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[Nickyp]

Hi, I have had issues with occasional spotting, have had an ultrasound and smear, all results clear. My womb lining is 3mm, so no issues there. I have noticed that the spotting seems to tie in with me being constipated and having to strain to go. Apologies if this is tmi, but just wondered if the straining  is the cause of my bleeding. Has anyone else experienced this or any advise- thank you!

[Nickyp]

Thanks Sparkle, I too have piles which I've had for years, could these be the cause of bleeding from the vagina, or would it be the piles that bleed?

[dahliagirl]

The fluctuating hormones might be a cause of the constipation that leads to straining if you see what I mean 

Otherwise, I do find that it does bring on bleeding if it was due anyway, or I get more of it if I have a period.

I try and drink plenty water, eat plenty fruit and veg, use movicol and suppositories (in order of frustration  )

[Nickyp]

I'm def post meno and on hrt, so it doesn't tie in with a period. I guess I just wanted to know if straining can cause vaginal bleeding or is it a coincidence?

[Taz2]

Are you sure it's not from the perineum? I have had small splits in mine due to VA and these can bleed during a bowel movement. It can seem as if the bleeding ( noticed when wiping) is from the vagina but it's from the skin in between the two.

Taz x

[Wrensong]

Hi Nickyp, I also had a perineal split due to VA - healed after a few months on systemic HRT plus Vagifem with a little Ovestin applied externally.  If you have VA, I also wonder whether the internal vaginal tissue could be so fragile that straining with a BM could open up any little tears - you would presumably know though, as I'd expect this to be sore. 

After 2 years on systemic HRT (admittedly poorly absorbed as has only just come to light) together with Vagifem, I've recently been told that persistent spotting could be due to atrophy.  Could you bear to ask your GP to have a look at the area?  I know you've had a smear & scan but they might be able to see if tissue lower down looks fragile and inspect the perineum to give you peace of mind & appropriate treatment if it is due to VA.  I would personally want everything else ruled out. 

I had TV-USS, smear & hysteroscopy, but the last of these was more than a year ago, so I have flagged it up again repeatedly to both GP & Menopause clinic & it will be investigated again if it continues, as unexplained bleeding should always be checked out.  Please don't be alarmed though - it's most likely nothing serious, but better to get GP or gynae opinion if you are at all unsure of the cause.

[Nickyp]

Can I just ask, with VA does it feel a bit like an mouth ulcer but inside. When I have the bleeding, which generally is after a strained bm it also feels sore when I wipe, almost as though I've wiped too hard or caught my nail. Sorry again if this is tmi, but I am finding the responses so helpful.

[Taz2]

That's a good description Nicky. I discovered what was wrong by using a magnifying mirror to have a good look - not a pleasant sight 

Taz x

[Wrensong]

Nickyp, VA for me has been at times intensely sore & like Sparkle's comment, just inside has been one of the worst areas.  In fact, I've recently been advised to double up on Vagifem, using 2 tablets three times a week, 1 inserted high up & one low down to try to improve the area just inside. 

There have been times when I've thought the VA was under reasonable control & felt relaxed about sex, only to find that on penetration, despite using a good lubricant, it's felt as though an unsuspected sore area has been torn open.  At other times the whole vaginal/bladder area can feel persistently inflamed for no apparent reason, so that it's impossible to know whether the discomfort is due to a UTI, thrush, something else or whether down to VA alone.  With VA the tissues of the GU tract (ie bladder as well as vaginal area, inside & out) become thinner & so much less robust & this, together with the decrease in natural lubrication that in fertile years helps balance the flora, means it's easier for infection to take hold.

Please don't be afraid to ask questions here - nothing is silly, taboo or tmi!  We are all learning from each other & like to help if we can.

[Nickyp]

Just an update, have been back to the docs today. Ironically I started to bleed just before. In a way it was a good thing so the doc could examine me. She could see a paper like cut which she said could be where the bleeding could be from. I've noticed on the other occasions that I have bled that things seem sore but then it all goes away again until the next time. The doc is confused and really not sure what to do, she is going to contact our local gynae cliinic for advise. Could this be va ? She has given me some cream in the meantime which might help, it's a lubricant not hormonal. Tia