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What causes spotting while on birth control, abdominal pain and diarrhea during menstruation?

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Posted on Tue, 26 May 2015
Question: hi i continue to spot when i am on birth control. right now i am on cilest. I have tried 3 different kinds of birth control but everytime i start to spot. in january i was checked again with pap smear negative and also hpv negative. Could i still have cell changes and that be why or bleed. I furthermore have severe pain around my periods which include diarrhea etc. my doctor has suspected endometriosis. I sometimes have some pain around my navel which comes along with the bleeding. i am now 8 days in my pill package. Do you think i need to stop taking the pills or could all this be related to endometriosis?
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Answered by Dr. Manisha Jain (25 minutes later)
Brief Answer:
Transvaginal ultrasound advised

Detailed Answer:
Hello dear, thanks for trusting health care magic.
This spotting in between periods despite of being on birth control pills is not a good sign.
I would like you to get a transvaginal ultrasound and pelvic examination by a good gynecologist.
Most common reason can be inadequate estrogen support by your birth control pill but it can also be due to some endometrial pathology like increased thickness of endometrium or a polyp inside uterus.
Your other history of severe pain in periods and Pain around naval area is consistent with endometriosis and ultrasound is a must to evaluate that too.
Till then keep taking your pills as before without a miss and in case spotting is bothersome then you can take tablet tranexemic acid 500 mg to stop it.
Get the ultrasound done and then we can discuss further management.
Take care
Regards
Dr Manisha
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Manisha Jain (4 minutes later)
but you dont expect cancer since you write polyp?
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Answered by Dr. Manisha Jain (18 minutes later)
Brief Answer:
polyp is common than cancer at your age

Detailed Answer:
You have less chances of cancer because you are young in age with negative pap and subtle bleeding history.
But definitely risk is still there, thats why I have asked you for ultrasound already to see for endometrial thickness which will give us an idea about the likely chances of malignancy and other causes of intermenstrual bleeding.
Polyp is the most common cause and much commoner than cancer.
So ultrasound is a must to know the likely cause and to decide further management.
Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Manisha Jain

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Practicing since :2007

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What causes spotting while on birth control, abdominal pain and diarrhea during menstruation?

Brief Answer: Transvaginal ultrasound advised Detailed Answer: Hello dear, thanks for trusting health care magic. This spotting in between periods despite of being on birth control pills is not a good sign. I would like you to get a transvaginal ultrasound and pelvic examination by a good gynecologist. Most common reason can be inadequate estrogen support by your birth control pill but it can also be due to some endometrial pathology like increased thickness of endometrium or a polyp inside uterus. Your other history of severe pain in periods and Pain around naval area is consistent with endometriosis and ultrasound is a must to evaluate that too. Till then keep taking your pills as before without a miss and in case spotting is bothersome then you can take tablet tranexemic acid 500 mg to stop it. Get the ultrasound done and then we can discuss further management. Take care Regards Dr Manisha