I am 26 years old, for 4 years I have been struggling with periodic blemishes. It started after three years of taking the oral hormonal contraceptive - Logest. Assuming these pills stopped keeping my cycle going, for the next 2 years I changed pills (these were Novynette, Midiana, Jeaninne, Yaz). After nothing had improved, my partner and I decided it was time to give up this method of contraception. It was August 2012. At that time, I had two normal cycles, 26 days, just like before I started taking hormonal contraception. Then the spotting reappeared. In the beginning, before and after menstruation. But then I didn't know when my cycle started and ended, I was able to stain for a few days, stop for 2-3 days, bleed again for 2 days, and so on. Now, spotting again occurs mainly 7-10 days before menstruation, then 5-6 days before menstruation and 3-4 days afterwards. So far, I have had several cytology tests (always group II), all hormonal tests. All the results are normal. The only fluctuations were between days 2 and 4 of the cycle, the LH: FSH ratio was 0.7. However, on the 10th day of the cycle, it was already 0.93. Progesterone on day 22 of the cycle was slightly above normal, but apparently doing well. Estradiol on the 2nd day of cycle 39, on the 10th - 55th, on the 13th - 170th Apparently this is a bit too small increase, but each time the estradiol was within the lab norms. TSH is a bit too high (4.13 - the norm is 5) considering the fact that we have been trying for a child since September 2013. So I take Euthyrox in a dose of 37.5. I haven't repeated my TSH test yet. Blood clotting results are in the middle of the norm. Neither the hematologist nor the neurologist see any indications for specialist examinations (e.g., MRI). In April 2014 I had a hysteroscopy. Histopathological examination showed no changes (only endometrium in the growth phase). However, during hysteroscopy, it was noticed that the fallopian tubes were swollen with blood, and it was enough to touch them with a webcam to spill the blood. So I did tests for chlamydia, ureaplasma and mycoplasma - they all came out negative. In April and May this year I was taking Cyclo-Progynova (HRT) to stabilize my bleeding. It was even worse. I did NOT bleed for 5 days in April (until hysteroscopy), in May for 8 days (currently having my period). My periods are painless. Onlyon the first day, sometimes my ovary hurts or my abdomen slightly hurts. The stains, however, are getting more intense and longer. Red bleeding often appears, sometimes with clots. During the cytology in May, the cervix began to bleed intensely (I had my previous cytology in February - group II), as if after contact with the sampling tool. Swabs from the cervical canal, of course, also remain unchanged (only bacteria typical of the vaginal flora, i.e. lactobacillus - moderately numerous). Doctors say that since the results are normal, there is no point in taking me to the hospital for additional tests. They believe that - because of this contact bleeding from the cervix - it is best to clean the uterine cavity and the cervical canal and do a colposcopy. I admit that I am a little scared. The proposed methods are quite invasive and I am planning offspring. Moreover, since the examination of the endometrium after hysteroscopy did not show any changes, I have the impression that everything is fine with the endometrium and there is no point in doing this test. I am concerned about the fallopian tube orifices that bleed when touched. Is it possible that they are bleeding, not the endometrium? For what reason? However, is cleaning definitely advisable? If so why? Or maybe you recommend some more research? I would like to add that I plan to make tumor markers next week.
Inflammation is a common cause of bleeding when touched. Long, unresponsive bleeding, without a diagnosed cause, is an indication for histopathological examination. Uterine curettage may be performed, but a biopsy may also be performed. The attending physician decides about the scope of the procedure.
Remember that our expert's answer is informative and will not replace a visit to the doctor.
Barbara GrzechocińskaAssistant professor at the Department of Obstetrics and Gynecology at the Medical University of Warsaw. I accept privately in Warsaw at ul. Krasińskiego 16 m 50 (registration is available every day from 8 a.m. to 8 p.m.).
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