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[shrosphirelass]

I have had issues with PMB for years whilst on HRT but this has more or less resolved following having a mirena.

 I have noticed that on most occasions following sex I have very light spotting, usually the day after.

 I do not really want to go down the 2 week pathway route having recently had a hysteroscopy with fibroid removed. Could it just be vaginal atrophy or just one of those things?

I know the gynae said any further bleeding may require a colposcopy. I recently had a clear smear though they just checked I didn't have the HPV virus and didn't send the sample for analysis

[CLKD]

Probably vaginal atrophy, it may be worth while asking for appropriate treatment - U don't need an examination.    As we age the vaginal walls may become thin = spotting.

I did have a polyp which bled on contact which resolved at peri  .  How do U feel overall? 

Let us know how you get on.

[Christine49]

I have been on HRT for a few years now constantly adjusting it. Now happy with what I am on but started to bleed after sex and also sore so I’m thinking it’s VA even though I’m on vagifem. Are you sore too or on any VA treatment?

[CLKD]

Christine49 - up the VA treatment to every night for 2-3 weeks.

[Wend861]

I have exactly the same problem. This has happened the last two times with a tiny amount of blood first the morning after and the second time two days later. I had a scan in January, which was ok, and a physical examination last month when a mild prolapse was found. I read on a different post that a condition called cervical ectopy, which is harmless, can cause bleeding in these circumstances. I have a doctors appointment this week to see what they think. I don't like the new system of not checking cells from a smear test where the patient doesn't have the HPV virus. Some ladies might not bother having it done going forward!

[bombsh3ll]

With a recent hysteroscopy and a mirena in situ there's no sense in going down the PMB pathway.

I would treat it as VA in the first instance.

If it doesn't resolve in 3 months with an adequately estrogenised vagina, I would see your GP for an examination.

In my opinion VA suggests inadequate systemic estrogen (although this view is not shared by some) but may be something you want to consider as well.

[CLKD]

Some ladies require both HRT as well as VA treatment.  It's a bit Trial and Error to get to a regime that suits.

[shrosphirelass]

Thanks all, I am on vagifem and also use estriol alongside and my symptoms are reasonably well controlled at the moment.

I agree that its frustrating they don't send the sample away. Is it because you cant have cervical cancer if you don't have the HPV virus?

I'm not that worried about it, it was only because they said any further bleeding should result in cervix investigations though they said my cervix looked healthy at a gynae exam.

I don't think the spotting will stop as it seems to occur quite regularly so I either put it out of my mind or tell the dr  (when and if I can get an appointment). Id really  rather not have any further invasive procedures.

[Wend861]

It is unlikely, but not impossible, to get cervical cancer unless you are positive for the HPV virus so they have decided not to look at any HPV negative samples.
I had a Dr's appt today and she told me the guidelines are to have a referral to gynae if you have had two episodes of bleeding after sex but you have to have ruled out infection so I have an appt to have swabs despite having no symptoms. She then said that I should try using Vagifem again every day for two weeks and then twice weekly and let her know after four weeks if that had helped. Hopefully it is VA and this will sort it out.

[shrosphirelass]

Wend876 let me know how you get on.

[CLKD]

Wend861 - if the twice weekly doesn't help then add every night if necessary.  Don't wait simply to 'let her know' because VA needs a bit of Trial and Error.  U will know how good the VA treatment is.

[Littledove]

I have had issues with PMB for years whilst on HRT but this has more or less resolved following having a mirena.

 I have noticed that on most occasions following sex I have very light spotting, usually the day after.

Hi Shropshire lass - did you get this resolved… I currently having bleeding after sex only …

 I do not really want to go down the 2 week pathway route having recently had a hysteroscopy with fibroid removed. Could it just be vaginal atrophy or just one of those things?

I know the gynae said any further bleeding may require a colposcopy. I recently had a clear smear though they just checked I didn't have the HPV virus and didn't send the sample for analysis