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abnormal bleeding
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Anon_168275 posted:
Hi! I just had my period on May 13th, about 5-6 days long. On the 14th day of my cycle I started spotting dark brown blood. About 3 days of this then bright red spotting but no flow. I'm 43, just had extensive infertilty workup (D&C, transvaginal ultrasound, and hysteroscopy, also day 3 FSH (was 21 ) I'm now on day 18 of my usual cycle with this bright red spotting. Never happened before...I do have a condition called adenomyosis(I'm not sure if I spelled it right, sorry!) My periods are always horrible, heavy bleeding, clots etc, but no pain, just super heavy and super long. My last pap smear was normal too...And MY HCG/HCT is perfect...so what is wrong?? Have horrible stress and was taking a lot of ibuprofren( not more then standard dose, just 2 tabs once daily for back pain) Help!!
1 Replies |Watch This Discussion | Report This| Share this:abnormal bleedingHi! I just had my period on May 13th, about 5-6 days long. On the 14th day of my cycle I started spotting dark brown blood. About 3 days of this then bright red spotting but no flow. I'm 43, just had extensive infertilty workup (D&C, transvaginal ultrasound, and hysteroscopy, also day 3 FSH (was 21 ) I'm now on day 18 of my usual cycle with this bright red spotting. Never happened before...I do have a condition called adenomyosis(I'm not sure if I spelled it right, sorry!) My periods are always horrible, heavy bleeding, clots etc, but no pain, just super heavy and super long. My last pap smear was normal too...And MY HCG/HCT is perfect...so what is wrong?? Have horrible stress and was taking a lot of ibuprofren( not more then standard dose, just 2 tabs once daily for back pain) Help!!
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Jane Harrison Hohner, RN, RNP responded:
Dear Anon: You mentioned that the spotting began about cycle day 14 (cycle day 1 being the first day of your last period). Given this specific timing the most likely cause would be bleeding with ovulation. Right before ovulation there is a brief spike of estrogen. When this level drops back down to normal, the sharp decline can destabilize the lining of the uterus leading to spotting/bleeding. Some women have this sign of ovulation every month; others only rarely. Fortunately the amount is usually scant and brief in duration.

Some other possible causes of erratic spotting can include a new chlamydia infection (unlikely if you are both monogamous). polyps of the lining of the uterus (doubt this given a hysteroscopy), or missed/erratic ovulations (usually there will be a history of missed/irregular periods).

You mentioned a day 3 FSH of 21--this type of elevation usually suggests "old eggs" with fewer ovulations, less progesterone production, and perhaps some spikes of estrogen in response to the elevated FSH. Thus your bleeding might be "hormonal".

Adenomyosis can prompt spotting in some women (along with the other endometriosis symptoms). Yet this was a single isolated episode.

If your erratic bleeding persists, or you develop other symptoms (eg pelvic pain from an ovarian cyst) see your GYN. They can give you the most "for sure" answer.

Yours,
Jane
Report This| Share this:abnormal bleedingDear Anon: You mentioned that the spotting began about cycle day 14 (cycle day 1 being the first day of your last period). Given this specific timing the most likely cause would be bleeding with ovulation. Right before ovulation there is a brief spike of estrogen. When this level drops back down to normal, the sharp decline can destabilize the lining of the uterus leading to spotting/bleeding. Some women have this sign of ovulation every month; others only rarely. Fortunately the amount is usually scant and brief in duration.<br /><br />Some other possible causes of erratic spotting can include a new chlamydia infection (unlikely if you are both monogamous). polyps of the lining of the uterus (doubt this given a hysteroscopy), or missed/erratic ovulations (usually there will be a history of missed/irregular periods).<br /><br />You mentioned a day 3 FSH of 21--this type of elevation usually suggests "old eggs" with fewer ovulations, less progesterone production, and perhaps some spikes of estrogen in response to the elevated FSH. Thus your bleeding might be "hormonal".<br /><br />Adenomyosis can prompt spotting in some women (along with the other endometriosis symptoms). Yet this was a single isolated episode.<br /><br />If your erratic bleeding persists, or you develop other symptoms (eg pelvic pain from an ovarian cyst) see your GYN. They can give you the most "for sure" answer.<br /><br />Yours,<br />Jane
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