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What Causes Pre Menstrual Bleeding?

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Posted on Thu, 12 Jun 2014
Question: I have had irregular bleeding in between my periods the last few months. Usually it is midway to 1 week before my period and only lasts one day. It is enough to have to use tampons. When my period comes it lasts a 5-6 days and seems normal. My OB has done an ultrasound (negative) and has recommended a hysterosalpingogram like test-except it is under ultrasound. It sounds painful. What could be causing the bleeding and is it worth doing the test?
doctor
Answered by Dr. Aarti Abraham (45 minutes later)
Brief Answer:
AS BELOW

Detailed Answer:
Hello
Thanks for writing to us with your health concern.
I cannot figure out what test you are talking about.
It might be one of two things.
ONe is a hysteroscopy guided D and C.
This is not done under ultrasound guidance, but under direct laparoscopic vision, and a piece of uterine lining is picked up and sent for biopsy.
The other could be a plain D and C, sometimes, some doctors do it under ultrasound guidance.
Basically, in both procedures, a sample of uterine tissue is taken and sent for evaluation.
It sounds painful, but I assure you it is not, it is a simple few minutes procedure and adequate anesthesia ( pain killers ) would be provided.
The pre menstrual bleeding could be caused by a polyp, thickening of uterine lining ( endometrial hyperplasia ) due to hormonal imbalance, endometriosis etc.
Yes , it is worthwhile doing the test.
Also, can you upload the ultrasound scan report that has been done so far ?
Also thorough internal evaluation ( per vaginum and per speculum ) should be done.
Hormonal levels should be measured - FSH , LH, TSH, Prolactin, DHEAS, Free Testosterone.
Stress, anxiety, weight gain, erratic eating or sleep , alcohol, smoking , travelling - all these can sometimes cause irregular cycles.
Wellbutrin and Zoloft too interfere with normal cycles.
All the best.
Please feel free to discuss further.
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. Chakravarthy Mazumdar
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Answered by
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Dr. Aarti Abraham

OBGYN

Practicing since :1998

Answered : 6004 Questions

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What Causes Pre Menstrual Bleeding?

Brief Answer: AS BELOW Detailed Answer: Hello Thanks for writing to us with your health concern. I cannot figure out what test you are talking about. It might be one of two things. ONe is a hysteroscopy guided D and C. This is not done under ultrasound guidance, but under direct laparoscopic vision, and a piece of uterine lining is picked up and sent for biopsy. The other could be a plain D and C, sometimes, some doctors do it under ultrasound guidance. Basically, in both procedures, a sample of uterine tissue is taken and sent for evaluation. It sounds painful, but I assure you it is not, it is a simple few minutes procedure and adequate anesthesia ( pain killers ) would be provided. The pre menstrual bleeding could be caused by a polyp, thickening of uterine lining ( endometrial hyperplasia ) due to hormonal imbalance, endometriosis etc. Yes , it is worthwhile doing the test. Also, can you upload the ultrasound scan report that has been done so far ? Also thorough internal evaluation ( per vaginum and per speculum ) should be done. Hormonal levels should be measured - FSH , LH, TSH, Prolactin, DHEAS, Free Testosterone. Stress, anxiety, weight gain, erratic eating or sleep , alcohol, smoking , travelling - all these can sometimes cause irregular cycles. Wellbutrin and Zoloft too interfere with normal cycles. All the best. Please feel free to discuss further.