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Dr. Andrew Rynne
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Dr. Andrew Rynne

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What causes vaginal spotting when diagnosed with multiple cysts on the ovary?

Answered by
Dr.
Dr. Richa Agarwal

OBGYN

Practicing since :1999

Answered : 3347 Questions

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Posted on Thu, 9 Nov 2017 in General Health
Question: Dear Doctor,

I was in touch with you few days ago.

As explained in my previous query, I had visited a Doctor in XXXXXXX due to abnormal spotting before period and followed by heavy period. I was informed of very low progesterone and multiple cysts on my ovary. The reports are as attached.

After treatment of Primolut for three months, I have stopped the treatment. The symptoms have returned again. The spotting has started on day 17 of my cycle. My next appointment with the doctor is in XXXXXXX 2018.

My question is having this type of spotting again warrant an emergency visit to the doctor or may I wait till XXXXXXX 2018? My next scheduled visit is in XXXXXXX 2018.

Thank you,
Abagtha
doctor
Answered by Dr. Richa Agarwal 30 minutes later
Brief Answer:
No need to visit again most likely.

Detailed Answer:
Hello dear,
Thanks for trusting me again about your health care.
I have gone through your reports and understand your concerns.
In your reports it shows your progesterone levels are low and due to hormonal imbalance only you are having spotting problem.
If you are not having any other symptoms along with spotting than you should not worry much about it and do not rush to the doctor before your appointment.
But if you are having any other associated symptoms like pain in abdomen along with spotting you must visit to your doctor.
Hope found useful,feel free to ask more information.
Good luck.
Regards
Above answer was peer-reviewed by : Dr. Vishesh Rohatgi
doctor
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Follow up: Dr. Richa Agarwal 15 minutes later
Dear Doctor,
The symptoms I have are spotting and heavy period. The only time I had pain was on the 15th day of my cycle, which has now disappeared. I do not know if this pain is significant enough to go to the doctor.
Regards
Abagtha
doctor
Answered by Dr. Richa Agarwal 2 hours later
Brief Answer:
Not very significant.

Detailed Answer:
Hello dear,
As you are having pain only for a day or it subsidies already than there is no need to worry about it.
If it is continuous in nature than we have to go for pelvic ultrasound to rule out the other causes.
Hope found useful.
Good luck.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Richa Agarwal 9 minutes later
Dear Doctor,
Okay thank you! I will then wait for my next scheduled appointment. Also, the doctor’s office has advised me to take Primolut again for another 3 months.
My question at this point is, for how long more a hormone therapy will be prescribed for me? I mean will the progesterone levels ever come back to normal for me?
I don’t know if my question is repetitive in nature with regards to the previous discussion we had. I am sorry if it is repetitive.
Thank you,
Abagtha
doctor
Answered by Dr. Richa Agarwal 2 hours later
Brief Answer:
You can take at least for 3-6 cycles.

Detailed Answer:
Hello dear,
You are always welcome.
As you are having heavy bleeding due to unopposed action of estrogen,so it is useful to take cyclic therapy of progesterone to control bleeding and cause withdrawal bleeding and reduce endometrial thickness.
You can go for 3-6 cycle of progesterone therapy without any harm.
If you are having any further clarification kindly ask me again, I am feeling comfortable in answeing you.so you should not worry about it.
Hope found useful.
Good luck.
Regards
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Richa Agarwal 43 minutes later
Okay Thank you Doctor! Yes, I am again prescribed Primolut for 3 months.
My spotting has started on day 17 of cycle. It used to happen before too! However, do you think starting so early in the cycle as a symptom of low progesterone is valid? I saw on websites that normally spotting can occur about 3-4 days before period and not 10 days before!

Lastly, why does low progesterone occur? Does it mean my ovary is not working well? Please note that I have only one ovary now, as the one was removed due to another issue!

Thank you
Abagtha
doctor
Answered by Dr. Richa Agarwal 2 hours later
Brief Answer:
Low progesterone due to lack of ovulation.

Detailed Answer:
Hello dear,
Low progesterone is due to lack of ovulation ( ovulation is not occur properly),so you are having low progesterone level.
Usually progesterone prescribed for 10 days in each cycle after ovulation ( as in normal cycle because progesterone usually released by follicles after ovulation).
In your case it is on lower side due to lack of ovulation, that is why we need progesterone in your case.( so we are usually following the normal menstrual cycle and give progesterone after ovulation to counteract the effect of estrogen otherwise in deficiency of progesterone thickening of endometrium occur ( due to unopposed action of estrogen).
So you can take it for another 3 cycles.
Hope able to clear your doubt, if any other questions kindly clear your doubt.
Hope found useful.
Good luck.
Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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