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Spotting, despite hysterectomy, never considered 'normal'
By Dr. Peter Gott | Columnist
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Published: 5/5/2008 12:19 AM

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Q. I have a problem that no doctor seems to think is serious, but I am very worried.

I had a complete hysterectomy when I was 28 because of cancer. I was lucky that it was caught early. I am 65 years old. About six years ago, I started to "spot." It is like a light menstrual period. I have seen three gynecologists, who all say it is "normal." I wear panty liners every day because I never know when it is going to start. Since I don't have a uterus anymore, why am I bleeding?

A. Vaginal bleeding in a post-menopausal, post-hysterectomy woman is never normal. This is not to say that the cause of your bleeding is necessarily serious, however.

A complete hysterectomy is a surgery that removes both the uterus and cervix. The ovaries and fallopian tubes remain intact.

Without knowing more, I cannot guess what is causing the bleeding. Do you have pain just prior to or associated with the onset of the bleeding? Have you had a pelvic exam? Have you had any testing? These are all important questions that need to be answered.

I urge you to find a gynecologist who will listen to your concerns and order appropriate testing. Perhaps you will have better luck beginning with your primary-care physician. He or she can listen to your concerns and symptoms and then direct you to a resource for appropriate help. If your local gynecologists refuse to take the appropriate steps, ask your doctor to speak with them directly. This may yield favorable results, testing and a diagnosis. If not, consider a different gynecological group outside your local area, a teaching hospital or a specialized clinic, such as is available at the Mayo Clinic or the Cleveland Clinic.

Your bleeding may be harmless, but given your history of cancer, you need to know definitively. Let me know how this turns out.

Q. I am a 62-year-old female. I have no major health problems, but I do get stiff and sore occasionally. Sometimes I can go a few days with little pain, and others it will be really bad. It usually happens after sitting for a while. Could it be arthritis? Is there any possibility (please don't laugh) that it could be from the mercury in my fillings? I worry that the cause of the pain and stiffness could be poisoning my body.

A. I believe that your pain is caused by age-related osteoarthritis, given the fact that it comes and goes. Mercury in your fillings is not the culprit.

The issue of mercury-induced illness from old fillings has been largely ruled out. Some consumers remain skeptical, however. Mercury can be very dangerous, primarily in people exposed to moderate amounts regularly. Because tooth fillings are relatively small and contain minimal amounts, I don't believe you should be worried. If you are still concerned, visit an oral surgeon, who can explain about older fillings. He or she should also be able to remove them and replace them with safer, modern material.

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