Auto immune disease and menstruation

Hi There!
I am 35, G1 P2 and have no intention of more children...my husband has had a vasectomy and I do not take any contraception. I have Lupus and Fibromylagia (fibromyalgia) and take Plaquinil, Dosulpin and Cocodamol. I have had 'weird' periods for a while now. I have always had regular 28 days cycles which start with a mega heavy bleed on day 1 calming down to a light bleed and then by day 5 it's all over. Since last summer I have had spotting for 5-7 days prior to menstruation then the usual heavy bleed on day 1-2 with it all over on day 5. Then more recently I have had odd days throughout my cycle when I have had spotting (brown and red) and not necessarilly around the time of ovulation and more noticably my cycles are now every 21 days with the same spotting beforehand so I feel like I am almost always looking out for blood!! This month has been the weirdest yet! I started spotting at the usual 5ish days before I was due on but it hasn't stopped...I've just had spotting of brown and red stuff everyday for 11 days...no sign of a real period and no real need for sanitory protection..maybe a panty liner. The discharge is non offensive and I have no other genital 'issues'.
I have been seeing a gynae for 2 years for regular smears for borderline CIN and HPV but all smears in the last 2 years have not shown any progression of CIN and they are not concerned at all. I have had a cervical errosion in the past which was treated and this has not been sent by my gynae since.
I mentioned all of this to my rheumatologist and she does not think that the irregularity is connected with the auto immune conditions and I don't think the menstrual cycle can be affected by my meds but I am open to suggestion on that! I had a full set of bloods done last week including TFT, LFT, U & E's, antibody tests as well as the regular FBC etc.. don't think hormonal tests were done and the results are not back yet.
Your suggestions and thoughts would be really appreciated!
Thanks!
Vicky x

[Elaine Brown, MD]

Hi!
Your symptoms sound suspicious for a polyp, either of the cervix or uterus.  If you were my patient, I would do a complete exam, pap smear (if it is due) and a saline ultrasound---looking for a polyp.  These are quite common and usually benign.  The other possibility is endometrial hyperplasia or a more minor thickening of the uterine lining.
A saline ultrasound should be able to detect any of these conditions.  An endometrial biopsy would be another (more painful) approach.
Good luck!
Dr B