Ever since I had a total hysterectomy 5 years ago, I get excruciating bouts of pain in my perineal region. It's a very sharp, drop you to your knees kind of pain. I do not have health insurance, but I see a nurse practitioner when needed. She refuses to do a pelvic exam, or pap smear and tells me I no longer need them. The doctor who did the surgery had put me on the vivelle patch. She took me off of them, and refuses to put me on any kind of HRT. Last night, for a very brief moment, I had very light spotting which is gone today. I also have pain in my right shoulder constantly, and nausea is becoming more frequent. I am now noticing that if I bend over sharply, to touch my toes for example, the pain is present. Any ideas on what this could be?