What is causing spotting?
Question
I am 35. I had a horrible menstrual history. I have endometriosis, fibroids, and heavy periods for 20 years. This past May I was placed on the pill because I was flooding a pad and tampon every 30 minutes. They checked my hormones, and blood tests, and except being anemic they said I was ok. The pill has made my periods light, and all is well. Last Saturday I started spotting. Could this be pregnancy? Or do you think my fibroids are bleeding? My period is due Saturday Dec 31st.
Teresa
Answer
Last Updated: July 24, 2013
Dear Teresa:
While it is possible that you are pregnant, the likelihood is very low. Most probably, you are having “breakthrough bleeding” which many women get while on the birth control pill. Many doctors will use “light” pills, meaning the dosage of artificial hormones in the pill is low compared to previous pills. This is to reduce the side effects of the hormones such as blood clots, high blood pressure, nausea, headaches, and low sex drive. However, there won’t be enough progesterone-type drug to keep the lining of the uterus intact and you will get spotting and bleeding before the period.
Yes, the fibroids are compounding the problem and women who have them will get heavy bleeding and/or spotting between periods. While you state that your hormone levels have been tested, I wonder if the progesterone levels were checked throughout the post-ovulation phase to see if you had enough of it for long enough. Many times women who have irregular cycles and/or extra spotting have inadequate progesterone levels throughout the full post-ovulation phase. Women have to be taught how to chart their cycles and then the doctor can order the progesterone checks at the appropriate time.
If your fibroids and endometriosis are so troublesome, I wonder why these were not surgically corrected. These are both associated with low fertility and/or poor pregnancy completion rates. Also, they seem to have caused you significant pain.
I hope that this helps you and your situation will get better!
Sincerely, Gretchen V. Marsh, D.O.
While it is possible that you are pregnant, the likelihood is very low. Most probably, you are having “breakthrough bleeding” which many women get while on the birth control pill. Many doctors will use “light” pills, meaning the dosage of artificial hormones in the pill is low compared to previous pills. This is to reduce the side effects of the hormones such as blood clots, high blood pressure, nausea, headaches, and low sex drive. However, there won’t be enough progesterone-type drug to keep the lining of the uterus intact and you will get spotting and bleeding before the period.
Yes, the fibroids are compounding the problem and women who have them will get heavy bleeding and/or spotting between periods. While you state that your hormone levels have been tested, I wonder if the progesterone levels were checked throughout the post-ovulation phase to see if you had enough of it for long enough. Many times women who have irregular cycles and/or extra spotting have inadequate progesterone levels throughout the full post-ovulation phase. Women have to be taught how to chart their cycles and then the doctor can order the progesterone checks at the appropriate time.
If your fibroids and endometriosis are so troublesome, I wonder why these were not surgically corrected. These are both associated with low fertility and/or poor pregnancy completion rates. Also, they seem to have caused you significant pain.
I hope that this helps you and your situation will get better!
Sincerely, Gretchen V. Marsh, D.O.
Answered By:
Gretchen Marsh, D.O.
Dr. Marsh graduated from Western University of Health Sciences in 1987 in Pomona, CA and is board certified in Family Medicine by the American Osteopathic Board of Family Physicians. She has been certified as a NaProTechnology® Medical Consultant (NaPro) and Creighton model Fertility Care System (CrMS) teacher since 2001. She and her husband, Jon, have 5 sons and live in the Reno region, where she sees patients in person, in addition to her telehealth services offered via MyCatholicDoctor.com
