Women's Health Community

Dear An: You mentioned that you have had a similar discharge for the past two years but it has now become a constant problem. Apparently, it was checked for infections and other problems before--and nothing pathological was found. The main description would be that it smells like menstrual blood, but it is not a blood tinged discharge. Hope I am tracking you correctly.

Aging tends not to increase the amount of vaginal discharge, but hormonal changes certainly can. Estrogen tends to increase volume of vaginal and cervical secretions. In the final year or so before menopause estrogen levels can have spikes which MIGHT increase discharge. Yet this seems less likely at age 40.

Very rarely a problem inside the uterus can produce a bad smelling vaginal discharge (eg degenerating fibroid, isolated lesion of abnormal cells, etc.). Given that this is happening daily now I would urge you to see a GYN. They can do tests for infection, vaginal pH and look for other routine causes. If you have risk factors for some of the rare conditions (eg known fibroids, or a thickened lining of the uterus) a GYN can do additional testing (eg ultrasound or endometrial biopsy).

Since you have no health insurance (which often means no recent PAP or breast exam) you might be able to see a GYN for an annual exam and PAP if you are without insurance and over age 40. Check this link and click on your geographic area:

http://www.cdc.gov/cancer/nbccedp /

Yours,
Jane

Thank you so much for your reply. I genuinely appreciate it.

You did track it correctly, except I may not have described accurately enough that every couple of weeks I have one day of a full on period day or two of regular menstrual flow, then it goes back to just a brownish tinged discharge. My last pap and exam were in July 2010 and were clear. I had a milder, whiter & clear version of this same yuck. They cleared a sac of clear fluid out of my uterus that they said was just fluid.

You mentioned several topics that made me concerned but relieved about the perimenopause. My core body temperature has been warmer for the last 9 months or more, I have increased breast tenderness, fatigue and some other symptoms I have found on sites. I do have family hx of fibroids but also female cancers.

I am signing back up with health insurance. My business has finally picked up enough for me to afford it. Thank you for the link. There isn't anything near me, but health insurance will get me the checkups I need.

Thank you again.

Dear An: Thanks for the feedback and corrections. That you are having some menstrual-like bleeding every two weeks is not normal and need to be evaluated. You diagnosis would be "abnormal uterine bleeding." Some POSSIBLE causes of this could be missed ovulations, polyps of the uterine lining, precancerous abnormal cells in the lining of the uterus, or fibroids wihtin the cavity of the uterus. As noted above, a GYN would likely do an ultrasound and/or and endometrial biopsy.

In terms of collections of fluid inside the uterus, Fluid during an ultrasound might mean a number of things:

1. Hyperplasia--This suggests that the lining of the uterus is overly thickened, which is can be caused by missed ovulations and/or being obese.

2. Polyps--These are benign growths of soft tissue, similar to polyps found in the nose, rectum, etc.

3. Cervical stenosis--If the outflow tract from inside the uterus to the vaginal canal is closed or very restricted, fluid or even menstrual flow can be retained inside the uterus. This is more likely to occur if the cervix has been scarred (eg cone biopsy) or if the woman is after menopause.

4. Fibroids within the uterine cavity--Benign overgrowths of uterine muscle tissue (fibroids) can protrude into the uterine cavity and disrupt the evenness of the lining of the uterus.

5. Cancer of the lining of the uterus--While this is the least common reason, it is why any collection of fluid is followed up by further testing such as an endometrial biopsy.

I am so glad to hear about your ability to get insurance. If you see a primary care provider initially (some insurances work this way), all you have to say is "I have been having abnormal uterine bleeding." That can usually get you a referral to a GYN if you cannot self-refer.

Yours,
Jane