Irregular Period and Spotting
A reader asks Dr Dana about her irregular period and spotting. Read on to know what you should do if you have the same issue.
Question: I am a 23 year old mother of one. My husband and I are working on having our second child, however my period has been irregular. Occasionally I experience dark brown spotting, sometimes accompanied with mucus that is only visible when wiped. Is that considered as my period? I have also been experiencing diarrhea and sharp pain in my abdomen. Is there something wrong should I consult a gynaecologist or just wait for my period to come?
Answer From Dr Dana:
Your symptoms may sound like endometriosis. For women presenting with symptoms suggestive of endometriosis, a definitive diagnosis of most forms of endometriosis requires visual inspection of the pelvis at laparoscopy as the 'gold standard' investigation.
However, pain symptoms suggestive of the disease can be treated without a definitive diagnosis using a therapeutic trial of a hormonal drug to reduce menstrual flow. In women with laparoscopically confirmed disease, suppression of ovarian function for 6-months reduces endometriosis-associated pain; all hormonal drugs studied are equally effective although their side-effects and cost profiles differ.
Ablation of endometriotic lesions reduces endometriosis-associated pain and the smallest effect is seen in patients with minimal disease. In minimal-mild endometriosis, suppression of ovarian function to improve fertility is not effective, but ablation of endometriotic lesions plus adhesiolysis is effective compared to diagnostic laparoscopy alone.
There is insufficient evidence available to determine whether surgical excision of moderate-severe endometriosis enhances pregnancy rates.
IVF is appropriate treatment especially if there are coexisting causes of infertility and/or other treatments have failed, but IVF pregnancy rates are lower in women with endometriosis than in those with tubal infertility.
So please consult a OBGYN for exclusion of endometriosis.