QuestionHello. I'm hoping to get your opinion with what could be wrong. I have an appointment next month with a new OB/GYN (first time discussing my problems) and am also hoping you can offer advice for what questions I should ask.
I came off of Yaz in December, and my husband and I are trying to conceive. Through charting I have found that I ovulate regularly and have 28-32 day cycles. Since coming off of birth control though I've been spotting a lot. It started out lasting a few days after my period ended, returning around 8 days past ovulation and lasting until my period started again. It's increased and is now lasting just about all month! The same has been happening with cramping. I noticed cramps that feel like ovulation pains, and they're lasting just about all month now too. Sometimes they're dull/achy, but sometimes they're really sharp! They're usually just on one side at a time but they alternate sides throughout the day.
Low progesterone and endometriosis have been suggested by ladies on my charting site as possible causes, and I'm wondering if you think either of those could be likely? Throughout my life I've also had really bad menstrual cramps (I used to have trouble getting up and walking, but not since coming off birth control), heavy period bleeding, painful sex, and some other problems.
I know you can't diagnose anything online, but I would really appreciate any input you might have! I'm getting really worried as the time spotting continues to increase! Thank you!!
AnswerHello Gillian from the U.S.,
I'm afraid that I cannot make a diagnosis without further examination and information. I would also not want to plant ideas in your mind that might be completely off base. There are too many possibilities and they need to be investigated. Basically, you need a pelvic exam, probably an ultrasound, some blood testing (especially hormones) and possibly a hysteroscopy to look into the uterine cavity. These would all be looking for specific etiologies. Certainly, endometriosis is a possibility with the history of severe cramping and painful intercourse. An outpatient surgery called laparoscopy would be required to make this diagnosis. However, endometriosis does not usually last all month long. Progesterone has nothing to do with your symptoms. I would also recommend that you be very careful about the information and advice you read from the internet, especially from non-physicians. Spotting comes from the vagina, cervix or uterus. That is where the examination has to start. If it is causing a lot of discomfort, then I would call your doc and get in sooner. Sorry I can't be more helpful.
Good Luck,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf
