Dr. Sue Ellen Carpenter, MD

The hymen is seen with a visible inspection of the vaginal opening. No scope is needed. I assume the cystoscopy is being done by a urologist. The cystoscope will go directly into the urethra which is anterior to the vaginal opening and does not disturb the hymen. Unless the urologist has a reason to focus on the hymen, I would not expect her to comment on it. Warm regards, Dr. Carpenter [signature_1589971089]

A yeast infection has these symptoms. You can see an Obgyn or their nurse or midwife for diagnosis or try Monistat or lotrimin over the counter. Warm regards, [signature_1589971089]

You may have pre eclampsia which is a medical emergency. Do you have OB care? call your doctor immediately or return to the ER of a hospital with excellent ob care and don't leave.

I hope you have tested by now. I am sorry for the roller coaster you have been on. This is more often the nature of trying to conceive than not. If you have been disappointed again, it is time to talk to your OB/GYN or better yet a fertility specialist. You dont usually need a referral to a specialist and, even though it may seem intimidating, we can often save you time, money and heart ache by pointing you if the best direction. Warm regards, Dr. Carpenter [signature_1589971089]

You would have to inquire among providers in your area. Often, the most informative ultrasounds of non-pregnant women are also internal. The answer depends on your purpose for seeing the gynecologist. There are some questions that cant be answered without a speculum exam or an internal ultrasound. I would encourage you to try to find a level of comfort (therapeutic alliance) with your provider, who could be a medical doctor, a nurse practitioner, a physicians assistant or a certified nurse midwife so that you can discuss your concerns and understand whether an internal exam is essential for answering your questions. This takes time and openness on your part and on the part of the provider. I am a fertility specialist, so internal exams are critical for treatment. I have had a great deal of success working patiently with women who did not think they could tolerate an exam to help them achieve their goals. For some of them, I work with a physical therapist who can teach them to tolerate an exam. She is a wonderful specialist and her help has been life-enhancing for several women who struggled with this. Warm regards, Dr. Carpenter [signature_1589971089]

I believe you should be seen today, either by your OBGYN or by a local emergency room. Warm regards

It is likely that you are pregnant. You may be miscarrying, but some bleeding in early pregnancy is common and does not necessarily mean a loss. These symptoms can also indicate an ectopic (tubal) pregnancy. You need bloodwork for an HCG and progesterone level. It is likely you will need to repeat it in 2 days to check the trend. Depending on the level, you may need an internal ultrasound to see what you have. It is hard to see much on ultrasound before the level of HCG is about 500. Good luck to you. Warm regards, Dr. Carpenter [signature_1589971089]

I would suggest that you try to be seen today. Ideally, at your physicians office, alternatively in an emergency room. Meanwhile, I be careful to stay hydrated. I suspect you may need hormonal and/or antibiotic treatment to help stabilize the situation. Warm regards, Dr. Carpenter [signature_1589971089]

An increase in the blood flow (and pain) can be natural after delivery, however, this sounds extreme. Please see your doctor for evaluation. It is easiest to evaluate when you are not on your cycle. I would expect the evaluation to include an internal ultrasound, cervical cultures and bloodwork.

I would suggest a pregnancy test (HCG) and a progesterone level if you are trying to conceive. Some women ovulate (progesterone >3 in the luteal phase), but need to supplement to encourage implantation (progesterone <15).

A pregnancy test makes sense. Some women find they spot for the first few months of pregnancy.