Steroids and Postmenopausal bleeding

[Young65]

I had a steroid shot in the knee and began bleeding about two weeks later. Had an ultrasound, now doc wants to do hysteroscopy and D & C. Is that really necessary if bleeding is caused by steroid injection? Why so little information about this problem? I was only able to find four medical articles that address this issue.

[happytulip]

Any postmenopausal bleed, even if it is just one should be investigated. Any GP that doesn't do that is taking a risk with your health.

It's easy to put all of our symptoms down to our known medical problems but unfortunately that doesn't mean we are immune to other conditions. Your GP.is doing the right thing by doing an ultra sound for certain. I would have possibly expected them to wait for the Us report before committing to a hysteroscopy and a D&C but maybe there is a reason for this that you don't know about.

If you are at all concerned I would definitely encourage you to pick up the phone and see if you can get some clarification from the team. Sorry, I've just seen that I've assumed it's your GP and you referred to the person as Doc.

But yes, guidelines state that a postmenopausal bleed needs investigating. You don't know for certain that it was down to the steroids. And if you have the investigation and there is nothing to be found thenas my Doc says "reassurance is a great thing."

Take care and I hope it all goes ok.

[Gnarli]

In your position I'd be quite grateful that the GP is being so proactive. It's easy to blame steroids or our condition when things go wrong. Sometimes it's down to coincidence rather than cause don't you think?

[nomoreheels]

Hiya Young65, welcome. As you're new here I've no idea of your age (unless the 65 is age or year of birth?) but personally if I was in your position I’d prefer to have my GP take an FSH test first if you're not that long into menopause or are perimenopausal. I'm not sure you're in the UK either so ideas may be different where you are, that the suggested hysteroscopy & D&C may be common practice after one postmenopausal bleed, that's is if it is a year or more since your last period. It just seems a little gung ho to me.

[AgedCrone]

Yes it is necessary...you are lucky to have a caring doctor.

I have had both procedures & they are not difficult to cope with.....mine proved nothing....I was & am still fine.

Any unexplained bleeding at any age must be investigated.....thankfully these simple procedures can set your mind at rest.....to ensure nothing nasty is going on.

Personally I have never known steroids to cause bleeding...but an awful lot of very simple conditions can cause a bleed .....so don’t worry too much.

[KittyJ]

Firstly you don’t know it was caused by the injection, secondly I’d be very glad investigations are being carried out as the earlier you catch things the better. The doctors must have a reason for doing the procedures, did they not tell you why? I’d ring and ask if you think it’s unnecessary. I’ve had both done and they didn’t take long. They can’t force you to have them done but I would want to have peace of mind.

[lilyak]

Its extremely unlikely the bleeding was caused by the steroid shot. A D&C is a very minor procedure, but it wouldn't be recommended unless your doctor had good reason. You don't state if you've read the US report, but your doctor would have, and is recommending this course of action. I don't advocate blindly following medical advice, but in this case your doctor is absolutely doing all the right things. Perhaps you could make an appointment to discuss his/her reasoning to put your mind at ease and aid in your decision making? It is always your decision. As others have said your doctor sounds to be caring and proactive, and I would be very pleased for that.

[Young65]

Thank you all for your thoughtful comments.

[Justme70]

I found your comment when searching for info about postmenopausal bleeding after a steroid shot. I got a lumbar injection 2 weeks ago and have been spotting for 2 days. I'm 51 and haven't had a period since I was 40. I reported it to the Drs office and of course she said she doesn't believe it's related to the steroid shot. I call bs because it's the only thing different that's happened. The article I read said I should have been informed of this possible adverse side effect. I didn't want the procedure to begin with but pretty much didn't have a choice if I wanted to get my medicine. After reading your comment saying 2 weeks after your shot, you bled I feel certain this is what caused my spotting. 😡

[Young65 in reply to Justme70]

Yes, many doctors have not heard of this because there have been relatively few studies done. Many women (and doctors) do not make the connection because of the time it takes for the bleeding process to begin from when you get the shot. I found a few studies from gynecological journals, so I am sure we are in the 2% of post-menopausal women who this happens to. Lucky us! I told my ortho guy (where I got the shot) and he left the room. When he came back, he said I was the first patient in his twelve years of practice that this happened to and that there were other things he could try if I needed another shot for my knee pain. The female gynecologist's reaction when I went to have the bleeding checked was, "Why don't they ever tell women this could happen?". So, stick up for yourself and don't let anyone make you feel like you're crazy or neurotic!