irregular bleeding

I am a 39 yo caucasian female. 2 childbirths 1988 &  2006.  I had an abnormal pap in December 2007. It was LGSIL. I had a biopsy and it came back ok (probable HPV).  I am not on birth control pills. I did take them for probably 17 years.  Anyway 3 times in the last 3 weeks I have had some bleeding (fresh blood) and not over a teaspoon at the most. No clumps from vagina when I had a hard bowel movement (strained).  I am certain it is not coming from anus.  My period is regular 26 or 28 days and heavier bleeding 1 or 2 days then it is pretty much over.  the first day of my last period was 7/21.  No family history of cervical or uterine cancer.  All my paps after the biopsy have been ok.  My last pap was 12/08.  What caould be causing this?  Is this a sign of cancer?  I did have cervical spine fusion surgery on 4/20/09.  No complications.  I am under no unusual stress.  Please advise.  I will make an appt with GYN tomorrow but wanted to know your thoughts.  Thanks for your time.

[Elaine Brown, MD]

Hi!
If you were my patient, I would start with a pelvic exam and pap smear.  It could be a polyp on your cervix that is causing the bleeding.  If I didn't find anything there, I would do an ultrasound to look at your uterine lining.  Sometimes a polyp or thickening of the lining can cause irregular bleeding too.  I would also perform a rectal exam looking for blood and hemorrhoids--just to be thorough!  At 39, it is very UNlikely to be cancer. It may be something that is treatable with a short course of progesterone, or removal of a polyp.  I would also suggest that you increase your fluids and fibre in your diet so that you don't have to strain at stool!
Good luck!
Dr B