I’m a 39 year old woman that for the past 4 days has had pelvic pain non stop, lower back pain and with it pink spotting. Sex is painful and has been for a few years most often the morning after sex I have bleeding.

My history is 3 kids born via cesarean and my tubes done with the last child 11 years ago. I had an Endometrial ablation done 8 years ago due to Fibroids but 4 years after that my period started coming back but only a day here and there. For the last few years I have complained about pain I get, it feels almost like someone is trying to pull my insides out. Last March I had an Ultrasound done and was told I had Ovarian Cysts but they shouldn’t be bothering me. My doctor told me to try different sex positions and put me on the pill to regulate my periods, I have since stopped taking them. I now get a period that lasts for maybe 3 days near the end of the month but always get red or brown gooey spotting on and off all month. My friend told me to try to feel my cervix, when I did it was very painful and I had one large hard bump, another half the size and various smaller ones. I also have not had a pap in about 11 years. My boyfriend wants me to go to the hospital, he doesn’t trust my doctor very much but I am nervous about hospitals. Any advice would be appreciated…

Answered by: Maria/ MD Health Forum. com Team

Bleeding after sexual intercourse or post coital bleeding calls for a careful evaluation of a physician. Such symptom may result from benign to serious conditions that affect the vagina, cervix or uterus. Peri-menopausal women, for example, may be at risk for atrophic vaginitis which occurs due to significant decrease in estrogen levels. Common signs and symptoms of atrophic vaginitis include: bleeding after intercourse, vaginal dryness, soreness, itching, pressure, white discharge, malodorous discharge due to infection.

Presence of cervical polyps or small finger-like growths on the cervix or the cervical canal is also considered as a common cause of post-coital bleeding. Chronic inflammation, abnormal response to increased levels of estrogen and presence of clogged blood vessels are factors that are thought to contribute to cervical polyps formation.

Women with cervical ectroption may experience bleeding. Cervical ectroption occurs when the inner lining of the cervical canal protrudes through the external os of the cervix. Fine blood vessels within the cervix’ inner are easily traumatized and it increases the likelihood for abrasion during sexual intercourse. Cervical ectroption is often found in younger women, those who take taking birth control pills and pregnant women whose cervices are softer than normal.

Bleeding after intercourse may also indicate cervical dysplasia, a pre-cancerous condition which causes abnormal changes in the cells that line the cervix. Cervical dysplasia may progress to cancer if left untreated. It is important for women to undergo pap test at recommended intervals. Pap test is considered as an effective tool in fighting cancer because it detects minor changes in the cervical cells before they have a chance to become malignant.

The other symptoms that you have been experiecing-low back pain, pain during intercourse and low back pain- commonly present in pelvic inflammatory disease (PID) or inflammation of the female reproductive organs. PID typically results from the spread of sexually transmitted bacteria from the vagina to the uterus and upper genital tract.

I recommend that you inform your doctor about your symptoms. Unless physical examination and tests are done, you will not know which is causing your bleeding and other discomfort. Treatment can only be initiated if the diagnosis is confirmed by tests. I understand that going to health-care facilities is quite stressful for many people, however, it’s still the best option.

This blog entry is for your general information only. I recommend that you discuss your symptoms with your own doctor.

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Tags: cervical dysplasia, cervical ectroption, cervical polyp, cervix, postcoital bleeding

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