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anonymous1000462 Asked January 2020

I had a total hysterectomy 23 yrs ago and now noticed bright red blood on toilet paper. What could it be?

It happened last month when I wiped and some spots on my underwear. lasted 2 days. This month same thing. I also seem to get the chills. I am scared. I am 65 yrs old.

BBS2019 Feb 2020
Check with your PCP for advice.

If you are seeing BRB (bright red blood) on the toilet tissue, you need evaluation for gastrointestinal tract bleeding. That means you need to see a gastroenterologist who will likely order a colonoscopy. The good news is the bowel prep is a lot easier now than in the past. And at age 65, you are covered by Medicare, including colonoscopies.

A colonoscopy is an exam of the bowel using a tiny camera on a tube. Any abnormalities like anal fissures, polyps, internal hemorrhoids, diverticular pouches, inflammatory bowel disorders can be found and often treated on the spot. It's an outpatient procedure and you will be in and out within a matter of hours. Most BRB on toilet tissue is due to bleeding internal hemorrhoids, anal fissures or polyps, none of which is "cancer."

If you are uncertain where the BRB is coming from, your PCP will want to do a urinalysis and cytology (to check for urinary tract infection or other issues.) If positive testing, you may be referred to a urologist for further evaluation. If the bleeding is thought to be coming from the vaginal tract, a gynecologic exam should be done to check for polyps, fissures, infections.

You may need all 3 evaluations, but base on my experience reviewing medical charts for over 40 years, BRB is most often from a source lower in the large bowel and is not a life threatening issue. But you won't know until you get an evaluation.

Sendhelp Feb 2020
Anyone, always get checked out (by your gyn, urologist, or gastroenterologist) when there is an unknown source of bleeding.
imo.

Leaving this thread up to the real experts now. Having a very busy day ahead with appointments.

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Sendhelp Feb 2020
Still reluctant to talk about 'female' things, but here we all are.
And I had worked for a gynecologist!
Maybe it was a good thing the OP brought this topic up.
I hope by now she is feeling more supported, a bit more understood. We are here for her.

Barb,
When I mentioned 'toxic shock'. I was referring to your comment about your condition at age 40, and your being told to never use tampons, as one reason why. I was worried about tampons, but still used them, way back then.
Sendhelp Feb 2020
Well, for sure, I never never ever mentioned having my period to my mother again.
BarbBrooklyn Feb 2020
Send, I was born in 1953. Toxic shock wasnt around until I was out of college. It was just a very "dont talk about female things" world that I grew up in. And not in a good way.
JoAnn29 Feb 2020
I was born in 1949. Yes, it was a private thing. It shocked me when my daughter came home and a girl in school hollered at a boy "leave me alone, I am on the rag".
Sendhelp Feb 2020
Barb,
Well, toxic shock was a worry, not sure about now.

"Toxic shock syndrome is a sudden, potentially fatal condition. It's caused by the release of toxins from an overgrowth of bacteria called Staphylococcus aureus, or staph, which is found in many women's bodies. Toxic shock syndrome affects menstruating women, especially those who use super-absorbent tampons"
(from the internet).

BarbBrooklyn Feb 2020
Send, when I was in my 40s and mentioned to my mom that I was having irregular vaginal spotting, she asked how I knew it was vaginal and not urethral. I said " I used a tampon to check, mom". My mother thought that tampons were un-something. Really not sure what. I had been told never to use them.

Bizarre time that I grew up in.
JoAnn29 Feb 2020
This happened when I was on the pill.
Sendhelp Feb 2020
Barb,
Yes, I was brought up in that same 'silent' era when our periods were not mentioned.
When my mother saw that I was bleeding into the toilet, not knowing what to do, she panicked and ran through the house, yelling for my father....."Paul, Paul, go to the store to get your daughter some kotex!". I had siblings, one was a brother.

The silent era. I was so embarrassed!

All of us are going to take blood spotting more seriously, thanks to Marcia!

BarbBrooklyn Feb 2020
Marcia, I'm not trying to alarm you, really!. Is the bright red blood coming from the front (vaginal or urethral area) or from your rectum? If you have an old tampon lying around, you can figure out pretty easily if it is vaginal or urethral blood.

It really matters what you tell the doctor what you are seeing so that s/he can do the right testing.

Ffolks of the over 60 age group were brought up in what I like to say was the "total silence" era. I was told never to discuss my period with ANYONE. (Geez, what was that about, mom?).

Fortunately, we live in more enlightened times.

Wishingvyou all the best!!!

Sendhelp Feb 2020
Thanks for explaining Marcia.
Forgive us that do not read back farther, and those who cannot find your answers in the 'REPLY'. It is more of an issue with the function of the website, not you. And not that we caregivers here do not care about you, and not that we cannot identify with you or the very real fears you are experiencing. We do care!

Do not ignore getting ALL the tests needed to make sure there is no cancer.

JoAnn29 Feb 2020
Marcia, if you have no cervix, then no need for a pap smear. Thats what a pap smear is for, detecting cervical cancer.

But glad everything seems OK.
anonymous1000462 Feb 2020
They did a pap smear for screening of malignant neoplasm of the vagina. They still called it a pap test even though I don't have a cervix.
elaine1962 Feb 2020
15 years ago when my mother was 80 years old my mother had vaginal bleeding. She never had a hysterectomy. She called the doctor but then she got scared and cancelled the appointment. The doctor sent her a certified letter with return receipt to my mother insisting she come in. They checked her out and found out it was nothing, but they do did a D&C at the outpatient hospital. She never had bleeding since then.

bluefinspirit Feb 2020
Thank you, Sendhelp!
Marciaw419 came to this forum because she was terrified about some bleeding. I think she needed some advice from anyone with experience, but I think mostly she just wanted to have her own fears and anxieties lifted a bit by sharing. Most of us are not doctors, so I think the best we can do sometimes is give love and support.
XOXO
anonymous1000462 Feb 2020
Thank you, very well worded and that is exactly what I needed, I was terrified. Seemed to be let down by some.
Sendhelp Feb 2020
We are all sorry Marcia.
It was scary to have a cancer diagnosis.
Glad that it is cured now.

We get carried away sometimes, making us human caregivers.
cwillie Feb 2020
The OP never mentioned cancer as the reason for her hysterectomy.
Sendhelp Feb 2020
The OP is correct, a PAP Smear or a SWAB is done after TAH.

"Similarly, if you had a partial hysterectomy or a total hysterectomy — when both the uterus and cervix are removed — for a cancerous or precancerous condition, regular Pap tests may still be recommended as an early detection tool to monitor for a new cancer or precancerous change."

Marciaw419,
What can we say to confuse matters worse?🤦‍♀️

Hope you are not scared after getting checked out.

cwillie Feb 2020
I checked that article out and it says atrophy can be related to no sexual activity, with or without a partner - and that isn't the same thing as no intercourse 😉

lealonnie1 Feb 2020
https://www.mayoclinic.org/diseases-conditions/vaginal-atrophy/symptoms-causes/syc-20352288

Here's what Dr Google says on the subject, including vaginal atrophy being caused from lack of intercourse. The OP must have had a partial hysterectomy, not a full one.
Estrogen can reverse this condition.

Good luck!
anonymous1000462 Feb 2020
I had a total hysterectomy in May of 1996 due to cervical cancer,
Rainmom Feb 2020
Radical hysterectomy: complete removal of the uterus, cervix, upper vagina, and parametrium. Lymph nodes, ovaries, and fallopian tubes are also usually removed in this situation.

Total hysterectomy: complete removal of the uterus and cervix, with or without removing the ovaries.

Subtotal hysterectomy: removal of the uterus, leaving the cervix in.

I had a “total” hysterectomy back in 2016. I was looking on the bright side when I made a comment to my surgeon about not having to giddy-up into the stirrups ever again. Bursting my happy moment my surgeon reminded me that my ovaries were being left intact for the tiny bit of estrogen they produced - and they needed to be checked every two years. Oh well.

But cwillie is absolutely correct. Having no cervix pretty much makes a tradition Pap smear impossible.

BarbBrooklyn Feb 2020
How does seeing bright red blood get caused by lack of sexual activity? I think you need to get more specific answers from the doc.
Tothill Feb 2020
Vaginal Atrophy can lead to tears which can bleed. I had an Aunt who started to bleed after wiping herself. Tears can happen while walking, panties rubbing on the Vuvla etc.

There is a new belief that vaginal dryness should be treated to help maintain a healthy Vagina and Vulva. Special moisturizers are used.

Sexual activity keeps the pelvic floor muscles in shape and contribute to natural lubrication and keeps dryness at bay.
cwillie Feb 2020
I do hope this doctor was a gynecologist, I kind of wonder what kind of pap test could have been done on a woman who has had a total hysterectomy - no cervix to swab, right?
Sendhelp Feb 2020
CWillie,
Only you would have noticed this....you are still bright as ever!
What she needs is an occult blood in stool test, imo.
Rainmom Feb 2020
“Can be caused by no sexual activity.”

Not to make light of the situation...

But I have to admit I had a good giggle as to the potential remedy. Much more fun than “Two aspirin and call me in the morning”.
JoAnn29 Feb 2020
I am 70 and have had dry problems for ages. Have to use a lubricant or I get really irritated to the point of very bad discomfort.
bluefinspirit Feb 2020
Marcia, You send this message to me that I think you intended to post to the entire forum so I'm posting it here:

"I am not sure how to post an update on my situation. I went to GYN and had a pap test on the 27th and waited for the results. However it came back as they didn't have enough cells. So I repeated the pap test.
Yesterday received a call that the pap test was normal.
What a relief.
Said its called vaginal atrophy.
Can be caused by no sexual activity.
Anyone hear of that? Thank you, I wanted to update everyone."

It sounds like you got really good news. I'm so happy for you!
cwillie Feb 2020
thanks for copying that for us, I was wondering
bluefinspirit Jan 2020
Marcia,
How about if you let us do the worrying for you? ;-)
anonymous1000462 Jan 2020
Thank you that would be nice, appreciate it.
BBS2019 Jan 2020
Bright red blood is from the rectum may be sign of anything from hemorrhoids, anal fissure, to an inflammatory bowel disorder to polyps of the gastrointestinal tract to rectal or bowel cancer. Dark red blood from the rectum or on the stool usually means that bleeding is somewhere above the rectum, so typically not hemorrhoids or anal fissure. Make a note of the appearance of the "spots" and when you see them. Make an appointment with your primary care MD today.

If you are 65, you are most likely covered by Medicare in some form. Medicare includes a colonoscopy as part of their recommended screenings, which should take place every 10 years starting at age 50. If you have never had a colonoscopy and have rectal bleeding, this is what the primary care MD will order for you. I had my second one done last year and the bowel prep was far easier than for the first one 10 years prior.

If you are uncertain where the bleeding is coming from, other workups may be needed. Bleeding from the vagina will need a gynecologist exam. Bleeding into the urine can be worked up by the primary care MD (they will do a urinalysis and culture to check for a urinary tract infection-UTI_ and other pathology.) If a UTI only, antibiotics may be prescribed. I had a UTI recently, which I thought would pass, but I started to have dull pain in my flank. The MD diagnosed ascending pyelonephritis, which would have landed me in the hospital if I let it go any longer. An antibiotic cured it.

It's possible to have rectal bleeding and a UTI at the same time. These are not related but still need to be investigated and treated. Don't wait any longer. You will feel more relieved once you put yourself in the hands of a physician who can find answers for you.

BarbBrooklyn Jan 2020
Marcia, how are you?
anonymous1000462 Jan 2020
I have an appointment scheduled for the 27th of January and haven't seen any spotting since 1st of January. But am having it checked out. Will keep everyone informed once it is figured out. Just wish I would stop thinking about it. Thank you.
JoAnn29 Jan 2020
I think since chills are involved it maybe a UTI. But I am a worrier too.
worriedinCali Jan 2020
Yes I was going to say the same thing. Hopefully OP just has a UTI.
anonymous1000462 Jan 2020
It is out of fear, but after reading everyones post, I do plan to call my PCP and find out. It is just too scary if it is serious. I will keep you updated, thanks.

SoVeryExhausted Jan 2020
I had the same thing. I'm 60. Turned out I had a benign polyp near my cervix. Painless procedure to remove it.

cwillie Jan 2020
I would have imagined most women can tell the difference between bleeding from the urethra or the vagina but from the answers given maybe not? In either case you know this is NOT NORMAL and needs to be investigated. It was a discussion on this forum about taking care of our own health that prompted me to stop ignoring some very minor bleeding of my own and I'm glad I did because it was endometrial cancer. Get it checked.
Sendhelp Feb 2020
Cwillie,
It is not unusual for a woman not to know!
A patient was given a same day appointment when her mother called to say her 35 y.o. daughter was bleeding from her rear.
Turns out she was just having her period.

And the doctor was mad at me for allowing the appointment!
freqflyer Jan 2020
marciaw, this is just a long shot, did you eat beets recently? Beets can cause one's bodily function to be red. Also, you could have a hemorrhoid that is irritated and that bled.

As others had recommend, best to have a doctor check out every possible. Hopefully this is something very minor.
anonymous1000462 Jan 2020
No I didn't eat beets but wish it was that simple. And yes hope its minor. thank you.
JoAnn29 Jan 2020
Please don't ignore this. I don't think Urgent care is needed but would call ur PCP tomorrow.

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