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Bleeding 8 mos. post-op--Update, stopping hormones:  anyone else gone w/out hormones? Bleeding 8 mos. post-op--Update, stopping hormones: anyone else gone w/out hormones?

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Unread 11-14-2010, 12:03 PM
Bleeding 8 mos. post-op--Update, stopping hormones: anyone else gone w/out hormones?

I am going crazy here trying to figure out what is going on. Please bear with me while I try to explain fully. I had a complete LAVH with tubes ovaries and cervix all removed due to problems with endometriosis. I seemed to have an uneventful healing process. At about 5 mos. post-op I started having some bleeding again. Bright red, sometimes very little, sometimes more. It wasn't happening every day, I would have some for 2 or 3 days in a row, then nothing for 2 or 3 days. I reported this to my doc who did a very thorough pelvic exam thinking it would be granulation tissue and found none. The bleeding continued and at 8 mos. post-op he did another pelvic, and also a vaginal ultrasound and still found nothing unusual. This past week he took me back into surgery to check even more thoroughly thinking maybe it still was granulation in an area he couldn't see in the office. He still found none, but he said he opened up and re-sealed the vaginal cuff and treated me with vaginal estrogen cream. Now, not only is he stumped, but I am freaking out as to where this could be coming from. He told me to go off my oral estrogen and just use the vaginal cream to see if this might be the culprit, but I have no way of affording the vaginal cream he prescribed. PLEASE, please somebody has to have gone thru this and might be able to shed some light on this for me. I am very emotional right now, and my husband is no help...I feel like I am losing my mind......HELP!!!!!!!
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Unread 11-14-2010, 12:40 PM
Re: Intermittent vaginal bleeding 8 mos. post-op

Hi there - I too had some vaginal bleeding this week - 5months post op after TAH . Never really had any bleeding after op but this too was bright red. Only lasted a very short time, but prior to the bleed my stomach felt very heavy for a few days. After the bleed, it felt back to normal. Not sure whether I did too much or twisted or jolted myself and I am waiting for an appointment back with the consultant. Very worrying time. If anyone else has had this type of bleeding perhaps they would be so good at explaining what is going on with us.
Unread 11-16-2010, 11:46 PM
Re: Intermittent vaginal bleeding 8 mos. post-op

Okay, so once again, its been 3 days since the surgery to check for granulation and this morning I had a little bleeding again.....Someone, somewhere has got to be able to shed some light here for me. Any kind of input would be helpful and welcomed. I know I can't be the only one having this problem with no signal as to what is going on....ANYONE???????
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Unread 11-17-2010, 08:16 AM
Re: Intermittent vaginal bleeding 8 mos. post-op

I found this information on another site - Women's Health Resource.

Vaginal bleeding after a hysterectomy common and how long should it last?

Normal post operative bleeding lasts from several days to several weeks after surgery. After the first couple of days the bleeding turns into spotting, usually dark red but sometimes bright red. Then in most instances, the bleeding stops for good. Sometimes there may be a burst of bleeding at about 2-3 weeks if there was a collection of blood clot in the pelvis from right after the surgery. And occasionally at about 2 - 8 weeks after surgery, there may be some bright red vaginal spotting due to suture dissolving. The timing depends upon the type of suture used and how fast it dissolves. This may be spontaneous bright red spotting (it is rarely ever heavy) or it may happen after intercourse or physical activity.

That is the normal course of usual postoperative vaginal bleeding. Sometimes, however, bleeding can occur at other times or even much later (up to years). Causes include:

•granulation tissue (healing tissue growing on its own)
•prolapse of a faloppian tube (1)
•endometriosis of the end of the vagina (2)
•atrophic vaginitis due to low estrogen levels and traumatic irritation
•a cancerous growth at end of the vagina (3)
In the situation you describe of bleeding at 4.5 months, you will need to have a vaginal speculum exam to look at the end of the vagina. Most likely you have some granulation tissue at the end of the vagina. On appearance it would look like a dark red, beefy friable polypoid growth at the end of the vagina. It bleeds easily with touching. The treatment is to biopsy it away and use vaginal sulfa or other antibiotic cream. There usually are no pain fibers at all. If it hurts at all during biopsy, it may represent a prolapsed tube if only a hysterectomy was performed without removing the tubes and ovaries. A prolapsed tube more often causes pain rather than bleeding and it may need to be removed under anesthesia rather than in the office.

This bleeding is not a serious problem but be sure to see your doctor.

I had bleeding problems on and off for over 4 weeks but I also had an infection and once I went on meds the bleeding stopped completely. Not one single spot 48 hours after starting the meds. Hope this information helps. Good luck.
Unread 11-21-2010, 03:48 PM
Re: Intermittent vaginal bleeding 8 mos. post-op


A couple thoughts come to mind. Are you and your doctor both positive the bleeding is vaginal? Is there any chance at all it could be from your bladder for instance?

Also, has your doctor checked to see if you have vaginal endometriosis that could be bleeding as it responds to your estrogen?

Right now, the bleeding could be part of healing from your recent surgery so don't panic!

You may also want to get a second opinion from a doctor who typically treats women with complex health issues. Maybe a gynecological surgeon. Look for someone other than an OB/GYN. You want a specialist who may have encountered some of the less than typical health issues women experience. If you can, look for an endometriosis specialist.

Keep a diary of the bleeding and any other symptoms you experience. Keep track of any and all medications, vitamins, and supplements you are taking. Note any sexual intercourse. Then share all of this information with your doctors.

in there!

Unread 11-21-2010, 06:38 PM
Re: Intermittent vaginal bleeding 8 mos. post-op

Thank you Weiser for your input. My doc did do a urine culture twice and there was no sign of infection or blood. As for vaginal endo, I assume between the exams and the follow up surgery he would have found that if it was present. I live in a small town and the options for more specialized care are extremely limited without having to travel more than 2 hours away, so thats out for now. I did have some bleeding again today, now 9 days post-op, but again it was light. I just can't figure out if its not coming from the vaginal cuff and it doesn't seem to be from any infection, where can it be coming from? He did start me on vaginal estrogen cream, I assume he found some vaginal atrophy and maybe thinks the slight bleeding could be from that, but I haven't had my follow-up appt. with him yet to see exactly what he has to say. Since I've been having this problem though, sex has been out because my hubby is a little nervous to do anything its definitely not from being too dry and maybe causing abrasions..( hope not TMI). I guess I'm still at the wait and see point, just hoping that its not something that should NOT wait. Thanks again, I'll post again after my appt. and let you all know what he has to say.
Unread 11-30-2010, 06:33 PM
Re: Intermittent vaginal bleeding 8 mos. post-op

Not sure if any of you are still following this, but I had my post-op appt. today. I guess his suggestion is to take me off all estrogen to see if it is feeding any remaining endometriosis implants. If the bleeding and cramping stop....great...if not, another laparoscopy to look inside and see what is going on. I am hopeful that stopping the hormones will solve this problem, but now I am concerned about my emotional well-being. He originally started me on the oral estrogen about a week after my LAVH, when my hormones hit bottom and I felt like I had lost my mind. I had a horrible bout with severe depression, and to be honest, was ready to 'throw in the towel on everything'. I've struggled with depression for about 15 years and had it pretty well controlled until then. He started me on a second anti-depressant in hopes that this will help curb another replay. Is there anyone in here that can relate to a similar scenario and let me know how things went for them without any hormones whatsoever?? Thanks to all of you that have responded so far....just knowing I'm not alone really makes a difference....husbands just don't understand some things......Connie
Unread 12-01-2010, 12:21 AM
Re: Intermittent vaginal bleeding 8 mos. post-op


I hope that the anti-depressant does help ward off the menopause symptoms for you! Others who are unable to use ERT for one reason or another have found anti-depressants to be beneficial for keeping surgical menopause symptoms in check!

If the symptoms do disappear after being off of estrogen for a time, but you feel you do need estrogen for your well being, talk to your doctor about different methods of ERT that may be less systemic. Also, ask about using progesterone along with any allowed ERT.

Also, if the problem is determined to be endo and/or if you do decide to have an exploratory lap, consider consulting with an endo specialist. The more skilled the surgeon, the better results you could obtain.

You are not alone so do hang in there!
Unread 12-01-2010, 07:02 PM
Re: Intermittent vaginal bleeding 8 mos. post-op

Weiser....thanks for your reply. He did mention that if I feel like I am on a downward spiral again, to call him right away and he would try out a combination hormone (estrogen/progesterone) on me, but he'd really like to see what happens without any. I'm keeping my fingers crossed because I don't want to have to choose between my sanity or clearing up the problems I've had with the endo. I'll keep you posted as my body realizes that the estrogen is becoming scarce!! Thanks for your understanding and concern.
Unread 12-16-2010, 08:56 PM
Re: Bleeding 8 mos. post-op--Update, stopping hormones: anyone else gone w/out hormo

Well, here I am 2 1/2 weeks since going cold turkey on all ERT. I am happy to report that all bleeding has stopped, so I guess my doc finally honed in on the cause of it....thank goodness!! I also haven't had a complete emotional meltdown like I had shortly after my LAVH.....phew!! I am experiencing more anxiety than ever, feeling 'wired' quite a lot since then and finding myself clenching my jaw and grinding my teeth almost constantly. Not sure if I should see my GP and talk to him about this and maybe he could adjust my meds to compensate, or just be happy that I feel somewhat 'normal'. Thank you to all of you for your support and your replies to my's nice to know there are people who really understand what you're going through because they've been there themselves. I hope that my experiences may someday help someone else also!!

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