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What Causes Abnormal Vaginal Bleeding With Low Back Pain?

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Posted on Tue, 2 Feb 2016
Question: I am day 13 of my cycle. I started BC 4 months ago. I had a pelvic mri in early November. Ultrasound and pelvic exam in early December. Last week I had a pap test and pelvic exam. The MRI, Ultrasound and Pap came back normal.

Here is my question. Why would i have abnormal vaginal bleeding. The blood is bright red. I also have low back pain and it feels like im having my period. Admittedly, my normal scheduled period was not XXXXXXX in that i didnt really bleed and only had dark but not heavy spotting for about 2 weeks.

One more thing, i gave myself a pelvic exam this morning. This seemed odd. Right at the opening, when i pushed back not forwards, i felt a hard knot. Once i released a stool the knot went away. Would i feel a stool from my vagina?

I am not sure what else I can do. Other than a camera test and biopsy, everything has been done.

What can this be? Should I be concerned and go back to doctor again. I'm 44 so it seems early for pre menopause but maybe not.
doctor
Answered by Dr. Deepti Verma (51 minutes later)
Brief Answer:
Proper internal examination is required

Detailed Answer:
Hi dear,
I have gone through your question and understand your concerns.
Abnormal vaginal bleeding in the perimenopausal group can be due to cervical cancer, endometrial pathologies like hyperplasia, dysfunctional uterine bleeding or endometrial cancer.
The hard lump in the vagina can be due to cervical growth, polyp or stools which are felt through vagina.
I will suggest you to consult an OBGYN specialist to get properly examined internally, investigated including endometrial biopsy and get further management accordingly.
Hope you found the answer helpful.
Please do get back for further queries.
Regards
Dr Deepti Verma
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Deepti Verma (2 hours later)
Well the response is definitely concerning. So you are saying it could still be cancer even if ultrasound on 12/10 was normal and pelvic MRI on 11/18 was normal? Pelvic exams have also been normal?

I called my doctor and they agree it is cause for concern but are leaning towards it being too low a dose of birth control.

My question: if another ultrasound shows nothing abnormal should I still pursue further cancer testing (e.g. Biopsy).

Does light bleeding make it less concerning as I was told to watch for heavy bleeding?

Additional information. Ultrasound results from about one month ago (12/10).
My ultrasound results from a month ago showed no concerning tumors.

Endo: simple cyst @ 7 mm, The thickness was .50, Length 7.39, Height 3.49, and width 3.32

left ovary- no tumors/masses, length: 2.89, Height: 2.0, Width 2.52, Volume 7.62

right ovary - No tumors/masses, length 3.2, height 2.0, width 2.35 and volume 7.87

Since I had the symptoms last month too, I thought this may be helpful.
doctor
Answered by Dr. Deepti Verma (56 minutes later)
Brief Answer:
Endometrial biopsy is mandatort

Detailed Answer:
Hi dear,
Sorry for being a bit late, I was stuck in an emergency.

If the ultrasound and MRI are normal repeatedly, then the chances of cancer are mostly ruled out.

However, if spotting and repeated bleeding are continued, then an endometrial biopsy is mandatory to rule out other conditions like dysfunctional uterine bleeding and endometrial hyperplasia, which are not diagnosed on ultrasound.

Hope you found the answer helpful.

Please do get back for further queries.

Regards
Dr Deepti Verma
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
Answered by
Dr.
Dr. Deepti Verma

OBGYN, Maternal and Fetal Medicine

Practicing since :2009

Answered : 5064 Questions

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What Causes Abnormal Vaginal Bleeding With Low Back Pain?

Brief Answer: Proper internal examination is required Detailed Answer: Hi dear, I have gone through your question and understand your concerns. Abnormal vaginal bleeding in the perimenopausal group can be due to cervical cancer, endometrial pathologies like hyperplasia, dysfunctional uterine bleeding or endometrial cancer. The hard lump in the vagina can be due to cervical growth, polyp or stools which are felt through vagina. I will suggest you to consult an OBGYN specialist to get properly examined internally, investigated including endometrial biopsy and get further management accordingly. Hope you found the answer helpful. Please do get back for further queries. Regards Dr Deepti Verma