Abnormal Bleeding: Uterine Fibroids and Related Concerns

Uterine fibroid bleeding

Hello Doctor: Last month, I experienced abnormal bleeding.
After my menstrual period ended, I had a transvaginal ultrasound, which revealed a small tumor about 1 cm in size.
Later, during my ovulation period, I had brown discharge that lasted for about one to two days, but I still occasionally have a little light brown discharge.
This month, after my menstrual period ended normally, I am now on the fourteenth day post-menstruation and suddenly started bleeding.
The amount is not much, resembling the onset of menstruation rather than brown discharge.

1.
Could this be ovulation bleeding?
2.
Is it possible that this is influenced by the uterine fibroid? Before the abnormal bleeding last month, I had never experienced ovulation bleeding symptoms.
It started suddenly after the tumor was detected, which is a bit concerning.

3.
Could this be caused by changes in the uterine fibroid?
4.
Is there a possibility that this is related to endometrial cancer?
Thank you, Doctor!

Nìmíng, 20~29 year old female. Ask Date: 2017/09/22

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Last month, I experienced abnormal bleeding.
After my menstrual period ended, I had a transvaginal ultrasound which revealed a small tumor about one centimeter in size.
Later, during ovulation, I had brown discharge that lasted for about one to two days, but I still occasionally have a little light brown discharge.
This month, after my menstrual period ended normally, I am now on the fourteenth day post-menstruation and suddenly started bleeding.
The amount is not much, resembling the start of my period rather than brown discharge.

1.
Is this ovulation bleeding?
Answer: It is likely ovulation bleeding.

2.
Could this be influenced by the uterine fibroid?
Answer: It is unlikely.

3.
Could this be caused by changes in the uterine fibroid?
Answer: It is unlikely.

4.
Is there a possibility that this is related to endometrial cancer?
Answer: The likelihood is low.

Reply Date: 2017/09/22

More Info

Abnormal bleeding can be a concerning symptom for many women, and understanding its potential causes is crucial for appropriate management. In your case, you have experienced abnormal bleeding, a small uterine fibroid, and changes in your menstrual cycle, which raises several important questions regarding the nature of your symptoms.

1. Is this bleeding related to ovulation?
It is possible that the bleeding you are experiencing could be ovulation-related. Ovulation bleeding, also known as mid-cycle spotting, can occur when the follicle releases an egg, leading to a temporary drop in estrogen levels. This drop can cause a small amount of bleeding or spotting, often characterized by light pink or brown discharge. However, since you mentioned that this bleeding is occurring 14 days after your last menstrual period and resembles the onset of your period, it may not strictly be ovulation bleeding.
2. Could the uterine fibroid be influencing this bleeding?
Uterine fibroids are benign tumors that can develop in the uterus and may cause various symptoms, including abnormal bleeding. While small fibroids (like the one you mentioned being about 1 cm) may not typically cause significant issues, they can still contribute to changes in your menstrual cycle or cause intermittent spotting. If the fibroid is located in a position that affects the uterine lining or if it has grown, it could potentially lead to increased bleeding or changes in your menstrual pattern.

3. Is there a possibility of fibroid degeneration?
Fibroids can undergo changes, including degeneration, particularly if they outgrow their blood supply. This can lead to acute pain and abnormal bleeding. However, degeneration usually presents with more severe symptoms, including significant pain. If your bleeding is mild and not accompanied by severe discomfort, it is less likely to be due to degeneration.

4. Could this be related to endometrial cancer?
While it is essential to consider all possibilities, the risk of endometrial cancer is generally low in younger women, especially if there are no other risk factors present (such as obesity, a family history of endometrial cancer, or prolonged exposure to estrogen without progesterone). However, any abnormal bleeding, particularly in women over 35 or those with risk factors, should be evaluated thoroughly. If you have concerns about the possibility of endometrial cancer, it is vital to discuss this with your healthcare provider, who may recommend further evaluation, such as an endometrial biopsy or additional imaging studies.

In summary, while your symptoms may be related to ovulation or the presence of a fibroid, it is essential to monitor the situation closely. If the bleeding persists, worsens, or is accompanied by other concerning symptoms (such as severe pain or changes in your overall health), you should seek medical attention promptly. A healthcare provider can perform a thorough evaluation, including imaging and possibly a biopsy, to rule out any serious conditions and provide you with the best management options. Regular follow-ups and open communication with your healthcare provider are key to addressing your concerns and ensuring your reproductive health.

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