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What Causes Spotting And Irregular Menstrual Bleeding?

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Posted on Mon, 6 Jun 2016
Question: Dear Doctor,
It is now 8 days since abnormal spotting and bleeding has started for me.
First it was only like spotting that could be seen only on toilet tissue. However, now the amount of bleeding has increased and it reaches the pad like a light bleeding. Sometimes I notice small speck of tissue or fibrous material along with the blood.
The doctor I consult told me that I need to come back to her only after my period.
Till then really I am left confused whether the problem is due to uterine polyp or ovarian cyst!
I hope the problem is nothing serious and things will settle down.
Regards
XXXXX
doctor
Answered by Dr. Aarti Abraham (20 hours later)
Brief Answer:
More likely to be the polyp

Detailed Answer:
Dear XXXXX,
Thank you for getting back in touch.
I genuinely think that the spotting is due to the polyp.
There was no cyst seen in the scan that was done recently.
SO that is really not likely.
Yes, the polypectomy, if needed, will be done after your next period, so they will re examine you after your next period.
DO not worry, a polyp recurs and is very irritating in that aspect, but it is not life threatening.
I can understand your dismay though !
Take care.
And I am so sorry for the delays in my response, will be more prompt next time.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Aarti Abraham (4 hours later)
 Dear Doctor
Thank you for your reply and reassurance about my situation.
I do hope it is only a polyp as you say. There was no cyst reported in the scan of 24th. However, the only thing that bothers me is that the gyneac told me that the follicle(s) is still there and when she zoomed in a lot she could see a small dark portion.
I can put up with bleeding, another D&C , etc but I really don't want another borderline case. .....
I would like to inform you that my period started today. so today will be Day 1.
I have a question. If till 24th I had maturing follicles and 29th a cyst, and with my period starting off yesterday. ...It has been only around 7-9 days since I would have ovulated. Is this time frame enough for the cyst to die?
I hope my ovary will be normal when I go in next week to see the doctor.
Regards,
XXXX
doctor
Answered by Dr. Aarti Abraham (17 hours later)
Brief Answer:
As below

Detailed Answer:
Hello dear.
Yes, I understand your concern.
Yes, the cyst can resolve in that time period, that often happens if it is a simple cyst.
Please do not worry about that.
And yes, a simple surgery can remove the polyp, even if is there.
Let me know the findings of the review ultrasound scan.
Will pray that it is indeed not an ovarian tumour, I do not think it will be the case.
When you had a borderline ovarian tumour last time, did you have the issue of spotting at that time ?
Was only the tumour removed or the whole ovary ?
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Aarti Abraham (11 minutes later)
Dear Doctor,
Yes, I had spotting problem when i had the tumor, but that spotting was different. It was more like a few drops. This time instead the spotting and bleeding resembles more of the time that i had the polyp. I so hope it is a simple cyst and it has disappeared. Will revert back to you with the findings of next ultrasound.
The previous time with the borderline case, the entire ovary was removed along with tube.
Regards,
XXXXX
doctor
Answered by Dr. Aarti Abraham (1 hour later)
Brief Answer:
As below

Detailed Answer:
Okay, since entire ovary was removed, risk of recurrence is low.
Please stop worrying.
Only the repeat scan will tell you the facts. so keep your fingers crossed.
Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Aarti Abraham (4 hours later)
Dear Doctor,

I know I must stop thinking about all this and rest my case till next scan. However, I just can't stop and so many doubts and queries come up.

I think I have one more query and I hope you will understand and help me out.
The doctor who scanned me is an experienced radiologist. However, the scan was done only as abdominal one and not as transvaginal.

I just want to ask you, can any cyst(s) with tiny solid part on the wall of it be missed out through abdominal scan? Is it possible? Or are abdominal scans equally clear as transvaginal?
I ask this because I was under the impression that transvaginal scans are the most clear ones.

Thank you in advance.
XXXX
doctor
Answered by Dr. Aarti Abraham (3 hours later)
Brief Answer:
As below

Detailed Answer:
Dear XXXXX
You have been in touch with me since a long time.
I can understand your anxiety and it is natural.
Please ask me as many questions as you want, even if you find them silly, because I never find anything silly or unimportant.
It is my honour that you choose me to give you guidance during stressful times.
I was not aware at all that only an abdominal scan was done.
A lot of pelvic details, most importantly, a polyp, can be missed on abdominal scans.
Only a transvaginal scan is clear and useful for knowing about polyps or cysts.
Please insist on a transvaginal scan next time.
It is much more useful and accurate for pelvic conditions.
And you are a very intelligent person to have thought of this.
I assumed it was a TVS ( transvaginal scan ).
Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Aarti Abraham (33 minutes later)
Dear Doctor,
Yes, the first scan, which I also uploaded on the website, was only abdominal. And it was reported as Graffian follicles with one matured follicle. However, the second time, at the gyneac, it was transvaginal in which the same follicle looked like a cyst.
So this means the abdominal scan can have a margin of error!
Great ...! It only adds to the anxiety. ...I have my next scan on 11th. I hope it will be all clear.
Regards,
XXXXX
doctor
Answered by Dr. Aarti Abraham (10 hours later)
Brief Answer:
As below

Detailed Answer:
Okay, I am more confused now.
I thought only one ultrasound scan was done !
Anyways, you just have to ensure that the scan done on the 11th will be transvaginal, and if possible done by the gynecologist .
Try and get the printed report and the images, so that you can upload them and send them to me.
Best of luck.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Aarti Abraham

OBGYN

Practicing since :1998

Answered : 6004 Questions

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What Causes Spotting And Irregular Menstrual Bleeding?

Brief Answer: More likely to be the polyp Detailed Answer: Dear XXXXX, Thank you for getting back in touch. I genuinely think that the spotting is due to the polyp. There was no cyst seen in the scan that was done recently. SO that is really not likely. Yes, the polypectomy, if needed, will be done after your next period, so they will re examine you after your next period. DO not worry, a polyp recurs and is very irritating in that aspect, but it is not life threatening. I can understand your dismay though ! Take care. And I am so sorry for the delays in my response, will be more prompt next time.