Perimenopause and post coital bleeding

[portomar1970]

Ok so this has happened for the second or third time this year and I am really starting to get terrified. I am about to turn 47 and I spotted for the 2nd or 3rd time after sex AGAIN!! The last time it happened I did go see the doctor and after I told her my symptoms (late periods, skipped periods, spotting in between periods, spotting only periods etc etc) she chalked it up to perimenopause and told me it was all normal. In fact, I was all ready and undressed thinking she would give me a pelvic exam, but she didn't even do that!! I am due for my regular 1 year follow up in 2 weeks so I know I will get an exam then, but I am SUPER anxious and worried sick about this. Has anyone here experienced any brown spotting after sex? I only noticed the brown blood after I wiped and it was gone after that. This sucks, I am really worried. My last Pap smear and in fact all my pap smears have always been negative, including a negative HPV reflux test, so I am not worried about cervical cancer, my worry is uterine cancer. These past 12 months have been so crazy with such unpredictable periods, and last month (dec) I only had a period for 2 days and barely 2 days. Any thoughts, comments anything would really be appreciated, I am soooooo worried!!
S

[Catherine S]

Hi there. If you're in peri menopause then this would include...amongst all the other wonderful symptoms...vaginal dryness, so this could result in more friction during sex. Perimenopause can also produce brown discharge which is often mistaken for blood. This is when old bits of womb lining that haven't been completely discarded during periods mixes with normal vaginal discharge. Penetration during sex can dislodge this.

My experience of perimenopause was a time in my life never to be repeated

I'm definately coming back as a cat

ISB x

[GlassPinata]

Post-coital spotting is most likely to do with your cervix, not your uterus.
When I had it ten years ago, it turned out to be cervical polyps (benign, easily removed in the doctor's office).
Another poster on here recently had the same issue, and it turned out to be cervical ectropion/ cervical erosion (also a benign and common condition).
With your negative PAP and HPV test, you obviously need not worry about cervical cancer; I don't think you should worry about uterine cancer either, as I don't think that post-coital bleeding is one of the symptoms of it.
Even if the issue is your uterus, there is no reason to think it's cancer. I also had bleeding between cycles at one point, and the issue turned out to be endometrial/uterine polyps (also benign, but not so easy to remove; it required a day surgery, but I was fine the next day and able to return to work).
The issue could be a thickened endometrial lining caused by a hormone imbalance such as progesterone deficiency, which is very common during perimenopause; your uterine lining can become abnormally thick, to the point that parts of it are breaking off throughout your cycle, thus causing random spotting.
All the issues I've described above are common, benign reasons for the problem you are describing.
Uterine cancer is very uncommon in reproductive-age women; it usually occurs in women who are beyond menopause.
Definitely see your doctor and keep pushing for further testing until you figure out what is going on; an ultrasound can measure the thickness of your uterine lining and also detect any polyps that might be there. An endometrial biopsy can check for uterine cancer (warning: these are not fun).
Chances are you may just need some progesterone supplements or something to get you back on track.
Please try not to drive yourself mad with worry. These issues are very common in women our age.
Best wishes.

[Catherine S]

Glass Pinata, if the blood is old...as in brown rather than red, then it might well be coming from the uterus not the cervix, which would tend to produce fresh red blood spotting. I had a cauterisation procedure because of a cervical erosion and the spotting was red and not brown, which is what has been mentioned by Portomar.

ISB x

[GlassPinata]

Weirdly enough, when I had spotting because of my polyp issues, the spotting could be all sorts of different colors: red, brown, pink.
I thought that was very significant and mentioned it to the doctor, and spent a lot of time on the internet trying to find out if this was old blood or new blood or what.
The doctor said it didn't matter what color the blood was; that only indicates the blood's transit time, like how long it took coming out.
That could be wrong, but that's what the doctor told me.
It does seem like bleeding from the cervix would most likely be redder, since the cervix is farther down than the uterus, thus a shorter transit time.