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Had Long Cycle First Time. After Periods Have Black Spotting And Bleeding With Stools. Underlying Cause?

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Posted on Mon, 2 Sep 2013
Question: This July I had a cycle of 33 days ( 28.6.2013 to 30.7.2013) which has never happened before. Usually the length of my cycle is 25-28 days. After my periods ended, for the past 3 days (cd 12, cd 13, and cd 14) I am having black spotting (vaginal) during the day and little bleeding while passing morning stool. Also recently on 9th of this month I fell down and fractured my ankle. I'm concerned as this has never happened before. My case history is mentioned in the question below. Kindly advise.
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Answered by Dr. Rhea Chanda (29 minutes later)
Brief Answer:
your answer

Detailed Answer:
Hi,
By your history,i also believe that endometriosis can be a issue here. You have already been treated with Zoladex which is one of the treatments for endometriosis. But the diagnosis of endometriosis can only be confirmed by a diagnostic laproscopy. You were given the zoladex before any confirmed diagnosis. Now in endometriosis,ovulation is a problem in most cases, along with heavy bleeding and pain. From the follicular studies you have mentioned,i see that you dont have large enough follicles.Your follicles are maturing properly. I think that you should go for a diagnostic and therapeutic laproscopy first. Once that is done, the severity of the endometriosis can be defined. In severe endometriosis you may need another course of zoladex. After that you will need ovulation induction drugs again. With regular follicular monitoring, along with folic acid and duphaston, your chances will be better. That outcome is too early to predict. We will have to see eventually how you respond to the treatment.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Rhea Chanda (9 hours later)
Dear Dr. XXXXXXX

After I posted the question yesterday, I have started bleeding (this is red blood). This was cycle day 14 and 15. I tested with an Home pregnancy test today morning and it is showing a positive. Now I am really scared. Could it be an ectopic?
doctor
Answered by Dr. Rhea Chanda (1 hour later)
If the pregnancy test is showing positive and you are also bleeding then you need to get an ultrasound asap. Ecotpic can only be diagnosed on an ultrasound though there are other signs like acute abdominal pain, sweating and tachy cardia . If your pregnancy test is positive then you first need to confirm it again with an ultrasound and a blood test . I suggest you see your doctor immediately .
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Rhea Chanda

OBGYN

Practicing since :2005

Answered : 3161 Questions

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Had Long Cycle First Time. After Periods Have Black Spotting And Bleeding With Stools. Underlying Cause?

Brief Answer:
your answer

Detailed Answer:
Hi,
By your history,i also believe that endometriosis can be a issue here. You have already been treated with Zoladex which is one of the treatments for endometriosis. But the diagnosis of endometriosis can only be confirmed by a diagnostic laproscopy. You were given the zoladex before any confirmed diagnosis. Now in endometriosis,ovulation is a problem in most cases, along with heavy bleeding and pain. From the follicular studies you have mentioned,i see that you dont have large enough follicles.Your follicles are maturing properly. I think that you should go for a diagnostic and therapeutic laproscopy first. Once that is done, the severity of the endometriosis can be defined. In severe endometriosis you may need another course of zoladex. After that you will need ovulation induction drugs again. With regular follicular monitoring, along with folic acid and duphaston, your chances will be better. That outcome is too early to predict. We will have to see eventually how you respond to the treatment.