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Fatigue, cramps, unexpected bleeding. Had tubal pregnancy, C-section. HPV positive

Hi, I am currently experiencing some symptoms during my period that are concerning to me. I did not expect to start my menstrual cycle for at least another week and a half - two weeks. However yesterday, I began feeling very fatigued (rather suddenly), followed by mild to moderate (or what I would consider to be typical) menstration cramps . Nearly immediately after I began cramping, I starting bleeding, which I am sure is nothing to be alarmed over. However,  I have never experienced this in such short order. I typically have cramping and fatigue for a day or two and then usually  know  to expect my period.  So when I had PMS symptoms (2 wks early) and then within the same hour menstration; I found it kind of odd. The color was different than I am used to, far more brown, although there was a fair amount of blood there seemed to be a certain translucent quality to the texture...some sort of discharge I imagine.  Perhaps, I should also mention this, although it is super embarrassing; there seemed to be an odd odor to the blood. I am an extremely hygienic individual, so it was not an odor of that nature, I really don t know how on earth I would begin explain it...or if it is even noteworthy. At that point I simply conceded that I was having a bit of an irregular menstrual cycle and moved on with my day.  Last night•Early this morning, I awoke from a deep sleep with nausea and an all around nasty feeling: sweaty, chills, etc., (I am unsure as to whether or not I actually had a fever, as I did not take my temperature,  but certainly felt symptoms as though I did).  I was restless, but eventually went back to sleep with no further issues until this morning.  Around 9 am I began feeling very clammy and shakey.  Followed by a sudden onset of severe cramps, I found them to be so intense that I actually had to sit down on the side walk while walking my daughter to the bus stop. At that point I was significantly concerned with what is going on with my body - the pain was alarming. I got home and the intensity and sharpness of the cramping heightened drastically...I felt debilitated by the pain and was actually brought to tears , again I felt feverish and weak. I know if I hadn t been home alone, I probably would have gone to the E.R. The pain was so sudden and excruciating, and was desperate to find relief and I had hoped,  perhaps, I would be able to have a bowel movement . While I did feel some weird urge to push, I found there was no pressure in my rear or low back - but almost more of a pain in the void of pressure - if that makes any sense at all?  After about an hour and a half of the intense cramping it eventually subsided.  When the cramping and subsequent pain began to let up, my blood flow had lightened in volume and color - now a vibrant, bright red color - with no obvious clotting.  As of this moment I am now far more comfortable, however I do feel a more constant dull ache in my low abdomen. Occasionally I will feel a sharp little pain that seems to switch off between the left and right side. Also the volume of the blood has increased to what I would consider rather  heavy flow and is still lacking in the usual clots, it remains bright red - almost looks like fake blood. I apologize if you find this to be excessively detailed, I just hope that by providing you with all the info I can think of, you may in turn be able to provide me with some help... Below please find a brief history of conditions and procedures that may be related or helpful in further addressing any concerns. I have had two c-sections (2005 and 2009). I am 28 years old, no history of any violence in our home. I am relatively healthy. I am prescribed medication for A.D.D. and anxiety, which is not a medication I take daily and haven t needed it in the last several weeks.  The only significant medical issues to speak of are  ones exclusive to my gender. For example; I suffered a tubal pregnancy a little over a year and a half ago. As a result of the tubal pregnancy my doctor removed the right Fallopian tube and clipped the left. After I had the surgery to address the aforementioned unviable pregnancy, my former doctor advised me that I had severe scarring from my Caesarian. The doctor noted that the scar tissue had made its way up to my intestines. And began to develop in a manner he found disconcerting. Afterwards he advised me that he had cleaned it all up in there .  I recall him making remarks to the same effect (re: scar tissue) when he delivered my now 2.5 yr old daughter via c-section.  The scar tissue from the cesarian delivery of my first born  had become a bit bothersome during my second pregnancy as it was latched on to the placenta and felt rather uncomfortable as I grew, this according to my ob•gyn. So in the last two and half years, my scar tissue has been removed twice during surgery.  About a year ago I was also advised that my right ovary appeared to be very ill and was discolored and shrunk. My doctor said he would like to take it out, however I had some concerns with him - and I have stupidly not taken measures or done  any type of follow up. I was also told that there was some unusual sort of fluctuating mark on that same ovary.  One more bit of history in this arena: I tested positive for HPV when I was 22 and had abnormal pap smears at that time. I had several normal procedures and eventually some sort of day surgery to address the abnormal cells on my cervix wall - I am sure you will be far more familiar with what I am referring to then I am. For the year that followed the abnormal pap I was seen very regularly to ensure the solution had been effective.  In the 5 yrs since have had normal paps,  although I am due for one.  Again, I m really am terribly sorry if I ve included a ton of unnecessary  info., I am sure you are very busy. I just need some ideas as to how proceed. Do I need to be seen? If so, is this something that needs to be addressed right away or just something to keep an eye on.  What are your thoughts on what a possible diagnosis would be, after an exam of course? I really don t like to be dramatic about medical issues and  I would truly hate to waste anyone s time, but my experience today was actually pretty scary...if there is a possibility that I may be experiencing something that requires tx., I would really hate to wait to allow any ailment to develop further.  If you actually read this whole thing - then wow - I am so very appreciative for your time and patience!  I would be equally thankful for any  information or pointers you may be able to provide. Thank you very much.  Best Regards • Kim M • email •  YYYY@YYYY
Fri, 2 May 2014
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OBGYN 's  Response
Thanks for writing to us.
Fro the description provided a vaginal infection or chronic cervicitis needs to be ruled out after a direct examination and few investigations.
I hope this information has been both informative and helpful for you.
Dr. Rakhi Tayal ,
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