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Can adenomyosis cause dark discharge between periods?

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Practicing since : 1999
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Can adenomyosis cause abnormal dark ( looks like old blood) discharge between periods?
Posted Sat, 8 Feb 2014 in Women's Health
Answered by Dr. Timothy Raichle 26 minutes later
Brief Answer: Hello, I would be happy to help... Detailed Answer: Normally the part of the uterus that grows and sheds each month is well-defined and separate from the surrounding muscle of the uterus. When the glands that grow and shed each month "invade" the muscle part of the uterus this is called adenomyosis. It is a very difficult diagnosis to make on exam or ultrasound. It is usually based on a history of increasingly painful and heavier periods over time. It can certainly produce bleeding between your periods like you are describing, but the full workup of your abnormal bleeding should include: 1. An ultrasound (probably already done) 2. An endometrial biopsy (to rule out pre-cancerous changes in anyone over the age of 40) 3. An ultrasound called a sonohysterogram (fluid is pushed into the uterus to aid imaging of the lining to rule out things like uterine polyps) It is usually a diagnosis made once a uterus is removed and the pathology is confirmed as adenomyosis. So in answer to your question, yes it could cause this but other things can too and they should be ruled out first. I hope that this helps - let me know if you have any further questions.
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Follow-up: Can adenomyosis cause dark discharge between periods? 16 minutes later
Yes, ultrasound suggested adenomyosis as did an MRI. A previous sonohysteragram saw a fibroid prolapsing into my cervix. The dr. Can also visualize this when doing an interval exam. However, the fibroid doesn't seem to show up on the ultrasounds or MRI. Is that a concern?
Answered by Dr. Timothy Raichle 9 minutes later
Brief Answer: Thank you for the followup information! Detailed Answer: Okay, this all is beginning to make sense. Fibroids, by the way, are benign tumors of the uterus arising from the smooth muscle. They can cause heavier bleeding and more painful cycles as well. When they are in the lining and even prolapsing out of the cervix, they can certainly be associated with bleeding unrelated to your cycle. Depending on the size of the fibroid, the best treatment to start with would be a "hysteroscopic myomectomy". This is not a difficult procedure. The fact that the doctor can see it on exam but it does not show up on MRI imaging suggests that it is not that big. In any case, the extra bleeding and brownish discharge is related to this fibroid and the description of adenomyosis is likely an incidental and possibly unrelated problem. I hope that this helps - let me know!
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Follow-up: Can adenomyosis cause dark discharge between periods? 0 minute later
Thanks. The fibroid is apparently about the size of the tip of the dr.'s thumb. What is involved in the procedure? Is it done in a hospital or something that can be done in an office setting? Thanks.
Answered by Dr. Timothy Raichle 20 minutes later
Brief Answer: I am glad to help! Detailed Answer: While some clinics perform office hysteroscopy for problems such as this, I think that it would best be performed in an OR setting in a hospital. This involves taking you to the OR, administering anesthetic so you are comfortable, placing you in a position such as for a pap smear, visualizing the cervix and passing a camera (from the end of which you can pass instruments to remove the fibroid) into the uterus. This is an outpatient procedure. If afterwards, you were satisfied, then nothing else would need to be done. If you still had problems, then you could talk with your doctor about a complete hysterectomy. Let me know if this answers your question.
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