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Dr.Scheufele
Dr.Scheufele, Arzt
Kategorie: Medizin
Zufriedene Kunden: 19968
Erfahrung:  Allgemeinmedizin, Gynäkologie u. Geburtshilfe, über 20-jährige Praxiserfahrung
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Dear Dr Haver, Can you please help me For my last 3 cycles,

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Dear Dr Haver,
Can you please help me? For my last 3 cycles, I have been having spotting in between periods. The amount is tiny - only visible on toilet paper and not on underwear. It often seems to happen after a bowel movement. I had an abnormal PAP in December (PAP 3, as they call it here in Austria). This was due to inflammation. I was treated (vaginal suppositories for 5 days) and a repeat pap after this was normal. The doctor noted an ectropion which bled easily. Could this be the cause of my spotting?
Gepostet: vor 6 Jahren.
Kategorie: Medizin
Experte:  Dr.Scheufele hat geantwortet vor 6 Jahren.
Hello,

such an ectropion often causes a bleeding problem like this, espacially after sexual contact. As the PAP-Test came out normal now, there's no reason to worry. If the problem goes on, you should ask your gynecologist for an obliteration, this can be done ambulant and should resolve this bleeding easily.

Best regards,
Dr. N. Scheufele
Kunde: hat geantwortet vor 6 Jahren.
Thank you for your reply. It does not happen after sexual contact, but after bowel movements. Could bowel movements put pressure on the cervix which makes it bleed?

Could it not be a sign of cancer of the uterus or fallopian tubes? I know my ovaries are fine as I had a laparoscopy in October to remove cysts.

I am also worried it is a sign of a hormonal problem as I am hoping to try for my third baby this month. Could it signal a hormone problem or is it likely to just be the ectropion?
Experte:  Dr.Scheufele hat geantwortet vor 6 Jahren.
Bowel movements could also cause this kind of bleeding. Don't worry, because of the nromal PAP-result you are on the safer side, there is no danger for a cancer reason.
Light hormonal problems can play a roll in this case too, therefore I would recommend to take a herbal medicament called Mönchspfeffer (over-the-counter available in the pharmacy), which regulates the hormonal cyclus.

Regards,
Dr. N. Scheufele
Kunde: hat geantwortet vor 6 Jahren.
Is it safe to take Mönchspfeffer in pregnancy? And prior to conception?
Experte:  Dr.Scheufele hat geantwortet vor 6 Jahren.
When you become pregnant, this treatment should be stopped, but there is no danger to use it until coming to know about the pregnancy.

Regards,
Dr. N. Scheufele
Kunde: hat geantwortet vor 6 Jahren.
Thank you.

And, just going back to the PAP result, how can we be sure that the reliable test was the PAPII and not the PAPIII? I want to trust the pap2 as this is normal, but it was only 2 weeks after the pap3. Perhaps the dangerous cells were missed at the second test? (Although the doctor looked under a microscope at my cervix at the time, so does this make it more reliable?)

Finally, I have read that an ectropion can make it difficult to see cancerous cells on a pap. Is this true?

Thank you.
Experte:  Dr.Scheufele hat geantwortet vor 6 Jahren.
A PAPIII could occur because of an inflammation, so its definitely possible to get such a changing of the result after treatment, even in a short time. I assume that the colleague took the PAP-sample in a proffessional way, so you can trust in this result, even if there is an ectropion. To get the highest level of safety, I recommend to do a check again in 3 month.

Regards,
Dr. N. Scheufele
Kunde: hat geantwortet vor 6 Jahren.
So is it true that an ectropion can make it difficult to see cancerous cells on a pap? Can this mean something was missed?
Experte:  Dr.Scheufele hat geantwortet vor 6 Jahren.
No, even in case of an ectropion the PAP-result is secure, so you can definitely trust it.

Regards,
Dr. N. Scheufele
Dr.Scheufele und weitere Experten für Medizin sind bereit, Ihnen zu helfen.
Kunde: hat geantwortet vor 6 Jahren.
Thank you very much for your time
Experte:  Dr.Scheufele hat geantwortet vor 6 Jahren.
you're welcome ;-).

Best regards,
Dr. N. Scheufele
Kunde: hat geantwortet vor 6 Jahren.
Hello again.
Today I have spotting even without a bowel movement. I am very scared about what this might be. I am suffering from a cough and cold at the moment. Could the violent coughing cause the spotting?? I also have a borderline low thyroid (TSH 2.55 when normal range is up to 2.5). Could it be this? I am afraid of cancer.
Experte:  Dr.Scheufele hat geantwortet vor 6 Jahren.
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Kunde: hat geantwortet vor 6 Jahren.
I feel quite reassured that it's not cervical cancer because I have had regular paps, but could it not be uterine cancer or fallopian tube cancer? Or would this have been seen via the trans-vaginal ultrasaounds I had back in October? For a tumour to cause bleeding, would it have to be very big already??

Sorry to be so worried! I appreciate your reassurances.
Experte:  Dr.Scheufele hat geantwortet vor 6 Jahren.
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Kunde: hat geantwortet vor 6 Jahren.
Thank you for your reassurance. It is much appreciated.
Experte:  Dr.Scheufele hat geantwortet vor 6 Jahren.
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Kunde: hat geantwortet vor 6 Jahren.
Sorry - another worry has occurred to me. Could it possibly be early menopause? I have Hashimoto's disease of the thyroid and I just read that this can cause early menopause.

Can spotting be a sign of early menopause? My periods are regular, but I have had some night sweats recently, which is another worrying factor.

I believe I am ovulating however as I get an LH surge on an ovulation testing kit each month. Does this mean I can't be in pre-menopause??
Experte:  Dr.Scheufele hat geantwortet vor 6 Jahren.
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Kunde: hat geantwortet vor 6 Jahren.
So does the LH surge mean I am definitely ovulating?

And if I keep my thyroid levels in check with hormone replacement, does this mean I am not at higher risk of early menopause?
Experte:  Dr.Scheufele hat geantwortet vor 6 Jahren.
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