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What Causes Persistent Intermenstrual Spotting And Bleeding With Blood Clots?

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Posted on Tue, 29 Dec 2015
Question: i was suffering from spotting in between periods in July 2015. since then for last 5 months i am on cycloreg 10 mg to be taken once a day starting from 5th day of the cycle. for last 4 months my regular periods were scanty. as my haemoglobin level was 9.43 and was not increasing with diet i was advised 4 orofer intravenous iron injections one to be taken each week. i have completed course of 3 iron injection. this time i have observed that i had heavy periods with clots wherein i had to take 3 pads a day. this type of periods i had during 2013 whole year. but since XXXXXXX 2015 they had become scanty but stretched for 6-7 days. i would like to know if heavy periods and clots are normal. can cycloreg be the cause of this. can iron injection cause blood clots in menstrual blood. i had checked for endometriosis in august CA-125 test was normal. 4 months ago the sonography of uterus too was normal. there was just one clear water cyst which was not there in the next sonography test. i am worried of the heavy periods with clots for this cycle. please clear my doubtsi was suffering from spotting in between periods in July 2015. since then for last 5 months i am on cycloreg 10 mg to be taken once a day starting from 5th day of the cycle. for last 4 months my regular periods were scanty. as my haemoglobin level was 9.43 and was not increasing with diet i was advised 4 orofer intravenous iron injections one to be taken each week. i have completed course of 3 iron injection. this time i have observed that i had heavy periods with clots wherein i had to take 3 pads a day. this type of periods i had during 2013 whole year. but since XXXXXXX 2015 they had become scanty but stretched for 6-7 days. i would like to know if heavy periods and clots are normal. can cycloreg be the cause of this. can iron injection cause blood clots in menstrual blood. i had checked for endometriosis in august CA-125 test was normal. 4 months ago the sonography of uterus too was normal. there was just one clear water cyst which was not there in the next sonography test. i am worried of the heavy periods with clots for this cycle. please clear my doubts
doctor
Answered by Dr. Deepti Verma (18 minutes later)
Brief Answer:
Please get properly investigated

Detailed Answer:
Hi dear, I have gone through your question and understand your concerns.
Intermenstrual spotting and bleeding can be due to fibroids, endometrial pathologies like dysfunctional uterine bleeding, endometrial hyperplasia or carcinoma, or due to local lesions in cervix or vagina.
Heavy bleeding in this cycle can be due to the effect of the cycloreg or due to one of the above causes.
Injection of iron do not cause such symptoms.
In my opinion, you should get the following investigations done to determine the cause of abnormal bleeding pattern, before taking any treatment:
1. Pap smear to rule out cervical precancerous or cancerous lesions
2. Uterine endometrial biopsy to rule out its pathologies.
3. A proper internal examination by an OBGYN specialist to rule out any local lesions in the vagina or cervix like polyp.
Hope you found the answer helpful. Please do get back for further queries.
Wishing you good health.
Regards
Dr Deepti Verma
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Deepti Verma (15 minutes later)
gynaec has physically internally checked me. we have done sonography to check for fibroids a couple of months ago. sonography was normal. i had pap smear done 2 years ago which was normal. we have done CA - 125 test which was normal hence ovarian tumour and endometriosis was ruled out. should there still be cause to worry about clots or cancer??????
doctor
Answered by Dr. Deepti Verma (8 minutes later)
Brief Answer:
Do not panic

Detailed Answer:
Hi dear,
I am sorry if I made you more worried, but it is always advised to confirm the cause of abnormal uterine bleeding in females more than 35 years of age.
If the internal examination and pap smear are normal, then an endometrial biopsy should be done.
Mostly, the cause of such abnormal bleeding in this age group is hormonal changes in the endometrium called dysfunctional uterine bleeding, and it needs medical treatment.
However, endometrial hyperplasia and carcinoma, which are rare possibilities, should be ruled out before proceeding for treatment.
I suggest you not to panic.
Regards
Dr Deepti Verma
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. Deepti Verma

OBGYN, Maternal and Fetal Medicine

Practicing since :2009

Answered : 5064 Questions

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What Causes Persistent Intermenstrual Spotting And Bleeding With Blood Clots?

Brief Answer: Please get properly investigated Detailed Answer: Hi dear, I have gone through your question and understand your concerns. Intermenstrual spotting and bleeding can be due to fibroids, endometrial pathologies like dysfunctional uterine bleeding, endometrial hyperplasia or carcinoma, or due to local lesions in cervix or vagina. Heavy bleeding in this cycle can be due to the effect of the cycloreg or due to one of the above causes. Injection of iron do not cause such symptoms. In my opinion, you should get the following investigations done to determine the cause of abnormal bleeding pattern, before taking any treatment: 1. Pap smear to rule out cervical precancerous or cancerous lesions 2. Uterine endometrial biopsy to rule out its pathologies. 3. A proper internal examination by an OBGYN specialist to rule out any local lesions in the vagina or cervix like polyp. Hope you found the answer helpful. Please do get back for further queries. Wishing you good health. Regards Dr Deepti Verma