Resolved question:
I had sex on October 27th. The next morning I took Plan B. A few weeks (maybe 2-2 1/2) later, I had what I thought was my period. But it was much lighter than normal.
2 weeks later, I had short, sharp pains first in my right ovary. Then later, pulsating and sharp pains in my left ovary. This was accompanied by a dull ache, mostly to the left hand side.
I called Planned Parenthood to see if these were normal side effects of Plan B. They said they were not and that it could be an ectopic pregnancy and to go to the ER.
I went to the ER. My urine pregnancy test came back negative. (Just shy of 5 weeks after sex). She gave me a pelvic exam and said my ovaries didn't feel swollen and she couldn't find any cysts. All other immediate tests performed looked good except they diagnosed a bacterial vaginal infection and gave me medicine for that.
Five days later, the discharge looks better, but my left pelvic region is hurting much worse and is pretty consistent now. (It was coming and going before.)
So:
1) Is a pregnancy test at 4 weeks and 5 days always accurate, or could ectopic pregnancy still be on the table?
2.) Could this be a cyst that she could not feel?
3.) Are there any other strong possibilities?
4.) What should I do now?
A few other things: I have been really gassy and very tired.
Thank you.
Submitted:
4 Days
Category:
OBGYN
Hello,
Thank you for your consult at DoctorSpring.com.
Plan B does cause withdrawal bleeding / spotting, but not after 2 - 2.5 weeks. Also, cramping is a side effect of Plan B , but it rarely manifests that late. So, yes, what you experienced is very less likely due to the Plan B.
I request you to provide a few more details -
1. When was your last menstrual period BEFORE taking Plan B ?
2. Have you always had regular cycles ?
3. After Plan B, when you DID have the bleeding ( lighter than normal ) how long did it last.
Plan B can affect your next menstrual period, preponing or delaying it, making it heavier or lighter. So the lighter than normal period can be explained by the Plan B intake.
Regarding the pains, they need investigation. Firstly, just a pelvic exam is not sufficient to diagnose most of the conditions that make up your differential ( vaginal / pelvic infection / ectopic pregnancy / ovarian cyst - in that order ).
I think this is most likely a pelvic infection.
In addition to clinical exam, it needs a vaginal swab test AND a pelvic ultrasound scan done transvaginally ( to rule out uterine spread of infection ).
Secondly, at 4 weeks 5 days a urine pregnancy test is reliable, but then a urine pregnancy test is NEVER very reliable to diagnose ectopic pregnancy.
A blood B HCG test in conjunction with a pelvic ultrasound scan again is the gold standard of diagnosis.
Regarding ovarian cysts, many are often missed on palpation and internal exam - an ultrasound scan is the best modality to pick them up.
So, to answer your questions
1. An ectopic pregnancy is a possibility, but according to me , not very likely, going by your symptoms . I would put an infection as the first choice if I had to. However, that said, an ectopic needs to be ruled out, and can be simply done , by a pelvic ultrasound scan, which is the next logical step, as it would clarify most things.
2. Yes, it could be a cyst she could not feel.
3. As I said, infection is a strong possibility.
4. Right now, if possible, schedule an appointment with a gynecologist for - proper internal exam ( per vaginum and per speculum ), pelvic ultrasound scan ( should be done transvaginally ) , blood B HCG test ( if required after the first two are done ) , Pap smear and vaginal swab testing for specific kind of infection.
5. Meanwhile, get a scan done if scheduling the consultation can be a long process for you.
6. Get your routine blood work done ( CBC, TSH, Viral markers , STD screening ).
All the best.
Please feel free to discuss further.
Thank you so much for your reply.
I just moved and have yet to find a gyno or doctor in this area. I called yesterday to try and make a gyno appointment, but people are booked till mid- January.
How do I get a scan without a doctor's order? Is that more expensive? Can I still go through insurance?
Also, my period was maybe two weeks (I'm estimating) before taking Plan B. They are usually very regular.
I just remember that things were sticky down there and I thought - I'm probably ovulating and this was a stupid decision. Which is why I panicked and took Plan B. (This was an ex-fiance).
Last, the ER doctor did swab for something and do blood work. She said the immediate blood work looked good - no STDs. But that there was some blood work that took a little while to come back and they'd contact me if anything was irregular. They haven't contacted me, so I'm assuming that all check out.
Please let me know about the scan without an appointment from a doctor first. Thanks.
A direct scan would be more expensive.
You would need a doctor's order to be able to proceed with insurance.
Meanwhile, I dont see any option other than to wait while you schedule an appointment.
Take care