Hysterectomy Pathology Report - Hemorrhagic Endometrium

So, I have a strange question for you. I had my hysterectomy due to severe anemia. I need frequent iron infusions and they make me pretty ill.

I was reading the pathology report and it said the endometrium was hemorrhagic. I know that means I was bleeding or getting ready to bleed but I know my periods and I had finished a week and a half prior to the surgery and had no signs of starting up again right before surgery. I had Adenomysis and definitely had signs in the days leading up to my period. It was never a surprise.

So my question is could there somehow have been internal bleeding? Can you bleed internally through the uterus? I don't see how but I had two c-sections. They also found multiple small fibroids in the internal wall of my uterus. Both Adenomysis and fibroids can account for my anemia but I am just wondering if there could also have been internal bleeding because I still needed infusions even when we stopped my period with pills.

Any thoughts? I'll ask my doctor at my next appointment as well.

Thank you.

My pathology report showed adenomyosis as well - it was a post-op finding, not something my doctor checked for since I had a uterus full of fibroids. Supposedly I was menopausal, but after getting off BC pills at age 53, I was having "periods" (they weren't anything like I used to have) anywhere from 13-54 days apart. According to the report, I had "secretory phase endometrium", somewhere between 14-28 days in the cycle.

Like normal uterine lining, the endometrium trapped in the uterine walls (adenomyosis) tries to bleed and shed, but it's held within the muscle walls. That often accounts for the enlarged and rather non-elastic uterus we have. There's a good article here on Adenomyosis Basics which is informative. Cause isn't known, though there are theories; I never had a c-section, so that wouldn't have played into my condition.

Adeno can cause clots, breakthrough bleeding (I sure had this), and anemia. One source I've read explains that the build up can eventually escape the uterine walls. It sure seems plausible that adeno could have been a source of internal bleeding for you. Hopefully once your iron levels have returned to normal you won't need any more infusions, since you're not bleeding anything off anymore At almost 9 months post-op, I can say that I don't miss my monthly cycle.

Let us know what your doctor says - you've got me curious!