Medically Reviewed On: July 09, 2008

MARY WAGNER: Welcome to our webcast. I'm Mary Wagner. We're here today to talk about abnormal uterine bleeding from the patient's perspective. We have Dr. Grace Janik who is Associate Clinical Professor at the Medical College of Wisconsin and Director of Reproductive Endocrinology at St. Mary's Hospital in Milwaukee.

MARY WAGNER: Dr. Janik, would you like to introduce your patient.

GRACE JANIK, MD: Hi, Carol. Thanks for coming and sharing your story with us. It's important to share your story because there are a lot of patients out there like you that can benefit from hearing your experiences. How have you been feeling lately? I haven't seen you in a while.

CAROL: I'm great. Thank you.

GRACE JANIK, MD: I think it would be best to start with explaining what happened before you started seeing me.

CAROL: Okay. I had been trying to get pregnant for about two or three years. It wasn't working. My GYN had tried to -- also the problem I was also having was I was having a lot of spotting, like bleeding. Not heavy bleeding, but between and before and after my period, which was always normal. I would have these constant spotting, and also during...

GRACE JANIK, MD: How many days was it on either side?

CAROL: It was immediately before and immediately after and then sometime during ovulation, I would also have it.

GRACE JANIK, MD: Okay.

CAROL: This was a problem because I was trying to get pregnant and it would make it difficult and just uncomfortable to deal with and just to go ahead with the whole procedure of getting pregnant. But when I did try to get pregnant, it wasn't working. It wasn't working.

GRACE JANIK, MD: Annoying to have the bleeding. In addition, difficult to time intercourse.

CAROL: Right.

GRACE JANIK, MD: What happened next?

CAROL: He had also tried to put me on some birth control pills to control the spotting. But that wasn't something that I was very excited with because I was trying to get pregnant and this was going to maybe help with the spotting but not with the whole idea of getting pregnant.

GRACE JANIK, MD: So what did he do instead then?

CAROL: That's actually when I was referred to you, just to check what might be wrong, what might be causing this.

GRACE JANIK, MD: I thought you had a couple of D & Cs before you saw me too.

CAROL: Actually yes, I did. I'm sorry. I had two D & Cs. Those procedures were quite uncomfortable and they did help with the spotting for a couple of months, but then after that, the spotting just returned. And that's actually when I was referred to you because those things didn't help. So.

GRACE JANIK, MD: So you had the spotting, wasn't getting better with the D & Cs. You weren't getting pregnant.

CAROL: Right.

GRACE JANIK, MD: Now you had some testing before you saw me.

CAROL: Yeah, I did, but there was nothing really that they could find.

GRACE JANIK, MD: You had your husband checked out.

CAROL: My husband checked out fine. I checked out fine in terms of being fertile and no problems with -- there shouldn't have been any problems with getting pregnant actually. So.

GRACE JANIK, MD: And why don't you explain what happened when you first saw me. What did we do?

CAROL: When I first saw you, I was nervous. But I had explained my history to you and everything that had been done -- the D & Cs, the bleeding, the fact that I couldn't get pregnant. At which point, you proceeded to give me ultrasound just to make sure -- to see what was going on. And there wasn't anything shocking, but there was something that wasn't quite right. So right there, you proceeded with a hysteroscopy. That's when you found the polyp that was causing the whole big mess. It was removed right then and there. It wasn't at all like my experiences with the D & Cs. It was actually quite different and painless --relatively speaking it was nothing big. And I got to see the whole procedure on the screen. I got to see the polyp and everything. I actually got to go home the same day.

GRACE JANIK, MD: Same day so none of that anesthesia.

CAROL: None of that anesthesia that I had to experience with the D & Cs. None of that discomfort. You know, having to stay home for the weekend because it was just so uncomfortable, the nausea and everything. It was actually just very relieving to me to know that it was taken care of. It was found and taken care of. And except for maybe a little bit of spotting after the procedure, everything just went back to normal. I had my periods like I usually did. That was it.

GRACE JANIK, MD: No more spotting.

CAROL: No more spotting.

GRACE JANIK, MD: And that was about nine months ago, wasn't it?

CAROL: Nine months ago.

GRACE JANIK, MD: What else has happened in the last nine months?

CAROL: Well, two months ago -- I'm pregnant for two months now. And I'm very happy, very excited.

GRACE JANIK, MD: Congratulations.

CAROL: Thank you. So it was really, really great to know that that was something that was possible for me to get done. It was so painless and so quick in one visit. And that finally what the whole goal that I was trying to reach in terms of having a child is going to come true. And now I don't have to deal with the discomfort of the bleeding so I'm very happy.

GRACE JANIK, MD: Congratulations. I'll be happy to get that birth announcement.

CAROL: You will.

GRACE JANIK, MD: What I'd like everybody to know from Carol's story is that your treatment can really be initiated much earlier if you have a precise diagnosis. So her trial of potential birth control pills and the D & Cs all could have been averted had a hysteroscopy been done early on in this two to three year time period of back and forth visits to the hospital could have been avoided, in addition to improving her chances for fertility.

Even for infertility patients who aren't having active bleeding, it is important that some sort of evaluation of the uterus is done because polyps can interfere with fertility.

MARY WAGNER: Well, thank you, Dr. Janik, and thank you, Carol, for sharing your story with us. And thank you for watching our webcast. I'm Mary Wagner.