QuestionHello, My quesion - I am on menstural cycle day 11 and am still having spotting. I also have light spotting all month long. This has been happening to me for the past 5 months or so and started after a miscarriage in November. I already had two D&Cs since then so I know there is nothing in my uterus causing this (like a polyp). I assume this is a hormone issue but I have no idea what the issue is. I was on birth control for 10 years prior to the miscarriage. I took Femara this month but it was happening before this too and Femara hasn't solved the problem. In addition, I also have a short luteal phase. My period starts 9 days after ovulation. I have been trying to get pregnant with a second child for over a year and am seeing a specialist, but I cannot get an answer to why this keeps happening. It's very frustrating. I hope you can help! Thanks!
AnswerHello Mary from the U.S.,
Usually, after the menses (endometrial shedding), as the ovary is stimulated to produce an ovulatory follicle, the estrogen level rises and a new endometrial lining is made. The estrogen thickens the lining, which stops the menstrual flow, so there should not be any spotting or bleeding after that. If the spotting is brown blood, then that is old residual blood that was left over from your menses. It is possible that the blood is getting trapped in the uterine cavity either from a constricted cervical canal (cervical stenosis) or adhesions within the endometrial cavity from the D%26C's. These are both evaluated by a diagnostic hysteroscopy, which would be my next recommended step. In terms of the short luteal phase, that is consistent with a luteal phase defect, and requires progesterone supplementation. If you are seeing the proper specialist, he/she should be able to solve these problem for you.
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, and follow me on Facebook at http://bit.ly/9Iw9oV
