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What Causes Pre Menstrual Spotting?
Question: Dear Doctor, I had previously posted about this same condition few days ago. However, the question is now closed. So here is my question: The first day of my last period was on 17 Oct. I started spotting from 5th Nov onwards and that took me to the doctor. On transvaginal US it appeared as 16mm endometrium with cystic areas. Then MRI was conducted on 10 Nov. Results are: uterus 7.1 * 4.1*4.5 cm Normal in size and signal intensity. Thickened endometrium 16.5 mm. No obvious focal lesion. Junctional zone 3.5 mm Normal. No adnexal lesion bilaterally. No obvious pelvic lymphadenopathy. I spotted continuously from 5th Nov till 11th Nov. My next period started on 12 Nov and finished on 15 Nov. I expected that once the period is over, I should not have any more spotting. However, I am again back to spotting from 16th Nov. Today (17 Nov) also I spotted. I previously underwent a surgery to remove one of my ovaries (right ovary) due to an abnormal tumor (borderline tumor). I am quite concerned about this situation. Pl advice.
Brief Answer:
PLEASE PROVIDE MORE DETAILS
Detailed Answer:
Hello
Thanks for writing to us with your health concern.
Please let me know a few more details.
1. What is your height and weight ?
2. Prior to this have you always had regular cycles ?
3. Please upload the exact scan report, as opposed to typing it.
4. Please upload details and biopsy report of previous surgery too.
Please write back with the details so that I can opine further.
Take care.
PLEASE PROVIDE MORE DETAILS
Detailed Answer:
Hello
Thanks for writing to us with your health concern.
Please let me know a few more details.
1. What is your height and weight ?
2. Prior to this have you always had regular cycles ?
3. Please upload the exact scan report, as opposed to typing it.
4. Please upload details and biopsy report of previous surgery too.
Please write back with the details so that I can opine further.
Take care.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Dear Doctor,
As requested, please find attached two biopsy reports related to my previous surgeries. Then, please also find attached the latest follow up MRI scan for pelvic area.
My height is 156 cm and my weight is 60 kg.
From the time my surgeries were conducted, that is from the time one ovary was removed, my cycles were initially irregular. Sometimes with scanty bleeding, sometimes heavy bleeding followed by spotting, etc. However, from the past 3-4 cycles, they were getting into a pattern and were stabilizing. Then again, from this cycle onwards, the explained spotting started.
Looking forward to hearing from you.
As requested, please find attached two biopsy reports related to my previous surgeries. Then, please also find attached the latest follow up MRI scan for pelvic area.
My height is 156 cm and my weight is 60 kg.
From the time my surgeries were conducted, that is from the time one ovary was removed, my cycles were initially irregular. Sometimes with scanty bleeding, sometimes heavy bleeding followed by spotting, etc. However, from the past 3-4 cycles, they were getting into a pattern and were stabilizing. Then again, from this cycle onwards, the explained spotting started.
Looking forward to hearing from you.
Brief Answer:
ENDOMETRIAL HYPERPLASIA MOST PROBABLY
Detailed Answer:
Dear XXXX
Thanks for the updates.
There is actually nothing to worry about.
The complete surgery was done for the borderline ovarian tumour and that is fine .
Regarding the uterus, the endometrium ( lining of the uterus ) is thickened.
That is common just before the periods.
However, you are having pre menstrual spotting.
This condition is called endometrial hyperplasia ( thickening of the uterine lining, which then gets shed off sporadically and erratically, leading to spotting, typically before periods ).
This condition is most commonly due to hormonal imbalance, which occurs at certain phases of life.
Stress, anxiety, changes in weight, travelling, unaccustomed exercise, smoking, drinking, late nights, erratic eating - these are just some reasons.
What is your current height and weight ?
Do you smoke or drink, are diabetic or hypertensive ?
ANy family history of cancers ?
Just relax, what is needed next is an endometrial biopsy.
This is not a major surgery, it is a simple 2 minute outpatient procedure, where the lining of the uterus is sampled, and sent for biopsy.
The lab confirms the diagnosis of endometrial hyperplasia.
It is best and simply treated with 3 - 6 cycles of cyclical progesterone therapy, which helps in regular shedding of the lining and cures the condition.
Do not worry.
Schedule an appointment with your gynecologist at the earliest.
Take care.
ENDOMETRIAL HYPERPLASIA MOST PROBABLY
Detailed Answer:
Dear XXXX
Thanks for the updates.
There is actually nothing to worry about.
The complete surgery was done for the borderline ovarian tumour and that is fine .
Regarding the uterus, the endometrium ( lining of the uterus ) is thickened.
That is common just before the periods.
However, you are having pre menstrual spotting.
This condition is called endometrial hyperplasia ( thickening of the uterine lining, which then gets shed off sporadically and erratically, leading to spotting, typically before periods ).
This condition is most commonly due to hormonal imbalance, which occurs at certain phases of life.
Stress, anxiety, changes in weight, travelling, unaccustomed exercise, smoking, drinking, late nights, erratic eating - these are just some reasons.
What is your current height and weight ?
Do you smoke or drink, are diabetic or hypertensive ?
ANy family history of cancers ?
Just relax, what is needed next is an endometrial biopsy.
This is not a major surgery, it is a simple 2 minute outpatient procedure, where the lining of the uterus is sampled, and sent for biopsy.
The lab confirms the diagnosis of endometrial hyperplasia.
It is best and simply treated with 3 - 6 cycles of cyclical progesterone therapy, which helps in regular shedding of the lining and cures the condition.
Do not worry.
Schedule an appointment with your gynecologist at the earliest.
Take care.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
Thank you for your response.
I just want to let you know that now my period is over and I am again spotting. So in my case, is it possible to spot before and after period also?
My height is 156 cm and my weight is 60 kg.
Kindly advice.
XXXX
Thank you for your response.
I just want to let you know that now my period is over and I am again spotting. So in my case, is it possible to spot before and after period also?
My height is 156 cm and my weight is 60 kg.
Kindly advice.
XXXX
Brief Answer:
POSSIBLE
Detailed Answer:
Well yes it is quite possible because the lining might still not get completely shed off.
However, it is a hormonal imbalance and needs a biopsy to diagnose it, and cyclical progesterone corrects it in 90 % of cases.
POSSIBLE
Detailed Answer:
Well yes it is quite possible because the lining might still not get completely shed off.
However, it is a hormonal imbalance and needs a biopsy to diagnose it, and cyclical progesterone corrects it in 90 % of cases.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor, my gynecologist whom I had consulted wanted me to do D &C. She had earlier booked me in for the procedure on 18 Nov. So it was carried out for me yesterday. Unfortunately, I don't have a scanner now, hence I'm typing here the Discharge Summary.
"Principal Diagnosis: Submucous Fibroid.
Reason for Admission: Abnormal vaginal bleeding, history of borderline malignancy ovarian tumor. On transvaginal US thickened endometrium with cystic changes.
Intraoperative Findings: Thickened endometrium seen. On panoramic view slight depression seen at the fundus separating both ostia. Small submucous fibroid 1.5 cm anterior wall. Uterus sounded to 8cm, os dilated to 10mm, resection of submucous fibroid done with resectoscope. D&C done and specimen sent for HPE. Haemostasis secured. "
Please let me know your opinion as I'm concerned. My reports will come next week.
Thank you.
XXXX
"Principal Diagnosis: Submucous Fibroid.
Reason for Admission: Abnormal vaginal bleeding, history of borderline malignancy ovarian tumor. On transvaginal US thickened endometrium with cystic changes.
Intraoperative Findings: Thickened endometrium seen. On panoramic view slight depression seen at the fundus separating both ostia. Small submucous fibroid 1.5 cm anterior wall. Uterus sounded to 8cm, os dilated to 10mm, resection of submucous fibroid done with resectoscope. D&C done and specimen sent for HPE. Haemostasis secured. "
Please let me know your opinion as I'm concerned. My reports will come next week.
Thank you.
XXXX
Brief Answer:
SMALL FIBROID, AND UTERINE LINING, REMOVED.
Detailed Answer:
Hi XXXX
Thank you for the update.
As I told you there was thickening of the lining of the uterus, and it needed a biopsy.
THat is what was done, with a camera ( hysteroscope ).
Let me interpret the report for you.
Thickened endometrium was seen ( as expected ).
A small fibroid was seen, which was removed.
The fibroid as well as the thickened lining, both , were removed and sent for biopsy .
SO there is no cause for concern.
IT was a complete procedure again, and we need to wait for the biopsy report, which , in my opinion, will show no major abnormality.
You need to upload the biopsy reports also.
HOpe this clarifies the matter.
I am always open for more clarifications.
Take care.
SMALL FIBROID, AND UTERINE LINING, REMOVED.
Detailed Answer:
Hi XXXX
Thank you for the update.
As I told you there was thickening of the lining of the uterus, and it needed a biopsy.
THat is what was done, with a camera ( hysteroscope ).
Let me interpret the report for you.
Thickened endometrium was seen ( as expected ).
A small fibroid was seen, which was removed.
The fibroid as well as the thickened lining, both , were removed and sent for biopsy .
SO there is no cause for concern.
IT was a complete procedure again, and we need to wait for the biopsy report, which , in my opinion, will show no major abnormality.
You need to upload the biopsy reports also.
HOpe this clarifies the matter.
I am always open for more clarifications.
Take care.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor, thank you very much for your reply. As you would have sensed I'm quite nervous about the whole situation. I just wanted to know, if by chance, could a borderline tumor recur? I mean the scan doesn't show any abnormality, but can there be a possibility?
Additionally, I am surprised how both ultrasound and MRI scan didn't pick up this small fibroid.
Your inputs would clarify my doubts.
Thank you
XXXX
Additionally, I am surprised how both ultrasound and MRI scan didn't pick up this small fibroid.
Your inputs would clarify my doubts.
Thank you
XXXX
Brief Answer:
NO CONCERN ABOUT A TUMOUR
Detailed Answer:
Hello again.
There is no indication in the MRI or per operative hysteroscopic findings to be concerned about a borderline ovarian tumour.
The issue is intrauterine this time, not at all ovarian.
Recurrence rate of borderline tumours is less, less than 5 %, and with radical surgery that you have had, it is practically nil and tumour related deaths are unheard of.
IT is indeed strange that the fibroid was not detected on the ultrasound and MRI, it might have been obscured by the thickened uterine lining.
Do not worry.
Take care.
NO CONCERN ABOUT A TUMOUR
Detailed Answer:
Hello again.
There is no indication in the MRI or per operative hysteroscopic findings to be concerned about a borderline ovarian tumour.
The issue is intrauterine this time, not at all ovarian.
Recurrence rate of borderline tumours is less, less than 5 %, and with radical surgery that you have had, it is practically nil and tumour related deaths are unheard of.
IT is indeed strange that the fibroid was not detected on the ultrasound and MRI, it might have been obscured by the thickened uterine lining.
Do not worry.
Take care.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor, thank you very muchfor your reply and reassurance. It really means a lot.
Regards,
XXXX
Regards,
XXXX
Brief Answer:
THANK YOU FOR THE APPRECIATION. WISH YOU LUCK
Detailed Answer:
You are most welcome.
And you are very kind with your appreciation.
You can write in anytime using the following link , that would directly lead you to me .
http://doctor.healthcaremagic.com/doctors/dr-aarti-abraham/64623
Take care.
THANK YOU FOR THE APPRECIATION. WISH YOU LUCK
Detailed Answer:
You are most welcome.
And you are very kind with your appreciation.
You can write in anytime using the following link , that would directly lead you to me .
http://doctor.healthcaremagic.com/doctors/dr-aarti-abraham/64623
Take care.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor, one thing more I would like to check with you is that after the D& C, I am having almost like a light period. I am supposing this is normal. Please let me know when is it abnormal and when I have to seek medical attention.
Thank you
XXXX
Thank you
XXXX
Brief Answer:
NORMAL TO SPOT UPTO 2 WEEKS.
Detailed Answer:
After a D and C, or any other intra uterine procedure, for that matter, it is common to have light spotting / bleeding for a few days.
If it persists beyond 2 weeks, or turns into a really heavy flow with clots and excessive cramping, you need to see your doctor again.
Take care.
NORMAL TO SPOT UPTO 2 WEEKS.
Detailed Answer:
After a D and C, or any other intra uterine procedure, for that matter, it is common to have light spotting / bleeding for a few days.
If it persists beyond 2 weeks, or turns into a really heavy flow with clots and excessive cramping, you need to see your doctor again.
Take care.
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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