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Post Coital Bleeding,pelvic Examination,ultra Sound,dark Brown Blood Stain

Posted on Sat, 26 May 2012

Question: i am 45 years old. 3 months ago i had a post coital bleed. I was referred to a consultant who did a pelvic examination and an ultra sound. I was reassured all was ok. I have just had another post coital bleed. Both have occurred on the 8th day of my cycle and have been after late periods. otherwise my periods are still regular. 36 hours after this last time i had a really dark brown blood stain on my pants. now 48+ hours later i have almost clear discharge but with a few brown/black "bits". I am now really scared! I had a normal smear 12 months ago

Answered by Dr. Dr. Rakhi Tayal (15 minutes later)

Hello,

Thanks for writing to us.

Post coital bleeding is most commonly seen due to chronic cervicitis or cervical polyp.

I strongly recommend that you must go for a repeat pap smear testing and if this episode repeats itself, even a cervical biopsy may be needed.

Vaginitis and bacterial infection like chlamydia or gonorrhea may also cause such episodes and can be diagnosed by vaginal swab examination. Antibiotics are needed for treatment.

Other causes that need to be excluded are uterine fibroids, polyps or endometriosis which are not likely in your case as you have already had a clear ultrasound examination.

I hope my answer and recommendations are adequate and helpful. Waiting for your further follow up queries if any.

Regards.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Dr. Rakhi Tayal (16 hours later)

so why didn't the consultant perform a colcoscopy last time? I am now really worried that something serious has been missed for the last 3 months. He seemed to just accept that my last clear smear a year ago was adequate.

Answered by Dr. Dr. Rakhi Tayal (12 minutes later)

Hello again,

Thanks for writing back.

Ideally PAP smear should be repeated every year or you can get yourself vaccinated against HPV to reduce the chances of cervical cancer.

Since the episode has happened twice, you do need to have investigations done.

Hope my answer is helpful.

Wishing you a trouble free speedy recovery.

Regards,

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Dr. Rakhi Tayal (1 hour later)

but are you saying then that cervical cancer is the most likely cause? Why didn't the consultant think of this? Why haven't I bled after sex every time and there has been a 3 month gap?

Answered by Dr. Dr. Rakhi Tayal (4 hours later)

Hello.
Cervical cancer is not the most likely cause but it has to be kept in mind while thinking of the diagnosis as it is the most serious of the causes and needs to be ruled out first. It is not necessary the diagnosis. The most likely cause is just an unhealthy cervix- inflammation or a hormonal imbalance .
Do not worry and wait for the PAP smear.
Hope this helps.

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. Raju A.T