Light Bleeding After Cervical Smear and Vaginal Suppository Use: Is It Normal?

After using a suppository for one week following a pelvic examination and Pap smear, there is still slight bleeding?

Hello Doctor, I had a routine Pap smear in September, and the results indicated inflammation with increased discharge.
A week ago, during a follow-up visit, the doctor diagnosed a fungal infection and ordered an HPV screening, prescribing Insogen Vaginal Suppositories for one week.
I have used six doses so far.
When inserting the suppository, I feel a dry, rough sensation that is somewhat uncomfortable.
Although there has been a noticeable reduction in discharge, I sometimes notice remnants of the medication mixed with discharge when using the restroom, and after wiping, there is still a yellowish discharge that appears to be tinged with blood, along with some small fragments that resemble tissue or blood clots.
This was not present before the internal examination.
The doctor mentioned that there might be slight bleeding from the sampling, but it has been a week now.
Is this considered normal? Should I schedule an earlier follow-up appointment?

CL, 40~49 year old female. Ask Date: 2021/11/05

Dr. Wu Xianghui reply Obstetrics and Gynecology

1.
If there are concerns, it is recommended to return to the outpatient clinic for examination and consultation.
2.
"Vaginal infections" can cause abnormal discharge, perineal itching, odor, burning sensation during urination, frequent urination, and bleeding.
More severe cases may present with abdominal pain or fever.
The "treatment approach" varies depending on the symptoms and requires proper health education.
It is advisable to see a specialist in obstetrics and gynecology for examination and evaluation at the outpatient clinic.

Reply Date: 2021/11/05

More Info

After undergoing a cervical smear and using vaginal suppositories, experiencing light bleeding can be concerning, but it is important to understand the context and potential causes of this symptom.
Firstly, during a cervical smear (Pap test), it is common for some patients to experience light bleeding afterward. This is typically due to the sampling process, which can cause minor trauma to the cervical tissue. The bleeding is usually light and should resolve within a few days. However, if the bleeding persists beyond a week or becomes heavier, it is advisable to consult your healthcare provider.

In your case, you mentioned that you have been using a vaginal suppository (INSOGEN VAG) for a week, and while you have noticed a reduction in discharge, you are also observing some yellow discharge with blood or blood-like particles. This could be due to several factors:
1. Irritation from the Suppository: The sensation of dryness and roughness you experienced while inserting the suppository could indicate irritation of the vaginal or cervical tissues. This irritation can lead to minor bleeding, especially if the tissue is sensitive or inflamed.

2. Infection or Inflammation: Since you were diagnosed with a fungal infection, the inflammation associated with this condition could also contribute to bleeding. The presence of yellow discharge may suggest that the infection is still present or that there is an inflammatory response occurring.

3. Normal Healing Process: If the cervical tissue was slightly traumatized during the smear, it might take some time to heal completely. During this healing process, light spotting can occur, especially if there is any additional irritation from the suppository.

4. Hormonal Changes: If you are near your menstrual cycle, hormonal fluctuations can also lead to light spotting or changes in discharge.

Given that you have been experiencing this light bleeding for over a week, it is prudent to reach out to your healthcare provider for further evaluation. They may want to perform a physical examination to ensure that there are no complications, such as an ongoing infection or other issues that may require treatment.

In summary, while light bleeding after a cervical smear can be normal, the combination of your symptoms—especially the presence of yellow discharge and blood-like particles—warrants a follow-up with your physician. It is always better to err on the side of caution when it comes to your health, particularly after a recent medical procedure and the introduction of new medications. Your healthcare provider will be able to assess your situation more accurately and provide guidance tailored to your specific needs.

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