What Is The Reason For Irregular Bleeding Pattern And Red Stained Mucous Discharge?

Posted on Thu, 19 Apr 2012

Question: I am a 39yo trainee GP (family physician), healthy with BMI 25, have 3 children all born by C-section. Youngest is 19 months old and breastfeeding only morning and evening now, not through the day. My periods returned about 6m after she was born, and are very regular at 26 days between cycles. In the last 3-4 cycles, I have had a strange bleeding pattern with 2 days of light, red blood; then nothing at all (not even spotting) for further 1-2 days, followed by darker red / brown stained mucous taking me out to day 11 - 12 or so of the cycle. There is no bleeding after the mucous changes to the thin stringy ovulation mucous. Is this a common pattern or is an ultrasound (or other investigations) indicated? Thanks

Answered by Dr. Chetna Jain (5 hours later)

Dear Dr,

Spotting or any bloody discharge is not normal once menses are over except mid cycle ovulation bleed.

So I suggest you to get the following done:
1. Gynecological examination.
2. Pap smear
3. Trans-vaginal ultrasound

If there are no abnormality in the above tests, you can take a course of antibiotic.

If spotting persists despite the above measures you will have to get an opd endometrial biopsy.

Best wishes.

Regards,

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

Follow up: Dr. Chetna Jain (12 hours later)

Thanks for your reply Dr XXXXXXX I do have some followup questions.

Can you call menses over when I have only bled for two days? Previously I would bleed for at least 5 days and sometimes the last brownish discharge would persist to day 7.
I had a normal pap 12m ago (with exam); and my paps have always been normal.
I wondered if fibroids or polyps could block the cervix preventing / partially preventing the outflow of the shed endometrial lining?
I will definitely book an US.

Thanks for your time,

Jane

Answered by Dr. Chetna Jain (23 hours later)

Hi XXXXXXX

Thanks for the follow up.

Whatever is the duration of flow monthly cyclical bleed is
menses. The lesser bleeding in menses is unlikely to be due to
blockage from a polyp or fibroid. If so ,the blood collection in
uterine cavity will be seen by ultrasound. A gynecological examination is a must.Please do not avoid that.

Regards

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