Battling Urgency More Than A Month After Chlamydia Treatment

!!! trigger warning for readers/viewers - mentions mental health complications

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Hi all,

I'm desperately looking for answers as to why I'm still battling urinary urgency after my chlamydia treatment from a month ago.

I won't burden you with the 4 month long story details, but I'll give you a bullet point timeline of this 4 month long nightmare along with some other minute notes and details:

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MY SYMPTOM BREAKDOWN

- DECEMBER 2023

  • started feeling urinary urgency and pain when urinating, felt exactly like a UTI
  • noticed a lot of random spotting, in the middle of my menstrual cycle (I have the hormonal IUD Mirena, and am on year 4 of that IUD - assumed it was just irregular spotting due to the IUD)
  • thought it was a UTI, so got treated with an antibiotic for UTI via Telehealth (first antibiotic)
  • symptoms seemed to be knocked down a bit, but symptoms were not eradicated

- JANUARY 2024

  • still struggled with urgency and pain when urinating
  • experienced rectal bleeding for the first time in my life, only once and a small amount, yet still concerning
  • continued with random spotting in the middle of my menstrual cycle
  • figured maybe I had a different bacterial culture, was treated via Telehealth with a different antibiotic for a UTI (second antibiotic)
  • again, symptoms seemed to be knocked down a level, but symptoms were not eradicated

- FEBRUARY 2024

  • symptoms elevated drastically, urgency and frequency was constant, and pain was almost unbearable - I spent countless hours crying at the bottom of a warm shower trying to find relief
  • visited my local Planned Parenthood for a urine culture and to have STD/STI testing, full panel, blood and urine, and paid extra for a trichomoniasis test as well
  • urine culture came back with no traces of bacteria for UTI, but had to wait a week for my STD/STI testing to come back
  • doctor prescribed an antibiotic for trich in the meantime to see if it would help alleviate symptoms, a seven day course, two tablets a day (third antibiotic)
  • within that week, my STD results came in with a positive test for chlamydia (February 20th), all other STD/STI tests came back negative
  • finished the antibiotic round that was prescribed to me for trich, to be immediately followed by doxycycline for chlamydia, the seven day course, two tablets a day (fourth round of antibiotics in three months)
  • completed 1 round of Fluconazole within the month of February to combat the raging yeast infection that resulted due to the antibiotic for trich, and followed up with 2 more rounds (in March) to rule out the slim chance that yeast could be irritating my urethra
  • cut out all known bladder irritants such as coffee, alcohol, tea, fizzy drinks, spicy foods, etc.

- PRESENT DAY, MARCH 2024

  • it has been over a month since I received my positive result for chlamydia, and have since tested negative
  • urgency symptoms are the only symptom to stubbornly remain, but now only present right after I urinate and last for about 45 minutes to 2 hours, then disappear until I urinate again.
  • completed urinary tract crisis intervention supplements, insane amounts of D-Mannose and other supplements to support a healthy urinary tract and flush out any pesky leftover bacteria in the urinary tract (that was crazy, I had to take 20 pills a day for 3 days)
  • my periods have been normal, starting on time and lasting about as long as I expect them to
  • I have found a primary physician who has completed the following tests:
    • standard UTI test - negative result
    • microscopic UTI urinalysis test - no bacterial growth was found
    • pelvic exam - searching for symptoms of PID, no pain was discovered during the exam
    • chlamydia test - result came back negative
  • Primary physician to complete the following tests in the next month:
    • detailed urinary/vaginal test (MicroGenDX qPCR + NGS DNA Diagnostic - tests over 50,000 potential pathogens) with the help of a biofilm defense supplement to potentially detect triggers for interstitial cystitis
    • full bloodwork panel to detect any cancerous possibilities
    • potential pelvic floor physical therapy as a last ditch effort

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PARTNER'S SYMPTOM BREAKDOWN

For those whom are curious, here are the symptoms my partner (male) dealt with 3-4 weeks after his sexual encounter that I believe he contracted his infection from:

  • proclaimed asymptomatic in the urinary/genital regions, as far as he's told me - however, I do recall him making frequent trips to the restroom and being annoyed at how much he had to pee when we would hang out. I do also recall a moment of him complaining about a burning sensation, but blamed it on potentially coming in contact with my ordinary use of boric acid suppositories for healthy pH balance - I ritually use these after sex. (I'll give him the benefit of the doubt there, I'm sure with improper timing that could be irritating to his skin/urethra.)
  • came down with what he described to me as a lower respiratory infection which he exclaimed was bronchitis (symptoms such as itchy eyes and throat, sore throat, fever and an unrelenting cough that lasted longer than a month) and was treated with azithromycin. (A typical antibiotic used in treating chlamydia, and sometimes used to treat C. pneumoniae - he was treated with a similar dosage, if not identical to that of an antibiotic round which would be prescribed for a chlamydial infection.) He was treated for this 'lower respiratory infection' around 3 weeks after we slept together (he did take his time getting evaluated and treated), which was about 6-8 weeks after his encounter with his previous partner - before my symptoms elevated to an unbearable level, and before I considered an STI for my symptoms.
  • he was not tested for chlamydia until mine came back positive, as he didn't believe that an STI was a possibility - his test result came back negative. I think it's important to note that he was tested for chlamydia multiple weeks after he was treated with azithromycin, which would have been enough time to eradicate a possible chlamydial infection. However, because I tested positive, he was treated with doxycycline at this point as well. Basically, he was accidentally treated for chlamydia before either of us knew it had been contracted. (My gut microbiome is very bitter about this. Haha.)
  • please keep in mind, this is all information that I've gathered using my own context clues and research, as he hasn't been very willing to be upfront, honest, or even aware of his symptoms with me. He tells me his previous partner has been tested 4 times since their encounter because she has had some additional risky encounters since the sexual encounter they shared (according to him, she had a blackout night after alcohol intoxication and shared a sexual encounter with someone who was positive for herpes). She made it difficult for him to receive her test results, (emotional strain/manipulation) and he has withheld the detailed information she shared with him about her test results (also emotional strain and fear, I'm sure) but said her test results came back negative. I have a lingering feeling that I shouldn't blindly trust him or her at this point. He still stands firm on the idea that this infection did not come from him, so he has been hard to work with in this aspect. He has suggested some pretty outrageous ideas - such as suggesting I possibly could have got a UTI from being around my dog. I can't believe I have to explain this - but I sleep in the nude at times, like many people, and my dog tends to sneak up and sleep at the foot of the bed. He suggests that bacteria from his coat/shedding could be causing me UTI/chlamydial infection in my genital region. BIG TIME LOL. I've explained to him that STD's and UTI's don't work that way. Though this seems and feels incredibly unfair, inconsiderate, and downright insulting to me and my dog (again, LOL), I want to reiterate - I'm only seeking answers for my symptoms. But information on the timing of his symptoms may be beneficial to finding out just what it is that is going on with me, and why I'm still suffering.

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SUBNOTES

This has been my first experience with an STI in my life. I am 30 years old, female, relatively healthy, healthy BMI, relatively active. I have not dealt with urinary complications prior to this 4 month long season, outside of the occasional UTI (maybe one a year, MAYBE). I am fairly certain I know which partner I contracted the STI from (mentioned above), as I had not been sexually intimate with another partner since a year ago. I understand that symptoms don't always present immediately, but I have been highly symptomatic all of my life with any infection that I've come down with. Within 3-4 weeks of sleeping with my most recent partner is when I began experiencing these symptoms. I personally believe that I hadn't had chlamydia for longer than 3-4 months. My pelvic exams seem to back up this theory. I do vape regularly, but am quitting on the first of April out of sheer desperation to regain a healthy pelvic floor/ bladder/ kidneys.

  • It might be useful to know that as a child I suffered from Juvenile Rheumatoid Arthritis, an autoimmune disease that was treated with Methotrexate (a known chemotherapy and abortion pill) for about 7-9 years of my childhood. I seemingly grew out of this, as I do not suffer with inflammation of my joints as an adult. Throwing this in there in case there could be an autoimmune possibility/pelvic floor issue that someone may have any insight to.

!!! Above mentioned TRIGGER WARNING: I am concerned and incredibly desperate to figure out the cause of my continued urgency after emptying of my bladder, every single time. I have also suffered greatly in terms of mental health, and I think the eradication/depletion of my gut microbiome/bacteria has not helped with this matter. It has gotten to the point where I've nearly admitted myself into a mental health hospital to keep me from doing something that I can't take back.

Here are/were some of my theories:

  • after 4 rounds of antibiotics back to back, my gut microbiome has been obliterated. It's possible that it's taking my body longer to bounce back than usual, even though the studied and noted symptom eradication after doxycycline is within 2-4 weeks after completion. It has been around 8 weeks for me now, and I'm still suffering.
  • a kidney/bladder infection was a theory that I had until I got my two urine cultures back with absolutely zero growth found, so I'm ruling that out.
  • I also thought there may be a possibility that I'm dealing with PID, however with my assumed timeline and a thorough pelvic examination which resulted in no finding of any pelvic pain and/or tenderness - I am close to ruling this one out as well.
  • it could be possible that I'm dealing with a pelvic floor muscle group disorder. I have read that women who have UTI's can result in a hypertonic pelvic floor after 1-2 UTI's which typically last about a week or two. With the pain and tension I dealt with for 2 months straight, I think it's possible that my pelvic floor muscles may have taken a beating and are having a hard time recalibrating to a relaxed state, resulting in the feeling of urgency/frequency.
    • I think it's important to note that I have not dealt with incontinence. There have been no leaks, even though I've for sure THOUGHT I was going to leak, there have been none. I have had control for the most part. After urinating now, when I feel the urgency come on, with certain steps or jumps/skips/hops, I feel like I'm going to have leakage, but I don't.

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CONCLUSION

I currently show no bacterial growth in terms of my urinary tract/ kidneys/ or chlamydial infections.

I am struggling with urgency only after I urinate, for about 45 minutes to 2 hours, and then symptoms seem to disappear until I urinate again. This is incredibly difficult to navigate, as I am a volume bartender, standing and moving for two to three 12 hour shifts a week.

I am continuing further and more detailed testing out of desperation to find answers/ treatment.

I am quitting vaping at the first of this month to help alleviate inflammation/ bladder irritants.

I am feeling as if my struggles are leaning more on a functional level than a bacterial/infection level, but I'm more than willing to do everything possible in order to rule out and eventually find the culprit.

I have spent around $900 trying to figure this situation out and regain my healthy and happy body, and the bills keep piling up. I have received no financial help from my (above mentioned) partner. I have scoured the internet for any information that matches my situation. I've nearly sold myself on the idea that I might have bladder cancer. I am scared, concerned, and honestly a little bit traumatized The amount of pills I've taken in the last 4 months is depressing. I will do whatever it takes, but I'm really struggling to stay hopeful. And I pinky promise, I will never touch a bare penis again until I am in a committed relationship and have test results in hand. I learned the hard way.

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Any information, possible theories, suggestions or whatever you may be able to offer me would be so incredibly appreciated. I've been suffering for 4 months, and it's straining my mental health on a scary level. I never had urinary issues like this before my positive chlamydia result, and I'm really struggling to make a comeback, even though I'm showing no traces of bacterial growth. Please help however you can. Thank you so much in advance, and I'm so looking forward to your ideas/suggestions.