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Ask Dr. Norm S. Your Own Question
Dr. Norm S.
Dr. Norm S., Board Certified OB/GYN
Category: OB GYN
Satisfied Customers: 11231
Experience:  Over 30 years of experience in OB/GYN practice, including teaching students. Fellow of American Board of Obstetrics and Gynecology.
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I am 67 and have been having post menopausal bleeding x 29

Customer Question

I am 67 and have been having post menopausal bleeding x 29 days now. On HRT for 20+ years. Also have HX of idopathic vaginal inflammation (neg for yeast, STDs, etc) and lichen schlerosus. Had pelvic US on Friday with normal findings, however it mentioned a "cystic subtle lucency near the midline of the uterus adjacent to the endometrial stripe." My doctor is away and I want to know if this means anything ominous? Also, what then could be causing the bright red bleeding for so many days? More than spotting - but less than an average period. No weight loss or other overt symptoms. Thank you.
Submitted: 1 year ago.
Category: OB GYN
Expert:  Dr. Norm S. replied 1 year ago.

Do you know what the thickness of the endometrial stripe was?

Which HRT are you on? Thank you.

Customer: replied 1 year ago.
4 mm transvaginally. I am on Minivelle .075 and Progesterone 100 mg tablets
Customer: replied 1 year ago.
Have been on that for about a year - before that was on compounded bioidentical HRT
Expert:  Dr. Norm S. replied 1 year ago.

The cystic subtle lucency near the midline of the uterus adjacent to the endometrial stripe is likely a small amount of blood. Blood looks like any other fluid on ultrasound, and if it's in a circular shape, it will look cystic. In any case, since it's small and subtle, it's small, subtle and fluid filled, it's unlikely to be anything serious like cancer.

Bleeding will sometimes occur while taking HRT consisting of combined estrogen and progesterone. Since it has gone on for 29 days, it will probably need some change of your HRT to stop it. A D&C would also likely stop it, but I don't think that will be needed.

Perhaps just stopping the HRT for a week or so might be enough. That may work like stopping the birth control pill does, allowing any lining to clean off as needed. Then hopefully when you re-start the HRT, the bleeding would stop.

You'll be able to discuss this with your doctor upon his/her return. Best wishes.

Customer: replied 1 year ago.
Well, as long as that didn't indicate anything abnormal (like CA), then I can certainly wait for him to return. We have been concentrating so much on the inflammation problem and the LS, that I think my internals took a back seat. I was very worried. Still having no answers on the constant inflammation and it is very disconcerting since nothing seems to help. In constant discomfort and losing confidence in my doctor even though he is a well known vulvodynia specialist here in South Florida.
Expert:  Dr. Norm S. replied 1 year ago.

It's good that you're seeing a well known vulvodynia specialist, since it can be difficult to find good treatment. Sometimes it takes time and trying different solutions.

As far as the ultrasound findings, you can relax and wait to discuss it with your doctor.