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Date of last update: 10/14/2017.
Forum Name: Gynecology
Question: Intermenstrual bleeding
|jenniferiveycook - Thu Feb 17, 2005 4:27 pm||
I am 28 years old and have been off BC for 2 years in hopes of getting pregnant. Since then my periods have become very heavy - very painful - and clotting - miserable feeling - my normal average cycle is around 28-30 days - my last period was on january 27th then on february 10 mid cycle - I started spotting was brown and then became a little more heavy and red - used 1 tampon and lasted mostly 1 1/2 days - never done this before - called obgyn - he said to take pregnancy test - did that twice one week apart - both show up negative - I also just saw him in december and talked to him about the problems I was having - i have even experienced spotting after intercourse once a few months back - I just feel that something is not right - after 2 years I have also had no success of getting pregnant - should I be worried that something is wrong - pap smear from last visit came back ok - should I get a new obgyn - please help
|Dr. Tamer Fouad - Wed Jan 11, 2006 5:09 am||
"Spotting" refers to unexpected bleeding that does not require the protection of a sanitary or a tampon. Normally it doesn’t reach the underwear, but rather is swiped with toilet paper after a bowel movement or urination. The blood can be pink-tinged mucus, rusty brown or bright red. Brown discharge usually indicates "old blood".
Evaluating abnormal uterine bleeding in the reproductive years requires the exclusion of pregnancy or pregnancy-related disorders, medications known to cause abnormal uterine bleeding, iatrogenic causes, obvious genital tract pathology, and systemic conditions. Once all these causes are excluded it can be presumed that you have dysfunctional uterine bleeding.
Bleeding after sexual intercourse is known as postcoital bleeding. Cervical dysplasia and cervical cancer may be associated with postcoital bleeding and is the most significant cause.
However, there are many other causes such as chlamydial cervicitis. Other benign causes of bleeding include cervical polyps, which may become apparent as postcoital bleeding. Postcoital bleeding may result from atrophy of the vaginal and vulvar epithelium (atrophic vaginitis). This can happen as a result of menopause but can be seen in premenopausal women. Even quite minor traumatic lesions may cause severe postcoital bleeding if co-existent coagulation disorder. Ectropion may also present as postcoital bleeding.
1. Brenner PF. Differential diagnosis of abnormal uterine bleeding. Am J Obstet Gynecol 1996;175(3 Pt 2):766-9.
2. Rosenthal AN, Panoskaltsis T, Smith T, Soutter WP. The frequency of significant pathology in women attending a general gynaecological service for postcoital bleeding. BJOG 2001;108:103-6.
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