What Causes Abnormal Vaginal Spotting?

Posted on Thu, 5 Mar 2015

Question: I have been on Estrace 1mg and Provera 2.5 mg since Nov of 2014 for hot flashes and in January Nurse Practitioner had to in crease my Provera to 5 mg due to abnormal menstrual cycle less than 8 days apart, now I am having abnormal spotting every day, it's like when i go to restroom and wipe afterwards there is blood on tissue and a little in toilet. I have been trying to get lpn to relay info to NP twice to be exact but she seems to want to give me her opinion of what I need to do. Finally I told her I didn't need her opinion, I needed dr or np's advise. This has gotten very aggravating and the earliest I can get in to see dr or np is the end of the month, any suggestions? Do I need to discontinue using these meds or reduce dosage myself or what?

Answered by Dr. Shanti Vennam (21 minutes later)

Brief Answer:
Dosage needs adjustment.

Detailed Answer:
Hello,

Thanks for trusting us with your health concern.

I think several factors could be at play for the current situation. Firstly, the dwindling natural hormones at around menopause increase the need for hormone supplements constantly and if this need is not properly met, breakthrough bleeding ensues.

Secondly, weight management becomes tough in perimenopausal phase and this in turn creates further hormone imbalance. Diet regulation and proper exercise are mandatory.

In the current scenario, I think you may need to increase the hormone doses after proper evaluation of the hormone status of the body, a proper clinical assessment, sonogram and a pap smear. If you discontinue using the medication abruptly, bleeding disturbances continue to persist. The dosage needs to be adjusted and tapered slowly if you do not wish further hormone supplementation.

Hope your query has been clarified. Please feel free to contact for further information. I will be happy to help.

regards,
Shanti.V.

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

Follow up: Dr. Shanti Vennam (8 minutes later)

Would it be appropriate to increase dosage to7.5 or 10mg or just continue regime until I go for apoint mentioned at end of month.

Answered by Dr. Shanti Vennam (17 minutes later)

Brief Answer:
Can increase the dosage step-wise.

Detailed Answer:
Hi,

Thanks for writing back.

You can increase the dosage step-wise to titrate the optimum level if your doctor's appointment is way too far. Thus, you may increase the dose to 7.5 mg. and check for a couple of days to see if the bleeding gets arrested; if not, you may need to increase it further to 10 mg. Simultaneously, you can also take styptics and vitamin supplements.

Hope this helps. Please contact if you need any further help. I will be glad to do so.

regards,
Shanti.V.

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

Follow up: Dr. Shanti Vennam (18 minutes later)

Thank you

Answered by Dr. Shanti Vennam (14 minutes later)

Brief Answer:
Welcome any time.

Detailed Answer:
Hi,

You are most welcome to ask for help any time. I will be available.

Wish you good health.

regards,
Shanti.V.

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