What are the possible causes of dysuria, dysmenorrhea, and the presence of dark clots during menstruation?

Question

Hello doctor,

I am a 35-year-old female. It has been a year since I started experiencing pain during my monthly period. I did not have any problems before regarding my period.

Then, I experienced severe dysmenorrhea. I feel more unusual pain, especially when urinating. Heaviness leads to pain when urinating, and it will take a few minutes before I recover. I can feel the same pain for the past few days, but the severity of the pain is less without periods. I have not been sexually active for the past three years, and last year I did my Pap smear.

They told me there was some infection and gave me some antibiotics. I see some very dark clots during my period. Also, my period lasts for less than a week.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

It would be best if you had some investigations to reach the cause of the pain. Pain during menstruation could be premenstrual syndrome, but heaviness, painful micturition, and a previous history of an inflamed Pap smear need attention. It is better to have a few tests like a high vaginal swab for pelvic infection, urinalysis, urine culture, and cervical smear.

Go for a urinalysis if you are able to get an urgent result.

I suggest the following medication:

Tablet Augmentin (Amoxicillin and Clavulanate) 625 mg (milligram) 8 hourly for seven days.
Tablet of Paracetamol 500 mg 8 hourly from day two to five in case of period pain.
Tablet Doxycycline 100 mg 12 hours for seven days if the urine report comes back normal.

Follow all the laboratory results and have plenty of water and cranberry juice.

I suggest consulting a gynecologist for a local examination to exclude any prolapse, polyp, inflammatory lesion, or other pathology.

One transvaginal scan is also needed to exclude pelvic pathology like fibroids, adenomyosis, or endometriosis. In addition, an MRI (magnetic resonance scan) may be needed if any of these conditions are suspected on the scan.

Discuss all laboratory results with a gynecologist if the cervical smear comes positive. Sit in warm water twice or thrice daily to relieve the urinary infection.

However, please consult a physician, discuss with them, and start taking the medications with their consent.

Hope this helps.

Thanks and take care.