When A UTI...Isn't

Dear Dr. Kate,

I've been having this recurring problem that my OB/GYN and primary doctor can't seem to figure out. I started feeling like I have early symptoms of a UTI two months ago (I've had a few so I'm familiar with the symptoms). I have an urge to urinate but I don't have pain and sometimes it even goes away if I force myself to go less often, or avoid caffeine. Eventually it stops but then it seems to start again. When my symptoms started I went to my OB/GYN for a UTI test, which showed only an elevation in white blood cells, I took antibiotics and felt better for a while. I know that I don't have an STD, and it doesn't feel like a typical UTI. This has been not only a problem because I am uncomfortable but it also can make sex uncomfortable and even painful. My doctor doesn't seem to have an answer. Any ideas?

Thanks so much,
Sara

Sara,

It sounds like you may have interstitial cystitis, a diagnosis many doctors don't initially think about. IC is basically inflammation of the bladder that gives you all the signs of a UTI but there's no infection present. Bladder pressure, pain, and burning, along with the constant urge to pee, are the most common symptoms. It's a fairly common cause of chronic pelvic pain as well, affecting almost one million women.

You may want to see a urologist - they're the best equipped to do bladder testing and give you a definite diagnosis. Testing may include a potassium sensitivity test (through a slim catheter placed into your bladder) or cystoscopy (where the doctor can actually look inside your bladder through a skinny camera). Treatments vary from oral medications to actual treatment of your bladder, and depends on how severe your symptoms are. But once IC starts to intefere with your quality of life - which sounds like where you are - it's time to get help.

Best of health,
Dr. Kate

Pregnant On My Period?

Dear Dr. Kate,

Can I get pregnant if I have unprotected sex during my period? I've heard that you can, but what are the odds? Especially if I'm really regular...?

Messing Around During Menses

Dear Messing Around,

Short answer: yes, with low odds.

Long answer: If you're really regular, you likely ovulate around day 14 of your cycle (or 14 days after you start bleeding). This means that you can get pregnant from roughly day 10 to day 15. But you never know when your ovaries decide to go into overdrive and pop out an extra egg one month, that might be around during your period. So the chances aren't high, but it's far from impossible. Add on the fact that bleeding isn't always from a true period (but from an infection, stress, a polyp or fibroid), and you'll see why the chance is there.

Final answer: if you have a uterus, functioning ovaries, and an orgasming penis near your vagina, you CAN get pregnant. Even with birth control, even during your period, even right after a baby/miscarriage/abortion, even the first time you have sex. The odds may not be high, but it's still possible.

One Tube + One Ovary = One Real Chance of Pregnancy

I’ve come to the conclusion that there’s no reproductive justice. I have patients who are trying anything and everything to have a baby. I have patients who seem to get pregnant when they wink at their guy. Then there’s R. She came to me in disbelief after a home pregnancy test was positive. I confirmed her pregnancy with my own test and an ultrasound, then sat and listened to her story.

R. was convinced that she would never get pregnant again (she has two little ones at home) because of her medical history. She had her left fallopian tube removed for an ectopic pregnancy, and her right ovary removed due to a large cyst. “How in the world did the egg make it all the way across?” she asked. It is pretty amazing, to think that a single cell egg could float across the pelvis, dodging small intestines, and get captured by the other fallopian tube, in time to be fertilized. That’s the body’s imperative to reproduce, I told R. Where there’s any chance of pregnancy, the body takes it.

I’ve never seen a person too sick to get pregnant, despite what their doctors may say about their illnesses. And I’ve seen other patients beside R. where against all anatomical odds, they get pregnant. These cases, of course, happen most to women who weren’t planning pregnancy at all. Like I said, no justice. Yay for the tenacity of our ovaries…but you’d best be using birth control if you don’t want that stick to turn blue. Have any of you known someone who’s gotten pregnant against all odds?