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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Vaginal Spotting With Normal Hormonal Assay?

iam married presently not with husband since 1.5yrs i would like to conceive when iam going vacation for 2 months presently i dont have irregular menustral bleeding .since 3 weeks i have mild vaginal bleeding either fresh or brownish everyday .i did hormonal assay everything normal.recently i got increased my weight too .164 cm height with 69 kg weight and iam 30 yrs old ,is it pcod how i can diagnose
Fri, 5 Dec 2014
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OBGYN, Maternal and Fetal Medicine,  's  Response
hi...going through the case history..as you have mentioned spotting/scanty menses, so we rule out pregnancy.(however in your case you are not staying with husband ,so it's different situation)secondly about what hormonal study you unerwent included is not clear s. TSH/S prolactin/s.estradiol,/s progesterone/s testosterone ??... ...commonly with pregnancy test negative...spotting happens in luteal phase defects with S progesterone low levels and is corrected by giving progesterone,say in your case with the desire to concieve,I would prefer duphaston 10 mg from D 16-26 of the cycle .As of now to stop bleeding t tranexamic acid tds would be started for 3 days.also an ultrasound uterus and adnexa to rule out PiD and accordingly antibiotic course to be given.....thirdly for PCos also we will go for Ultrasound to see the ovarian volume and no. of follicles and the ovulation study,also I would like to know if there is any hair growth on face , chin etc.also above hormones give us an insight into the diagnosis of PCOS.(plus S LH,SFSH,Glucose tolerance test,s lipid profile).then regarding weight gain..your BMI is nearly 26 so life style modifiction in terms of exercise and diet would help foremost to regularise periods and hence ovulayion also. work up has to be complete to reach a diagnosis.
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What Causes Vaginal Spotting With Normal Hormonal Assay?

hi...going through the case history..as you have mentioned spotting/scanty menses, so we rule out pregnancy.(however in your case you are not staying with husband ,so it s different situation)secondly about what hormonal study you unerwent included is not clear s. TSH/S prolactin/s.estradiol,/s progesterone/s testosterone ??... ...commonly with pregnancy test negative...spotting happens in luteal phase defects with S progesterone low levels and is corrected by giving progesterone,say in your case with the desire to concieve,I would prefer duphaston 10 mg from D 16-26 of the cycle .As of now to stop bleeding t tranexamic acid tds would be started for 3 days.also an ultrasound uterus and adnexa to rule out PiD and accordingly antibiotic course to be given.....thirdly for PCos also we will go for Ultrasound to see the ovarian volume and no. of follicles and the ovulation study,also I would like to know if there is any hair growth on face , chin etc.also above hormones give us an insight into the diagnosis of PCOS.(plus S LH,SFSH,Glucose tolerance test,s lipid profile).then regarding weight gain..your BMI is nearly 26 so life style modifiction in terms of exercise and diet would help foremost to regularise periods and hence ovulayion also. work up has to be complete to reach a diagnosis.