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Hi, It's Dr. C. Board certified Ob-gyne. I can help you today.
Yes it's actually very common for a pap smear to trigger a bit of bleeding. If I see that there is a bit of blood from the brush at pap, I warn the woman that she may have a day or two of pink tinge discharge or spotting. This isn't the sign of anything bad or wrong happening. It's just the brush that we use to take the pap can irritate the tender surface when cells are rubbed off with the brush.
I hope this is reassuring and helpful. Please reply if I can clarify anything.
Ah, I just reread your question and see what you mean. At age 37, it's common for women to start to have some hormonal changes that can explain both the spotting 10 days earlier, the late period and the hot flashes. As the ovaries age, there are times that the estrogen level dips around ovulation (14 days before the next period comes). This can cause a slight spotting or bloody discharge that can last 1-2 days. Hot flashes or night sweats can accompany such low estrogen dips. There is another estrogen dip right before the period starts too. Many women as they get closer to 40 and into their 40s, will have intermittent symptoms similar to menopausal symptoms. These can include the spotting, delayed ovulation (hence late periods) and hot flashes that come and go. Usually when these changes start, I'll have women start tracking the symptoms to see if a cyclical pattern emerges. Often there are symptoms around ovulation and right before the onset of the period. Some women also note decreased vaginal lubrication during those estrogen dip times.
This doesn't sound worrisome. But do track it. The fact that you had a recent pelvic exam is very reassuring against anything serious going on. Thyroid disease can sometimes cause late periods and hot flashes, so if there is any other reason to suspect thyroid disease, it may be worth getting a blood test.
If due to perimenopausal changes, the symptoms will come and go and usually (especially the mid-cycle spotting) be on certain days of the period cycle.
Anything else I can add?
There could be fatigue or anxiety, skin dryness, constipation, dry hair, heart palpitations, foggy brain. The symptoms are pretty general. We do end up testing for thyroid function quite often because the symptoms can be so general.
Thyroid disorders are pretty easy to treat. Underfunctioning is much more common and requires taking a daily medication that has essentially no side effects if properly dosed.
Yes, there can be either weight gain or weight loss. But many women as they age get weight gain due to naturally slowing metabolism. But yes we do check women for underfunctioning thyroid quite often. The symptoms can overlap with menopausal, perimenopausal and normal changes with aging.
Anything else for today?
Usually not routinely. The guidelines do not include this as routine although some individual doctors might check it routinely during pregnancy. Most don't.
You mean the blood? The way to tell the difference is to put a tampon inside the vagina. If there is no blood on the tampon, the blood might have come from the urine instead. It's much more common for blood like this to show up from the vagina not the urine.
If there is a lot it will be in the bowl but that's true if it's from the vagina too. So that's not a reliable way to tell. You can wrap some tissue around your finger and put it inside the vagina to see if that's where it's coming from. Or a tampon like I mentioned.
Night sweats can be from many different causes. Hormonal ones will come and go and at first be on just certain days of the cycle, usually around ovulation and again before the period. Night sweats from other causes will persist, get worse and aren't on any cycle. Hormonal cause is BY FAR the most common reason in women above the age of 35.
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