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Having back pain and pelvic pain, with yellow vaginal discharge and brown spotting. Enlarged uterus on ultrasound

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I have had 5 months of back pain pelvic pain which is improving slightly. I have had excessive discharge which is not offensive and can be white or very watery or dark yellow. There was also a huge amount of ovulation jelly with brown spotting.
Although the pelvic pain can happen at any time I also get very bad period pain several days before my period starts and at the end of my period. They are not very heavy but seemed to last for about 10days with just brown blood being present for the last 5days of my period. There has been no bleeding in between although I thought I did have a minute amount of pink discharge. Blood tests 2 months ago normal. The ultra sound showed that my uterus was generally slightly enlarged but nothing significant and nothing else irregular was seen. I have googled this and worried myself with uterine cancer. Is it not significant because it is slightly enlarged? Should I be ok with this as pain has lessened slightly? Does the fact that the uterus enlarged mean the lining was thicker than normal is this the same thing? I was just about to start my period could this be the cause of slightly enlarged womb?
Posted Wed, 24 Apr 2013 in Women's Health
Answered by Dr. Kulsoom Qureshi 1 hour later
Thanks for discussing your concerns with us.
You have following points in your history which are significant to me:
1. Back pain/ Pelvic pain. Relation to periods.
2. Excessive discharge/ yellow color / pink color.
3. Brown spotting.
4. Uniformly enlarged uterus on ultrasound.
In women after 40 years of age, it is strongly recommended that any abnormal menstrual pattern should be investigated by doing a trans-vaginal ultrasound & endometrial biopsy. Endometrium is the lining of your womb ( uterus). Enlarged uterus means your womb is larger than normal & a thicker lining means innermost layer of your womb (endometrium) has become thick. This is not the case with you I guess.
I don't know much about your history & don't know whether you are at risk of uterine cancer but you still need investigations. Apart from two I already mentioned you also need to do a swab test of your discharge & pap smear of your cervix.
Womb size do not increase before your periods, so, this is not a likely cause of an enlarged uterus.
There are a number of benign ( non-cancerous) conditions which could present this way like pelvic infection ( your history of abnormal discharge), Adenomyosis ( your enlarged uterus along with pelvic pain), endomertriosis ( painful periods) & off course uterine & cervical cancer may also present like this.
You should see a Gynecologist for all these tests & clinical examination which may shortlist your tests.
This is good that pain is settling, but it would be a safe option for you to have tests done before getting reassurance.
Hope this answers your query. Please contact back if you want to discuss any more thing.
Wish you good health.
Best regards.
Above answer was peer-reviewed by
Follow-up: Having back pain and pelvic pain, with yellow vaginal discharge and brown spotting. Enlarged uterus on ultrasound 26 minutes later
I have had a pap smear and swabs all normal. The trans-vaginal ultrasound picked up enlarged uterus. I am not at any greater risk for uterine cancer having read up on it. The brown spotting was only in my ovulation jelly and at no other time.Things seem to be definitely settling even the discharge. The pink discharge was once and so small I wasn't even sure if it was pink.
My gynocolgist wrote to say my uterus just generally slightly enlarged but nothing significant. He does not suggest any further tests and felt a Mirena might calm things down. Do you know why he felt it wasn't significant and why he would be happy to leave things there. Is it because my uterus is only slightly enlarged from the trans vagunal scan?
Answered by Dr. Kulsoom Qureshi 30 minutes later
Welcome back.
This is good to know that your smear & swab tests are all normal. Hope your endometrial thickness is also normal.
To me, the reason why your Gynecologist was not giving it much importance is that his clinical diagnosis is a benign one like Adenonyosis which settles as soon as a women stops having menstruation ( menopause). That is why he suggested you Mirena which is likely to improve your pain & bleeding by causing endometrial atrophy.
Another reason could be your lower risk of uterine cancer as guided by your history & the fact that most uterine cancers present at a very early stage that can be easily treated by surgery & have a very good prognosis. So, perhaps he wants to save you from surgery & all the attendant risks.
Third reason could be your NHS protocols which strongly effect all the treatments & investigations offered to patients in UK.
I still recommend you to at least discuss about endometrial biopsy with your doctor & go ahead with the treat offered. It is likely to improve your quality of life after first few months.
I will be glad to respond if you want to discuss anything more.
Take care.
Above answer was peer-reviewed by
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