometimes have sex that only causes pain to.left lower abdomen? I am spotting after sex more often. UPT is negative.

I have always had horrible mood swings. Anxiety and depression. Excess hair on my chin. Horrible acne.along jaw line around.period. real kicker is that my mother stopped having periods at 24..

Should i just ask hey... can you screen me for pretty much everything? Check hormones. ...etc? Or am I.just being paranoid over nothing...
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Answered by Dr. Madhuri N Bagde 1 hour later
Brief Answer:
detailed answer below.

Detailed Answer:
Hello and welcome to HCM,

I can perfectly understand your issue and it is more related to the family history.

It is a good sign that you have overcome the apprehension already and seeing a gynecologist.

First of all there are too many problems and I will deal with them one by one:
About your bleeding after sex and normal pap: the commonest cause of bleeding after sex is cervical infection or erosion [ inflammation of the cervix]. Since you already had a pap which is negative then the chances of an infection are low. Other reasons for spotting may be trauma to the cervix or vagina during sex, so please check if this is an issue. If a pap is normal then an ultrasound of the pelvis will help rule out other causes like uterine fibroids that may also cause bleeding which may be incidentally linked to sex.
About the pain during sex: infections of the female genital system, excessive force, fibroids, a condition called endometriosis and ovarian tumors can all cause pain. So a gynec evaluation will help determine the cause. If the pain is intermittent and mild subsiding on its own there is no need to worry much.

About mood swings, anxiety and depression: if they occur in a specific time of the menstrual cycle then they are called premenstrual syndrome or if excessive, premenstrual dysphoric disorder. You must keep a symptom diary along with the day of your menstrual cycle for at least 3 months to make this diagnosis. Other wise it may just be simple anxiety and depression not related to the reproductive system.

About the acne and excess hair: these do indicate a hormonal imbalance. Stress also causes this imbalance so a blood test evaluation will help rule this out and it can be treated easily by drugs and some cosmetic treatment.

Now about your central issue: your mother had a premature menopause. I think that this is your main worry and concern which is triggering all the other imbalances. Please do not worry so much. There are so many causes of early menopause and she may have had any one of them. You may not be having them. Also if she had a child [ that is you] a genetic defect is unlikely.

However if you fear so much just get a complete hormone profile tested for the reproductive hormones [ will also help with acne and hairs], an ultrasound, a karyotype of the chormosomes as well as tests for determining the ovarian reserve [ AMH etc, your gynecologist will help].

The ovarian reserve helps to determine how many ova are there in the ovary and if they are normal along with your hormones then there is no need for you to fear at all.
daily exercise, a healthy diet and eating 2-3 fresh fruits daily helps a long way to control mood, acne and hirsuitism. So start a good routine with a positive attitude, stick to it and you will be fine.
So please remember we are in a modern world and do have a few tools to help in these cases. Just talk this out with your doctor, start treatment for the acne and chin hair and this will help a lot in boosting your confidence and also help with the moods. The results of the tests will further help with deciding the future course of action.

Hope this satisfies your query.
Thanks for using HCM.     
Feel free to ask any more questions that you may have.
Dr Madhuri Bagde
Consultant Obstetrician and Gynecologist

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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