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Spotting in some form almost daily

Hi.  Thanks for reading my question.  

I am 30 & having problems with abnormal bleeding.  I spotted bright red blood for almost 4 days before my period, got a normal period then I spotted for another 3 days.  Bleeding totaled 11 days.  After 3 day break from bleeding, spotted again.  Couldn't tell if I spotted in the second half of my cycle due to bleeding from an endometrial biopsy.  The same thing happened again this month & I am spotting during the second half of my cycle.  (I believe I ovulated due to cervical mucus changes.)  Not alot of blood, mostly just pink, brown & red tinges upon internal cervical mucus checks.

I had cultures for STD's & endometrial biopsy, all normal.  Had a normal pap 5 months ago & so my gyn said I didn't need one.  Also had a transvaginal utrasound which showed my uterus measuring 7.9 x 5.3 x 3.4mm, the endometrial complex to measure 5.2 mm, the right ovary to measure 3.8 x 2.6 x 2.4 with a 1.2 cm complex cyst and the left to measeure 4.0 x 2.0 x 1.9. I think the ultrasound was done around day 10 of my cycle but because of the spotting it is hard to tell.  My gyn said that he believes the cyst is from ovulation containing a blood clot and that it will disappear. He also said the cyst may be responsible for my spotting.   He said to repeat the ultrasound in 2 cycles.  After calling to his office regarding continous spotting, he put me on microgestin FE 1/20.  The nurse said that given all of the negative testing, it is probably hormonal.  

My questions are:

How likely it is that this small complex cyst is cancerous and secreting hormones causing the bleeding?  Also, should I take the birth control or would that hide symptoms that are possibly due to cancerous changes?  Finally, I was wondering if there are additional tests that I should ask for and how long can I safely wait doing the wait and see approach until I ask for additional tests.

Thank you for taking the time to read this and for your expertise and service.

3 Responses
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242604 tn?1328121225
MEDICAL PROFESSIONAL
Hi There,
thank you for your complete information.

You have had a very careful evaluation.  I do not think the ovarian cyst is related to your abnormal bleeding.

Here are some other thoughts for you to discuss with your doctor:

-Clotting abnormalities. Sometimes there is nothing wrong with the gyn system. But the abnormal bleeding is due to a blood problem. This can be as simple as taking too much aspirin or ibuprofen and not clotting well to an actual serious blood problem. The most serious condition is leukemia.  It is very easy to sort this out - if you have a CBC done (complete blood count). If that is normal, you do not have a serious blood problem.

-Trauma. Some women will develop irritation or even ulcers  from tampons. And if you are using tampons more because of more bleeding, that makes the problem worse.

-cervical cancer.  With all the good evaluation you have had, this is unlikely. But sometimes pap smears can miss a lesion, especially if it is deep in the cervical canal.  Ask your doctor about another pap smear (it is easy!) or even a good microscopic look at the surface of the cervix with colposcopy. There are some women with unexplained cervical bleeding where it makes sense to consider a LEEP biopsy but that is extreme.

best wishes
Helpful - 0
Avatar universal
Thank you for responding and for the good advice.  I will approach all of this w/ my doc.  He did not suggest a CBC.  I was assuming that it was because I had a normal CBC profile in October.  Is another one necessary?
Helpful - 0
242604 tn?1328121225
MEDICAL PROFESSIONAL
Hi there
it is easy to do and will probably be normal but why not check again.
take care
Helpful - 0

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