Constant spotting

[7costanza]

I’ve had near daily spotting since April and I’m losing my mind. I’ve had a Mirena since fall 2019 and had minimal spotting and periods until this spring. The onset of the spotting coincided with near crippling anxiety, which is now under control, but I’m not sure they’re related. In June my PCP put me on birth control (Apri) to try to control the spotting, which helped a bit. Last week I had the mirena removed and started a new pill (Jolessa, only supposed to have 4 periods a year with it). Two days after starting the new pill I started my period and have been spotting or full on bleeding since. Next step will be the fully continuous pill, which has significantly higher progesterone. She wants me to try the current pill for a couple months first but I’m very skeptical it’s going to resolve and am considering just asking for the high hormone one now.

I’ve always had issues with spotting when not on hormonal bc, and had to use progesterone in both my pregnancies, but this is beyond anything I’ve experienced before. My dr did a bunch of bloodwork and everything looked normal, she said I’m nowhere near menopause (I’m 37). She doesn’t suspect fibroids but I haven’t had an ultrasound or anything.

Has anyone had a similar issue and how did you fix it?

[expectantsteelerfan]

I take Seasonale bcp continuously so I'm not supposed to have a period, but for a while I was having spotting that would continue for months. But mine would stop if I did take the placebo week (or just stop taking the pill for a week) and then I'd get a full-blown period, and then the the spotting would stop for at least a month before starting again. My dr. 1st thought it was me taking my pill a little late that was triggering the spotting to start, but one month it started I swore I didn't not take a pill more than 5 minutes later than my regularly scheduled time, and eventually she realized one of the other medications I was on could be causing the pill to be less effective (and I was like HELLO SO GLAD I'M NOT USING THE PILL AS THE ONLY MEANS OF BC because I had been on that med for months and no dr. had told me it could make the pill less effective!).

You'd think drs. would consider everything else that you might be taking, but I'd at least start with making sure you have told them every other thing you take (even OTC stuff) to make sure nothing is causing the pill to be less effective.

[7costanza]

expectantsteelerfan Interesting, thanks! Maybe I’ll see if taking the placebo pills resolves the issue before switching. I only take vitamin D and B6 (to try to help with this issue, lol) and my doctor is aware but I’ll double check that neither interferes with the bcp.

[mofongo]

Im sorry:( as I’ve gotten older I’ve spotted and bled more erratically. I have endo and adenyosis, though. I think it’s the adeno as I’ve always had endo.

Anyway, what about an ablation? I had a hysteroscopy, where they insert a camera into your uterus, through the cervix. She took some biopsies and did some scraping, to make sure nothing else was going on.

Chronic cramping and bleeding is awful:(

[7costanza]

Oct 5, 2022 14:33:36 GMT -5 mofongo said:

Im sorry:( as I’ve gotten older I’ve spotted and bled more erratically. I have endo and adenyosis, though. I think it’s the adeno as I’ve always had endo.

Anyway, what about an ablation? I had a hysteroscopy, where they insert a camera into your uterus, through the cervix. She took some biopsies and did some scraping, to make sure nothing else was going on.

Chronic cramping and bleeding is awful:(

We did discuss an ablation but she said they’re typically pretty last resort so wants to wait a bit. She doesn’t do them so I’d have to see an actual gyn. Which I should probably do anyway.

[yaga]

I had constant spotting for about 5 years, and then intermittently for another few years. I tried all types of pills, the patch, and the ring. I have a history of both PCOS and endometriosis. It stopped completely after I had my first endo surgery. 😔

My endo (regular endo, not my RE) suggesting adding progesterone to my BC if it returned.

However, I really feel for you. It's incredibly frustrating. My GYN ran a few tests, but they didn't show anything and he seriously asked me if it was that big of a deal. I was dumbfounded. Yes, bleeding in some capacity out of my vagina DAILY for years is that big of a deal. The surgery for endo happened for other complications I ended up having, but seems like it could have been done a few years earlier. I no longer see that doctor.

[7costanza]

yaga 5 years?! Omg that sounds awful. And that doctor was an asshole. I think I need to push for more testing if I can’t get it under control with bcp.

[fryjack2]

Why is she hesitant to scan you? I had a polyp removed from my uterus that my doctor thought may be causing my random mid cycle bleeding.

I would ask for a scan of some kind of scan so that she can visualize anything that could potentially be contributing to the bleeding.

[fryjack2]

Oct 5, 2022 14:39:29 GMT -5 7costanza said:

Oct 5, 2022 14:33:36 GMT -5 mofongo said:

Im sorry:( as I’ve gotten older I’ve spotted and bled more erratically. I have endo and adenyosis, though. I think it’s the adeno as I’ve always had endo.

Anyway, what about an ablation? I had a hysteroscopy, where they insert a camera into your uterus, through the cervix. She took some biopsies and did some scraping, to make sure nothing else was going on.

Chronic cramping and bleeding is awful:(

We did discuss an ablation but she said they’re typically pretty last resort so wants to wait a bit. She doesn’t do them so I’d have to see an actual gyn. Which I should probably do anyway.

Oh! I missed that this is your PCP and not gyn managing this.  Yes, go to a gyn. 

[7costanza]

Oct 5, 2022 15:14:13 GMT -5 fryjack2 said:

Why is she hesitant to scan you? I had a polyp removed from my uterus that my doctor thought may be causing my random mid cycle bleeding.

I would ask for a scan of some kind of scan so that she can visualize anything that could potentially be contributing to the bleeding.

Did removing the polyp help? I am def going to go to a gyn if the spotting doesn’t stop in the somewhat near future.

[eddy]

I would also push for a scan. I think you have put in the time with this bleeding and one thing you have not ruled out is something like a polyp or cyst.

It sounds like she has been trying to manage your hormones, but there can be other causes of bleeding. I would want to rules those out at this point.

[glitzy07]

I was actually just at the GYN office when I read this post. I've been having similar constant spotting. My periods have gotten much heavier and I am probably bleeding or spotting 20 days a month. My doctor ordered an ultrasound and it turns out that I have some kind of pocket of fluid from my son's C-section 6 years ago that is causing the bleeding. But up until last year, I was on birth control that was regulating it by thinning the lining of my uterus. It's only in the last 6-9 months that the periods have gotten heavier and the spotting has gotten incredibly constant and annoying.

Unfortunately my options are to either go back on the pill or have one of two surgeries to stop it, one of which is a full hysterectomy.

[foundmylazybum]

I would schedule an appointment with a gynecologist as soon as possible.

You have tried hormonal options and they aren't working. Something else is going on and it's time to see someone who is more specialized.

[mofongo]

Ohhh, yes, please go see a gyn!

The doc shouldn’t be pushing more hormonal options, it’s been over 6 months!

[7costanza]

Thank you all!! I am going to call and get an appt with a gyn first thing tomorrow morning.

[7costanza]

Oct 5, 2022 15:51:49 GMT -5 glitzy07 said:

I was actually just at the GYN office when I read this post. I've been having similar constant spotting. My periods have gotten much heavier and I am probably bleeding or spotting 20 days a month. My doctor ordered an ultrasound and it turns out that I have some kind of pocket of fluid from my son's C-section 6 years ago that is causing the bleeding. But up until last year, I was on birth control that was regulating it by thinning the lining of my uterus. It's only in the last 6-9 months that the periods have gotten heavier and the spotting has gotten incredibly constant and annoying.

Unfortunately my options are to either go back on the pill or have one of two surgeries to stop it, one of which is a full hysterectomy.

Oh wow, something like that would have never crossed my mind. I hope whatever option you choose brings you relief!

[glitzy07]

Oct 5, 2022 16:26:00 GMT -5 7costanza said:

Oct 5, 2022 15:51:49 GMT -5 glitzy07 said:

I was actually just at the GYN office when I read this post. I've been having similar constant spotting. My periods have gotten much heavier and I am probably bleeding or spotting 20 days a month. My doctor ordered an ultrasound and it turns out that I have some kind of pocket of fluid from my son's C-section 6 years ago that is causing the bleeding. But up until last year, I was on birth control that was regulating it by thinning the lining of my uterus. It's only in the last 6-9 months that the periods have gotten heavier and the spotting has gotten incredibly constant and annoying.

Unfortunately my options are to either go back on the pill or have one of two surgeries to stop it, one of which is a full hysterectomy.

Oh wow, something like that would have never crossed my mind. I hope whatever option you choose brings you relief!

Me neither! Based on some of the conversations here and the one I had with my PCP, I thought that maybe an ablation would be recommended but not an actual surgery. Apparently the pocket of fluid is not actually causing any danger or anything, but the spotting will likely continue until I do something about it. For now I'm going to go back on the pill for the next couple of months and take some time to decide if either surgery would be a better option.

Good luck to you!

[wanderingback]

Abnormal bleeding should get a work up.
Now that the iud has been removed and eliminated as the cause should explore other things to rule things out and not just with blood work.
I’m not a gyn but I typically start with a pelvic ultrasound and then I do an endometrial biopsy. If both of those are normal then we discuss options for treatment and/or referral to gyn for another opinion.