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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Done LEEP For Abnormal Cells, Bleeding During Sex Or Bowel Movement. Have PCOS. Why Am I Like This?

I have experienced abnormal cells and had a leep done in 2005. since then off and on..now getting to the point of unbearable...i bleed during intimacy or even a bowel movement . I was told they were popping surface vessels in my cervix and nothing could be done to fix them. in office cauterization has repeatedly been tryed and never lasts. I also have pcos and am having difficulty conceiving. my new gyn put me on ocella and reccomended I go to an ivf center. Then bleeding is now excessive and I am fed up. I want this fixed before I even concider pregnancy but she said no. HELP. why am I like this. I want my intimate life back and a normal iron level.
Wed, 28 May 2014
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OBGYN 's  Response
Women with PCOS often have irregular bleeding. This is because the lining of the uterus never matures because there's not normal ovulation to produce progesterone. In other words the first part of the normal menstrual cycle makes estrogen which thickens the lining of the womb but after ovulation progesterone causes maturation and then the normal lining sheds. PCOS and irregular bleeding has nothing to do with your history of leep almost 10 years ago. You are bleeding irregularly because the lining never matures. It just grows and grows and sheds. Sometimes it's neglected it can even become premalignant or malignant because there's so much stimulation to grow without maturation.
so I would recommend the following. You need to see a gynecologist and have an endometrial sampling done to make sure there are no premalignant or malignant changes. You need a course of progesterone that will mature the lining of the uterus and cause it to shed. Normally this will stabilize the irregular bleeding and that would be followed by a more normal or even heavy menses. There are progesterone pills progestin implants progestin shots and a progestin coated IUD all of which are used to prevent malignancy in PCOS patients.
because you are interested in becoming pregnant after progesterone maturation you may wish to consider a mild antiestrogen such as Clomid. This should be done by infertility specialist you can keep an eye on things. Peace COS patients are often the easiest on infertility patients to treat. The reproductive endocrinologist or infertility specialist will most likely also check your thyroid and prolactin levels as these are two other conditions which can contribute to irregular cycles. Good luck I hope this explains things and I hope that you conceive soon.
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Done LEEP For Abnormal Cells, Bleeding During Sex Or Bowel Movement. Have PCOS. Why Am I Like This?

Women with PCOS often have irregular bleeding. This is because the lining of the uterus never matures because there s not normal ovulation to produce progesterone. In other words the first part of the normal menstrual cycle makes estrogen which thickens the lining of the womb but after ovulation progesterone causes maturation and then the normal lining sheds. PCOS and irregular bleeding has nothing to do with your history of leep almost 10 years ago. You are bleeding irregularly because the lining never matures. It just grows and grows and sheds. Sometimes it s neglected it can even become premalignant or malignant because there s so much stimulation to grow without maturation. so I would recommend the following. You need to see a gynecologist and have an endometrial sampling done to make sure there are no premalignant or malignant changes. You need a course of progesterone that will mature the lining of the uterus and cause it to shed. Normally this will stabilize the irregular bleeding and that would be followed by a more normal or even heavy menses. There are progesterone pills progestin implants progestin shots and a progestin coated IUD all of which are used to prevent malignancy in PCOS patients. because you are interested in becoming pregnant after progesterone maturation you may wish to consider a mild antiestrogen such as Clomid. This should be done by infertility specialist you can keep an eye on things. Peace COS patients are often the easiest on infertility patients to treat. The reproductive endocrinologist or infertility specialist will most likely also check your thyroid and prolactin levels as these are two other conditions which can contribute to irregular cycles. Good luck I hope this explains things and I hope that you conceive soon.