This question was answered on Mon 16, Jan 2012 08:14am by Dr.Kokil Mathur

Bleeding and I am worried

    
Asked by prof_killian (Female; 48; No significant problems.; Relevant drugs:Diovan low dose. Prenatal Vitamin daily. ) on Mon 16, Jan 2012 07:52am
Priced at $39.00

I am 48 years old. I have started a vigorous work out twice daily. I missed my period last month. While having intercourse I began to bleed. It has been 9 days and I am still lightly bleeding. A panty liner doesnt get bloody just spots. The blood is bright red. There is no pain but there are times that I feel pressure and some discomfort at the end of urination. Any ideas?

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Answer by Dr.Kokil Mathur  on Mon 16, Jan 2012 08:14am:

Hi! At 48 years of age you could be going through premenopause, and this can miss periods once in a while until they stop completely. Also vigorous workouts can affect the hormonal balance in the body, and this can cause missed periods. However, all missed periods should be investigated for pregnancy and you should take a pregnancy test. If it is positive, then bleeding after intercourse can be due to local causes or due to threatened abortion and needs to be investigated immediately. The various other causes for vaginal bleeding after sex are injury and friction, STDs like Chlamydia, gonorrhea, and trichomoniasis, cervical polyps, yeast infections, non specific vaginitis, endometriosis, cervical dysplasia which is a precancerous condition, uterine polyps, uterine fibroids and cervicitis (inflammation of cervix). None of them are conditions that should be ignored. At your age non specific cervicitis can be the leading cause. Since there is pain at the end of urination, UTI or urinary tract infection can co-exist but will not cause spotting as you are having. Since a confirmed diagnosis cannot be given on net please discuss these possibilities with your gynecologist once and get the required tests like internal examination, PAP smear, vaginal swab test for STD, and ultrasound. Please feel free to ask anything else you may want to know. Take care!

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Comments:

Comment by Dr Rowena S, MD on Mon 16, Jan 2012 12:57pm:
Hi, Welcome to the forum! How are you? I agree with Dr. Kokil that this could indeed be a part of perimenopause or hormonal changes that your body is going through right now. But with the presence of pressure and discomfort after urination and missed period, urinary tract infection and pregnancy should also be ruled out with urine tests. Vaginal bleeding after sexual contact is a symptom that should not also be ignored because it can be a warning sign of serious conditions like precancer (dysplasia) or cancer of the cervix or uterus and sexually transmitted diseases such as chlamydia and gonorrhea. Other harmless differentials that cause bleeding that needs to be ruled out are cervical ectropion, inadequate lubrication, injury to the uterine lining, vaginal atrophy, vaginal dryness, friction, trauma or vaginitis. With regards to cervical ectropion, these are cells that are normally found inside the cervix but can also be found outside of the cervix. These can become irritated and inflamed by the higher acid content of vaginal secretions or during trauma. For proper diagnosis, it is best that you have this checked by your gynecologist for proper evaluation. A pelvic examination, including speculum exam and pap smear will help with the diagnosis. Take care and feel free to write us for further queries that you may have. Warm regards.

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