Menopause

I am pre-menopausal and have had a dark, bloody and thick vaginal discharge between periods.  I have sought medical care and my doctor doesn't seem concerned so much because I am of menopause age.  Most recently I saw him because of a blister type lesion that appeared on my labia.  Diagnostic culture ruled out herpes but I still have this discharge.  He recommended that I return should the blister return.  Is it normal for me to have this discharge if I am pre-menopausal.  I've also had some light spotting.

[Yvette BG]

Hi, Georgilynn--

I'm perimenopausal, too, and about 2 years ago (at 50) started having spotting as well as a weird discharge that sounds kind of like what you're describing. I thought it was just irregular hormones but then occasionally, I had a little cramping with it. (Do you have a cramping sensation?) The weird thing about the discharge is that it changed--sometimes it was bloody like bright to medium red, other times it was beige and sometimes even brownish or burgundy in color. This went on for a while before I finally got in to see the doctor--OI procrastinated because my mother was ill and then the doctor didn't have an appointment opening for several weeks when I finally called her.

The gynecologist did a Pap test and it came out OK. (I was kind of worried because I had a precancerous lesion that required treatment when I was 21.) The doctor right away wanted to do an endometrial biopsy. I've had two of those in the past and they are very painful (!), and also, there are risks associated with them and they are less expensive. I asked her instead if she would do an ultrasound, since it's less invasive and might be able to rule out a few things. She wasn't real happy with the suggestion, I could tell, but she said she would do it, but depending on what they found, I might have to have an endometrial biopsy anyway--to which I said, "OK, we'll cross that bridge when we come to it."  

It ended up they found a spot on the ultrasound that they thought could be a polyp or a growth of some sort. So she scheduled a hysteroscopy test to see if there was any cancer, etc. which there thankfully was not. It ended up what I had was a polyp in my endocervical canal and they removed it during the hysteroscopy procedure. Usually women don't get those until after menopause, from what I understand, and they couldn't say why I got it earlier. (Bad luck, maybe.)

In the long run, I was very glad I requested the ultrasound instead of going ahead with the endometrial biopsy. It is possible they could have missed the polyp with the endometrial biopsy, my husband who is a physician/internist said.

I aslo must mention, they automatically wanted to give me full anaesthetic and put me 100% out for the hysteroscopy procedure. I asked her if I could have "twilight" sedation instead--two reasons; since both my (biological) parents have dementia, I'm at risk and I don't want any unnecessary anaesthesia that could affect my brain. Also, I get very nauseated and sometimes throw up with anaesthetic, and more importantly, there are other medical risks with full anaesthesia that twilight has fewer chances of having, from what I understand. Again, the doctor wasn't too happy with my suggestion, but said OK. The procedure went fine--didn't remember anything and only had slight discomfort afterwards. Much less painful than I didn't the 2 enometrial biopsies!        

So---I would ask the doctor if maybe there is a possibility you have a polyp. And in my opinion, go the ultrasound route first if you can, and save the endometrial biopsy for only if absolutely necessary.

Please keep us posted on what happens.

Good luck,
Yvette

[Yvette BG]

Correction--I should've read over what I wrote before sending. What I meant to say is that the pelvic ultrasound is less expensive than the endometrial biopsy....