Hi, It's Dr. C. Board-certified Ob-gyne. I'm sorry that you're having this concern. Usually we wouldn't choose to treat this as a yeast infection over the phone. By far the most common reason for such bleeding is thinning of the tissue due to low estrogen
levels. During exercise, the blood pressure goes up and that can be enough to cause some oozing of blood from blood vessels in the genital area. The lack of estrogen in menopause causes the overlying tissue to get thin. I normally would have a woman get a pelvic ultrasound
to measure the endometrial lining. If less than 4 mm, the risk of cancer or precancer is low enough to treat as if it is the low estrogen. If greater than 4mm, the risk of a precancer or cancer is about 10% and normally we'd do a biopsy to make sure. If the lining is 4mm or less, we'd next treat with low dose topical estrogen. The symptoms are very common in women who are in menopause or nearing menopause. It is usually quite easy to solve. Estrogen cream is cheaper but messier to use. Vagifem tablets are easier to use but more expensive. Women need to check with their insurance to see if they have coverage for both equally.If so, the Vagifem tablets are preferred. Although it's an estrogen product, there is virtually no absorption into the blood stream of estrogen. So even though the package insert (which is required for all estrogen products by the FDA) will say things about breast cancer, blood clots
, etc., these warning do not apply to the Vagifem product. There is somewhat more absorption into the blood system with the cream. The only reason why women will definitely want the tablets is if a woman has a history of breast cancer, blood clots or heart attack. The proper usage is to use for the 2 products is as follows:Estrace (estradiol) cream - use 1 gram nightly for 7nights, than use 1 gram twice weeklyVagifem pellets - use one pellet nightly for 14 nights, than use twice weeklyMost women will notice an improvement within 2 weeks. I hope this information has been reassuring and helpful. Please reply if I can clarify anything. I want to make sure you have the most helpful information for your situation.