Patient: Hi doc iam a male 29yrs old my girlfriend 24. We had unprotected sex about 2days ago on 2nd april 2015. After my first ejuculation in her virgina she complain of lower abdomal pain and sharp pain on her lower back , she assumed that shes maybe pregnant it was our first time . What could be the promblem doctor shes not eating since and she vomit evrytime she eat something?
Doctor: Hello,Thanks for the query to ATD for an opinion,If you both as a couple were involved in sex for the first time and she experienced pain during and after the act especially in the lower abdomen back and even the vaginal region then there are two possibilities that either there is endometriosis or being the first time, the vaginal muscles being naturally taut and toned as they had been stretched during intercourse and various hormonal release like prostaglandins during the intercourse and also in the prostatic fluid in the ejaculate would cause uterine contractions which can cause the pain.The second possibility is more likely in her case and the sharp back pain and nausea with vomiting can be explained based on high prostaglandin levels during and post intercourse. This is natural in a way and shall subside as the levels or prostaglandin shall decrease. The symptoms are exaggerated during and after the first intercourse and can be treated with supportive management which involve NSAIDS, hot fomentation and anti emetics. This condition, however, become normal with frequent intercourse in the future as the body gets accustomed to it slowly.Nextly if there had been pain during deeper penetration and persisted, accompanied with a history of painful menses, then endometriosis in her case is likely. However, it is suggested that in either case she should be examined by a physician with a local and per vaginal examination and an ultrasound to rule any obvious organic cause. Also important is to opt for an emergency contraception within 72 hrs to prevent pregnancy as the intercourse had been unprotected unless you as couple were planning for the same.I hope i have answered your query in detail,Wishing you good health,Regards