Hysterectomy Done. Taking Lupron For Recurring Symptoms Of Endometriosis. Concerned For Cervical Cancer

Posted on Mon, 8 Apr 2013

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Mon, 8 Apr 2013 Answered on

Mon, 29 Apr 2013 Last reviewed on

Question : I am 38yo that is post hysterectomy with right salpingoopherectomy in 2008. I recently had to restart Lupron for recurring symptoms of endometriosis however. Within the last 2 months I have had post coital bleeding and am concerned about cervical cancer. I most recent pap (fall 2012) was normal. Should I be concerned? I have no other symptoms other than some very mild discomfort with intercourse.

Answered by Dr. Timothy Raichle (2 hours later)

Hello, I would be happy to help you with your question.

When they did your hysterectomy, did they leave the cervix?

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Timothy Raichle (29 minutes later)

Yes, it was cervical sparing

Answered by Dr. Timothy Raichle (2 hours later)

Thank you for the followup information. I am sorry for the delay.

In the setting of prior normal pap smears, the concern about cervical cancer is extremely low. Consider that putting you on Lupron temporarily makes you menopausal. This leads to low estrogen levels and 'thinning' of the skin in the vagina. Due to this 'thinning' and fragility of the vagina, pain with intercourse, and even bleeding with intercourse is not uncommon. In fact, this is a common complaint among post-menopausal women.

The best thing to do would be the following:
1. Schedule a visit with your OB
2. Have them do an exam to evaluate my theory
3. If there is no other explanation for the bleeding, then ask for vaginal estrogen. The best way to deliver this (without exacerbating your endometriosis) is a tablet called Vagifem
4. You need to use lubricants with intercourse, such as Astroglide.

Do not worry about cancer - this is extremely unlikely! Good luck.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar