I have extreme pain on urination and no bleeding on the second day of periods. Why?

Hi,

Welcome to icliniq.com.

Thanks for reaching out. I am looking forward to help you with your query. Based on the symptoms you have presented is quite common in women of your age group. Do not worry. If it is happening during midcycle then it is quite common. It might be associated with lower abdominal pain also known as ovulatory pain. However if such thing happening during the end of your cycle that is towards your expected periods date. The reasons could be,

1. Hormonal imbalances mostly low progesterone levels.

2. Recent change in hormonal contraceptive pill.

3. Stress, recent change in lifestyle.

4. Cervical polyp or erosion.

5. Vaginal infection.

6. Extreme weight loss or eating disorders.

7. Thyroid disorders.

8. Pregnancy.

First you need to do is an urine pregnancy test if you are sexually active. Other investigations which you need to do are,

1. Thyroid profile.
2. Complete blood test.
3. Serum prolactin test.
4. Pap smear if not done recently.
5. Ultrasound pelvis (can be done on non urgent basis if same thing recurs).

As you have mentioned that you had extreme pain during urination, mostly you have urinary tract infection for which you need to do an urine routine microscopy and culture sensitivity. I hope this answers your query. Looking forward to talk to you soon after your pathology results are out. Feel free to reach out with any further queries.