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Having vaginal bleeding. Sonogram revealed subserous fibroids. What is the cause?

May 2013
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Practicing since : 2006
Answered : 4909 Questions
I am 58 and post menopause since I was 53 when I had late stage colon cancer with mets. I recovered from that and have had a hip replacement and several surgeries on an anal fisutula which is now corrected. I have been having vaginal bleeding (v small but increasing in incidence with pink mucous) A sonogram revealed a new subserous fibroid which my gynae thinks may be the culprit. He says the bleeding is not hormonal in nature. As mets from colon c in the uterus are almost unheard of and new fibroids rare in post menopausal women what could be the cause? I am having an exploratory hysteroscope in a couple of weeks, with either a myomectomy or D&C, and of course histo-path. Is it likely that the fibroid was there before but just hadn't showed on previous scans and if so why would it suddenly bleed? Thanks very much XXXXX
Posted Thu, 12 Dec 2013 in Women's Health
Answered by Dr. Sree Gouri SR 25 minutes later
Brief Answer: Postmenopausal bleeding Detailed Answer: Hi, Thanks for the query. Fibroids can lead to excessive menstrual flow by increasing the surface area of endometrium, by increasing the blood supply to the uterus. But subserous fibroids lies in the outer layer of the uterus. For more details : So, usually they won't affect the endometrium. And fibroids generally get atrophied after menopause. Postmenopausal bleeding can be seen due to causes like : -During menopause, endometrial layer gets atrophied. That can lead to exposure of underlying blood vessels and can increase their fragility, leading to bleeding. -Endometrial abnormalities etc. -Cervical neoplasia etc. Possibly by hysteroscopy and other investigations, the cause for your problem can be identified. If no abnormality is detected, no need to worry. Spotting may not repeat. Hope I have answered your query. I will be available to answer followup queries. If you are satisfied with the answer, please give your review at the end of the discussion. Take care.
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Follow-up: Having vaginal bleeding. Sonogram revealed subserous fibroids. What is the cause? 3 minutes later
Thank you for your reply. I beg your pardon but I think I have misnamed my fibroid, not sub serous but submucosal, the one that grows from the endometrium, into the uterine cavity, sorry for my mistake. XXXXX
Answered by Dr. Sree Gouri SR 7 hours later
Brief Answer: Hysteroscopy helps in detecting the cause Detailed Answer: Hi, Usually fibroids will get regress after menopause. Rarely sub mucosal fibroids may lead to postmenopausal bleeding. This possibility is more if you are taking hormone replacement therapy. Hysteroscopy helps in finding out the possible cause. If the cause is fibroid, you can go for progesterone tablets to decrease the size. If your doctor suggests you can go for myomectomy. If the cause of the bleeding is endometrial hyperplasia or polyp, D&C can help in treating the problem. Take care.
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