How JustAnswer Works:
  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.
Ask Dr. Norm S. Your Own Question
Dr. Norm S.
Dr. Norm S., Board Certified OB/GYN
Category: OB GYN
Satisfied Customers: 11235
Experience:  Over 30 years of experience in OB/GYN practice, including teaching students. Fellow of American Board of Obstetrics and Gynecology.
Type Your OB GYN Question Here...
Dr. Norm S. is online now
A new question is answered every 9 seconds

For an experienced and highly rated OBGYN....

Customer Question

For an experienced and highly rated OBGYN....
Submitted: 1 year ago.
Category: OB GYN
Expert:  Dr. Norm S. replied 1 year ago.

It would be very helpful if you would give us some details about your question. Thank you.

Customer: replied 1 year ago.
I had an ultrasound yesterday. Afterwards, the nurse took a look and called the doctor b/c she knew I was VERY nervous. They told me that there was nothing alarming but a bloot clot was seen (I am actively spotting a little bit) I think she said the size was .8x.3. She told me that the differential could be a polyp. I am very upset about the thought of a polyp. I am 33 and I guess it would need to be removed. I am panicking about the chance of it being cancerous. My doctor said I could do a follow-up scan in 6-8 weeks.
Is seeing a bloot clot on an ultrasound normal during a time before period starts or during active spotting? How easy are these to identify in comparison to a polpy? I did have some old blood come out today, just a small amount of brown stringy discharge.
Anything reassuring about polyps? I am very very scared and panicked.
Customer: replied 1 year ago.
Also, I am on the pill which the dr thinks is the reason for my spotting/breakthrough bleeding. I am on a low dose .20. He thinks we just need to switch up my pill, but all I can think of is a cancerous polyp. =(
Expert:  Dr. Norm S. replied 1 year ago.

Uterine polyps are rarely cancer, and I've probably never seen a uterine polyp with cancer at age 33. So I wouldn't be much concerned. Polyps are usually easily removed using a hysteroscope.

A blood clot inside the uterus at the time that some bleeding is going on would not be unusual. A blood clot can appear similar to a polyp. Usually there will be enough difference that we can tell on ultrasound which is one or the other, but not always.

So I would go along with your doctor and have a repeat ultrasound in 4-6 weeks (I suspect that you'll be too nervous to wait 6-8 weeks). I'm pretty sure that by 4 weeks they'll be able to tell whether this is a polyp or not.

In case it's a polyp, it can usually be removed using local anesthesia plus IV sedation. Most of the time it's quite simple. Best wishes.

Customer: replied 1 year ago.
Another differential is a fibroid, but those are always benign (so I believe) so I am not as worried. I sure hope my doctor is correct. What scares me as well as I always have had off and on breakthrough bleeding just thinking that its my norm for the pill. 4 years ago after having all the testing, I was diagnosed with Unexplained Dysfunctional Bleeding so that is why I started the pill. My mind is thinking that I have been bleeding so long and maybe all this time its been a uterine cancer and its caught too late =( How treatable is uterine cancer? Are my cancer lower due to 2 pregnancies and the pill for 4 years? My lining was within normal limits so I guess that is good. I don't have the actual measurement in front of me.
Customer: replied 1 year ago.
The literature is stating a rate of malignant polyps around .5- 5%... that seems like a large range. Do you have a better idea of the consensus for premenstrual women at my age having bleeding and a cancerous polyp?
Expert:  Dr. Norm S. replied 1 year ago.

The pill does decrease the chance of uterine cancer, as do also the pregnancies.

Uterine cancer is highly treatable as long as it's found in the early stages. Uterine cancer is mostly found in women after menopause.

If this is a polyp, I would guess that the chance that it contains cancer is extremely small because of your age.

In case it's a fibroid, that can be more difficult to remove, but usually it can be done. If it were a fibroid, usually (but not always) you would have other fibroids seen on ultrasound.

Customer: replied 1 year ago.
I spoke with my doctor and to ease my mind he said he would like to do a hysterosonogram with saline. He could do it as early as today but now I'm on my period. Should I wait until after my period? Will this test be more definitive as to wether it's a polyp or blood clot? Since my period started I've had a few small clumps of older, dark brown, blood exit. I wonder if this is what could have been seen?
Expert:  Dr. Norm S. replied 1 year ago.

It is usually best to wait until after your period is over to do a hysterosonogram. Any blood clots can confuse the results. Usually a polyp or fibroid will show up very clearly on a sonohysterogram.

It's certainly possible that these clumps/clots where what was seen.

Customer: replied 1 year ago.
But would the doctor be able to tell the difference between clots and period debris and polyp and fibroids that how up so clearly this way? Would the blood clots move around more? I it safe to do it on period? The nurse told me many women do it while bleeding bc they need to figure out cause of bleeding anyway .
Expert:  Dr. Norm S. replied 1 year ago.

Probably the doctor would be able to tell the difference. It can be done during a period, but if there are clots inside, they can confuse the issue. Usually it's better to wait, unless the bleeding goes on and on.