Periods, Spotting, Bleeding, Pap Smears Normal, Stress, Obesity, Endocrine Disorders

Posted on Fri, 18 May 2012

Question: Hello Doctor. I am a 48 year old female. I started my regular period on April 10. It started with spotting. It continued and increased in flow and tapered off around Wed. April 20. I noticed when I wiped after urination or wore a light flow tampon that I was still bleeding. I still have a regular cycles. I also get regular pap smears, my last being Feb.2011. It was normal. I have been the care taker for my mom since XXXXXXX 2011 and I travelled to NYC for work over the last few days. I am only sharing this so you can know my stress levels. Thanks for your help. I am still experiencing bleeding when I wipe.

Answered by Dr. Jasvinder Singh (38 minutes later)

Hello,

Thanks for posting your query. Two points that are important for your symptoms are: your age (perimenopausal) and the stress levels. Taking this into account an important possibility for your symptoms can be anovulatory dysfunctional uterine bleeding. this occurs in perimenopausal women who have some causative factors like stress, obesity, exercise, endocrine disorders or can be idiopathic.

In this what happens is that the corpus luteum that is responsible for secreting progesterone in the latter half of the menstrual cycle, does not do so and hence the levels of estrogens rise. Now you need to get a complete examination done from a gynecologist. although your PAP smear had come out normal in Feb 2011, yet some other investigations needs to be done. these include hemoglobin, luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin, T4, thyroid stimulating hormone (TSH), pregnancy (by βhCG), and androgen profile.

Depending on the cause, treatment may be prescribed. You may need combined estrogen and progestin tablets.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health and waiting for your reply.

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

Follow up: Dr. Jasvinder Singh (2 hours later)

Thanks for your answer. I will have those tests done when I get back to LA May 3. In the meantime I forgot to mention that I still have breast tenderness like a regular period. That's why I think it is hormonal too. Is this common with what you diagnosed?

Answered by Dr. Jasvinder Singh (21 hours later)

Hi,

Breast tenderness is usually not present in anovulatory dysfunction uterine bleeding and is usually present in ovulatory dysfunction uterine bleeding. However both are hormonal and hence the hormones levels need to be done.

Please consult your gynecologist and get it done.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.

Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

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