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What Causes Pink Vaginal Discharge During Menopause?

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Posted on Tue, 22 Nov 2016
Question: I am 70 years old, post-menopausal since 54. I had a cone biopsy for cervical cancer in 1985; everything clear since then. I have a cyst on my left ovary that's been there since 1998 and is rowing slowly but still less than 5 mm at last TVU in March. I had a Pap smear and internal exam (with colposcopy and acetic acid on cervix - nothing showed up visually) on September 23 and no call back from the hospital;. Te cervix is both stenotic and atrophic. Tonight, I had some pink discharge from the vagina after a bowel movement. I am not sexually active. I will call my gyno in the morning but am pretty scared. Could this be stress related (vaginal atrophy?) I have been under an incredible amount of stress n the last few weeks.

a bit more info - the endometrium on the last XXXXXXX in March 2016 was 3.7 mm.

sorry, pretty scattered - had something like this back in 2006 - had a failed hysterosocopy (couldn't get cervix to dilate) under general anaesthetic which is when cervical stenosis was confirmed. All ultrasounds were normal for endometrium, etc...had the ovarian cyst then as well...spotting eventually stopped on its own around October, 2006. Have had yearly ultrasounds and Pap smears with colposcopy (no biopsy but acetic acid n cervix to detect abnormal cells)...so far, all OK...could something serious develop that quickly (sice the ultrasound in March or the colposcopy in September)? I have no pain and no bloating.
doctor
Answered by Dr. Ramadevi Wani (56 minutes later)
Brief Answer:
Pink discharge is most likely due to atrophic vaginitis.

Detailed Answer:
Hi
Welcome to healthcare magic. I am Dr Ramadevi Wani. I will be answering your concerns today.

I have read your notes meticulously.
Were you tested for HPV? What type of HPV were found? High risk or low risk?

Since you have had normal pap and ultrasound until recently, it is extremely unlikely for anything serious to develop that quickly. The pink discharge is most likely due to atrophic vaginal mucosa. So don't worry.

Have you checked for CA 125. This is a test to find out if there is anything serious with the ovarian cyst. If you have not done it, I suggest that you get it done as a baseline.

If you have further concerns, I will be happy to answer.

Best wishes,
Dr Rama.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Ramadevi Wani (21 minutes later)
Thanks! I had a CA125 done in April 2016 with a result of 5.7 - no problem there.
To the best of my knowledge, I have never been tested for HPV although I expect that was the cause of the cervical cancer in 1985. I have not been sexually active since 1991 but I know the HPV virus stays in your system. However, all my tests have been clear, including yearly Pap smears and colposcopy checks with the acetic acid.
I just checked my files and the endometrium was 3.2 mm last M\arch (not 3.7) Also, when my gyno did the Pap smear at colposcopy in September, he also did an internal and said he couldn't even feel my ovaries. There was no bleeding during or after the exam and that was only 4 weeks ago.
You say it is likely vaginal atrophy which would make sense because the exam in September was the first one I have ever had that actually hurt. The discharge tonight after the bowel movement was also viscous - thick and sticky, ...and pink. Does that conform with how vaginal atrophy presents?
I will call my gyno in the morning but would appreciate any clarification and reassurance you can give me now. I have been so careful since 1985; I have an anxiety disorder and occurrences like this really terrify me.


I really appreciate your help with this - I need to set my mind at ease so I can rest.
doctor
Answered by Dr. Ramadevi Wani (10 minutes later)
Brief Answer:
Details below.

Detailed Answer:
Hi,
Welcome back.
A normal CA 125 is very reassuring. This is good news.
Any endometrial thickness less than 4 mm is normal.
From your notes it is almost certain that the pink discharge is due to atrophic vaginitis.

Don't worry. Sleep now. You can confirm with your Gynecologist in the morning.

Regards,
Dr Rama
Above answer was peer-reviewed by : Dr. REMY KOSHY
doctor
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Follow up: Dr. Ramadevi Wani (18 hours later)
Thanks for all the positive info, Dr. XXXXXXX
Saw my gyno today and there was no bleeding during or after the exam (in fact, none since last night). He says it very likely could be due to atrophy (since everything in that area is certainly atrophied!),but I am going for a trans-vag ultrasound on Thursday to confirm endometrial thickness. If all is well there, we will not worry.
My doctor thinks it's very unlikely that things have changed drastically with the uterine lining since the end of March of 2016 when I had the last ultrasound. But on the off chance that they have, he says we are catching things early and , in his words "I will not die from this"...I have no other symptoms, am not obese, do not smoke, had one vaginal delivery, no HRT and no early menarche or late menopause. I will keep my fingers crossed although I am still very worried...Thursday seem a long way off and I am frankly scared of what will show up on the ultrasound.
Ordinarily, I have one ultrasound a year...the last one was 7 months ago when the endometrium measured 3.2 mm. Would the endometrial cells proliferate to a thickness of the lining that's greater than 4 or 5 mm in that short a time?
doctor
Answered by Dr. Ramadevi Wani (2 hours later)
Brief Answer:
I do not expect the endometrium to be thick.

Detailed Answer:
Hi,
Welcome back.
Do not worry so much.
Your very recent ultrasound has been normal.
In addition you do not have any risk factors for the serious disease.

So in my experience and opinion it is extremely unlikely that the endometrium will grow thicker in this short duration.

I hope this is helpful.
If you have further concerns do write to me.

Regards,
Dr Rama
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Nagamani Ng
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Answered by
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Dr. Ramadevi Wani

OBGYN

Practicing since :1985

Answered : 1459 Questions

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What Causes Pink Vaginal Discharge During Menopause?

Brief Answer: Pink discharge is most likely due to atrophic vaginitis. Detailed Answer: Hi Welcome to healthcare magic. I am Dr Ramadevi Wani. I will be answering your concerns today. I have read your notes meticulously. Were you tested for HPV? What type of HPV were found? High risk or low risk? Since you have had normal pap and ultrasound until recently, it is extremely unlikely for anything serious to develop that quickly. The pink discharge is most likely due to atrophic vaginal mucosa. So don't worry. Have you checked for CA 125. This is a test to find out if there is anything serious with the ovarian cyst. If you have not done it, I suggest that you get it done as a baseline. If you have further concerns, I will be happy to answer. Best wishes, Dr Rama.