Bleeding when going to the toilet (TMI photo included)

[TeddyOBear]

Hello all, just wondered if anyone else has had this.
I am on oestrogel 3 pumps a day and progesterone 2 capsules for 14 days each month. I had the pestrogel increased just over a week ago from 2 pumps to 3 pumps as I had been having terrible night sweats and also quite severe day sweats. When I was on 2 pumps, the symptoms never really went away and I was on this dose for 1 year.

I have been very constipated and following this I have been bleeding vaginally when I have my bowels open or sometimes just passing urine. It is definately vaginal bleeding, definitely not rectal. It only happens when I am having a wee or bowel movement. However, I have quite bad period pains. I am around half way though my cycle. I am 48, last period was quite light. Def perimenopausal, bloods etc confirmed this a year ago. Blood is bright red, not dark, no blood in stools. Photo below, sorry if it upsets anyone x

Have you had a conversation with your doctor about this? If not, that's the place I'd go as soon as you can. Just to be sure.

Thank you so much for your reply. I have sent the photo and done an e consult for my doctor. I am really lucky as I have great GP so I know they will be in touch tomorrow. I just wondered if anyone else had had this?

Does your hrt say bleeding / spotting can be a side effect?

I've occasionally had blood on wiping . ( not on hrt) , I think the act of going to the toilet helps it out.

You're doing the right thing by seeking medical advice.

Not on HRT but same has happened to me the last four weeks. Can you update me when you see your GP can never get in mine

Thank you for your replies. I think I have a tear. I don't think the bleeding is coming from high up. My lovely doctor was great. Says to keep an eye on it. She said progesterone changes could cause bleeding but I really don't think it's that. Just quite sore and today it's started again when I have my bowels open. Feel a bit worried but can def see a tear down there although had to be a contortionist to be able to see with a mirror.

Why would you have a tear that is causing that amount of bleeding @TeddyOBear ? Is this sex related and maybe vaginal dryness? A tear isn't normal if it's for no reason. The constipation is a bit of a red herring (not a cause) -all it's doing is forcing more blood out when you strain. You can get breakthrough bleeds on HRT sometimes when you increase the estrogen or it can be your own period coming outside the cycle .Maybe your GP should examine you just to be sure of what's going on. Use a tampon maybe to see where the blood's coming from?

Thank you @MadAboutChocolateLady, I appreciate your reply. Yes I did put a tampon in yesterday and kept it there all afternoon even when using the loo. There was still blood in the toilet especially as I had my bowels open too. There was nothing on the tampon, but the blood was still there. It was quite a lot on wiping and in the toilet but stopped pretty much as soon as I finished on the bathroom. The blood is definitely not rectal. It's not sex related so all I can think is the impacting from the constipation must have put pressure on a more delicate area. There is def a tear there. Managed to get a photo now so can show gp if needed. Gp is lovely, she advised that it could take a number of weeks to heal. I'm just keeping it clean and not put pressure on it. Feel so up in the air anyway with hormones not quite being right and some other family health issues it's upset me a bit. Thank you all though for taking the time to reply to me. I do appreciate it.

I understand it's distressing.
I really think your GP should see you. It's shocking she hasn't suggested that. All this providing photos etc isn't good enough. No one who is bleeding from anywhere should be told to wait and see if it heals.

If you're bleeding this much from a tear, it may need stitches just like after childbirth. The usual consequence from severe constipation is piles (bleeding from the rectum) not the vagina. Are you sure you don't have piles?

In any case, go and get it looked at!

Your GP needs to see you in person and address the source of the bleeding (once found). If they can't find it, ultrasound might be needed. It's probably nothing but I think (in my non-doctor opinion) that more needs doing.

There is something called a fistula which is where the wall of the vagina develops a hole. It's just possible that it's compacted poo and straining that's caused it (not childbirth.) But needs a proper diagnosis and maybe stitches if it's not just a hormone blip.

Thank you all for your replies and care. Believe it or not I'm a nurse with 25 years experience... d'oh! Def not a fistula, not piles, it is a vaginal tear. I've seen it. It's been fine today thankfully. Initially before I realised it was a tear, I thought it was vaginal but it isn't. I think given the menopause, how dry things have become and the pressure as I was very impacted, it may have put pressure on a weak spot - previous tear sustained in childbirth. My Gp surgery are great, we are so lucky. I can easily book to see them in person, they are very approachable. But, thank you all for taking the time to reply and be concerned, I do appreciate it.

If you are so dry that your vagina is tearing with constipation, this is very serious.
It will need minor surgery (stitching) because the photo you showed wasn't spotting, it was full-on bleeding.

You need to be examined. Don't assume it's anything until all the more serious issues have been ruled out.

All the best x

@MadAboutChocolateLady thank you xxx