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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Late Period, Discharge With Blood. Cervical Smear Normal. Worried About Uterine Cancer

Hi, my last period was late by a few days and, also, when it came it was very light (almost wouldn t qualify it as a period). However, I have had bloody discharge which has changed colour ever since the period started and this has now been going on for 2 weeks. I am very worried about it. I am 37, not pregnant.otherwise very healthy. recent cervical smear normal. I have seen a doctor and he suggested waiting until my next period to see what happens but I have insisted on a scan. I am due to have this next week but in the meantime am losing sleep with worry. Uterine cancer is on my mind. any help you can give very helpful. thank you
Fri, 5 Apr 2013
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General & Family Physician,  's  Response
Hi, thanks for asking in Healthcare Magic.
Continuous bleeding is functional in origin and may due to hormonal disturbance in your case. The other causes are
1. ectopic (tubal) pregnancy.
2. abortions.
3. submucosal polyps.
4. carcinoma of uterus.
5. uterine fibroids.
Since the cervical smear report is normal, the possibility of cervical cancer is ruled out.To rule out other causes, the investigations needed are
1. uterine aspiration cytology.
2. ultrasound.
3. hormonal assay.
4. CT scan.
5. MRI.
However to control bleeding if it is very heavy Conjugated estrogen like Premarin 25 mg IV every 4th hourly for the first 24 hours followed by oral tablets for 21 days combined with medroxyprogesterone 10 mg daily for 10 days will be useful
Usually the uterine cancer (endometrial and sarcomas) is more common after 40 years. The presenting symptoms are uterine (abdominal) enlargement and menorrhagia ( repeated irregular and excessive bleeding). Though you don't have these symptoms, since you are nearing 40 it is better to rule out uterine causes of bleeding.
I hope this is useful.
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Late Period, Discharge With Blood. Cervical Smear Normal. Worried About Uterine Cancer

Hi, thanks for asking in Healthcare Magic. Continuous bleeding is functional in origin and may due to hormonal disturbance in your case. The other causes are 1. ectopic (tubal) pregnancy. 2. abortions. 3. submucosal polyps. 4. carcinoma of uterus. 5. uterine fibroids. Since the cervical smear report is normal, the possibility of cervical cancer is ruled out.To rule out other causes, the investigations needed are 1. uterine aspiration cytology. 2. ultrasound. 3. hormonal assay. 4. CT scan. 5. MRI. However to control bleeding if it is very heavy Conjugated estrogen like Premarin 25 mg IV every 4th hourly for the first 24 hours followed by oral tablets for 21 days combined with medroxyprogesterone 10 mg daily for 10 days will be useful Usually the uterine cancer (endometrial and sarcomas) is more common after 40 years. The presenting symptoms are uterine (abdominal) enlargement and menorrhagia ( repeated irregular and excessive bleeding). Though you don t have these symptoms, since you are nearing 40 it is better to rule out uterine causes of bleeding. I hope this is useful.