Irregular Bleeding

I am a 38 yo. I have had 2 children 1988,2006 (full-term, 1 was a C-Seaction).Anyway, I have normal periods, 26-day cycle, until.. August of this year. I started bleeding a little bright red blood when straining to defecate.  My Dr. and I verified that it was NOT rectal and that my cervix had an irritated spot that he cauterized and gave me doxycycline to take.  I followed up and the spot was gone.  Now in October I started having more bleeding, when straining, after sex, and a few times when urinating.  I went to the Dr. yesterday and he said my cervix looks fine (he tried to make it bleed and it didn't).  He suggested that I have a D&C because of possible polyps that could be bleeding.  Also, I am due for a pap next month, but have  had yearly paps for 20+ years. I did have one pap 2 years ago that came back LGSIL. the follow-up biopsy was fine.  I have recently been diagnosed with hypothyroidism and am taking 25 MCG every other day. I started taking this medication in October.  No birth control pills for the past 4 years, except this month I took Plan B 1 dose.(I had bled once before this medicine).  Also I am almost finished with the second round of doxycycline.  Is it likely that I have uterine cancer? Is it routine to do D&C for uterine bleeding?  I am 150 lbs 5'5"

[Elaine Brown, MD]

Hi!
It is very UNLIKELY that you have cancer!  
If you were my patient, I would probably do an ultrasound before going in to the OR for a D&C, but I would probably end up doing the D&C too.

Intermenstrual and post coital bleeding are usually caused either by something going on with the cervix, eg. infection or dysplasia, or by something going on inside the uterus such as polyps or hyperplasia.

I like to do an ultrasound first, so I know what I am dealing with. That is just my style. In fact, a saline ultrasound can be used to guide biopsies in the office and that can all be done at one setting.  

A d&c should be combined with a hysterosopy so that all abnormal appearing areas can be biopsied or removed. It is a good procedure both for diagnosis and for treatment.  And, yes, it is commonly used to evaluate irregular bleeding.

I hope this is helpful!
Good luck!
Dr B