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Had total hysterectomy. Having light vaginal bleeding. Sonogram normal. What can this be?

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General & Family Physician
Practicing since : 2001
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Had totally hysterectomy at 28. I am 55. for over 6 weeks, I bleed vaginally light, then ld drop clots for 5 days. IT .STOPPED FOR 2 WEEKS AND AM BLEEDING LIGHTLY AGAIN. HAD SONAGRAM/PROBE WHICH SHOWED NOTHING
Posted Mon, 29 Jul 2013 in Women's Health
Answered by Dr. Michelle Gibson James 2 hours later
Hi, thanks for using healthcare magic

It is understandable to be concerned.
Post menopausal bleeding is a common problem however the most common cause is a problem with the endometrial lining of the uterus.

In your case , with a history of a hysterectomy, this is not a possibility so other causes must be considered.

The other causes can be divided into gyneacological and non gynaecological. The most common gynaecological causes would be vaginal atrophy or dryness or problems related to the cervix if it was a subtotal hysterectomy.
The vaginal dryness would respond to topical estrogen replacement creams and a pap smear would be able to assess the state of the cervix to determine if there are any problems with it.
Lesions of the ovary can also cause this symptom but this should have shown up on ultrasound.

In terms of non gynaecological causes, this is not as common but has been documented in the medical literature.
The possible cause is most commonly infiltration of a lesion into the vaginal area. There have been cases where the bleeding was related to lesions that would have originated from the appendix, the kidney and a lady where the bleeding was related to a lymphoma.
These are rare scenarios but are possibilities.

This is not meant to alarm, if it has I apologize. You may want to consider visiting your doctor for a reassessment which may include further more comprehensive imaging and blood investigations (full blood count, ESR (checks for inflammation), kidney blood tests such as creatinine. CEA)

I hope this helps, feel free to ask any other questions
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Follow-up: Had total hysterectomy. Having light vaginal bleeding. Sonogram normal. What can this be? 25 minutes later
Thank you for your answer Dortor. but I have n cervix, DEFINITLY N UTERERS, NR VARIES. I had 5 female surgeries, between 25-27 yrs. I have had a sonogram with probe. have been in hospital 2 xs, family physician is 28 years, surgeon I have seen said for gallbladder and 4 hernia repairs. Songram showed nothing and bloodd tests showed 0 cancer cell increase . I am 98 pounds and am 5'2. no stress. I have been a widow for 3 years. stress is as low as it can go. This is confusing a family doctor for 28 years, a surgeon and a specialist gyneclgist. I read, re-read yur answer. Any ideas I can bring up r bring to my drs? I already use cream estrogen and when I have relatinsins stuff is is a flip if I lightly bleed or literally drop colts and fill up a toliet please answer. XXXXXXX
Answered by Dr. Michelle Gibson James 1 hour later

If there is no cervix or ovaries then it is highly unlikely that the bleeding is related to a gynaecological cause.
In terms of the blood test showing no cancer cell increase, this is good. You did not indicate which particular cancer they were looking for but I am glad that particular result in negative.

As I mentioned, vaginal bleeding can be related to a reproductive structure but you indicate that these have been removed.

This means that it can be related to a non gynaecological structure such as in the abdomen. If the ultrasound was of the pelvis, imaging should be done of the abdomen as well.
There have been some women with vaginal bleeding after years of menopause where investigations have shown that it is related to the abdomen as well as the other causes mentioned previously.

A sonogram is a good investigation but there are imaging tests that are more accurate such as CT, this may be necessary to determine the cause of your symptoms.

Please feel free to ask any other questions
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