Ask an Expert: Stressful situations cause midcycle spotting?

Women's Health

Stressful situations cause midcycle spotting?
07/07/2008

Question:

Dear Doctor, I am 45 years old. I went for my yearly exam last Friday which included a pap smear etc. I noticed Saturday afternoon when using the restroom that I had slight spotting and or bleeding when I wiped. It should be noted that I had had intercourse with my husband the Friday evening following my pap smear.(We always use a condom) The spotting and or light bleeding has continued on and off through today (Monday) and is only seen when wiping. I called the doctors office and received a call back stating to "hold tight until we get the pap smear results back". It should be noted that in all the years I have had pap smears they have always come back normal. My last pap smear being last summer. My questions are: Could the bleeding be the result of the pap smear and or exam? Could the bleeding be the result of the pap smear combinded with having sex later that evening with the use of a condom and an already sensitive area on the cervix from where the pap smear was taken? Could the spotting or light bleeding be from mid cycle bleeding from ovalating or lack of? My period was 6-13 or 6-14 and my spotting or bleeding began on the 28th.(I do not or have not ever taken birth control pills) Could the bleeding be caused by me not taking my thyroid meds every day like I should? I have a difficult time remembering to take them every day. The last time my thyroid levels were checked my doctor stated that I needed to do a better job as my levels were not where they should be considering I am on medication for hypothyroidism. Again, my husband is the only person I have had sex with and we have always used condoms with the exception of the two times which resulted with the birth of our two children. Lastly, I just went through a very stressful/emotional few weeks with much higher stress than I have ever experienced in my lifetime.Could extremeful stressing situations cause mid cycle spotting and or bleeding? Your thoughts would greatly be appreciated. Thank you for your time.

Answer:

Thanks for your question - it’s a really good one.
First, a pap smear can irritate the cervix and cause a minimal amount of spotting for a day or so after the exam.
Second, the thyroid gland is one of the important glands in the reproductive cycle, so if you aren’t taking your thyroid medication regularly, there could be changes in your cycle because of fluctuating hormone levels. You also may be peri-menopausal (meaning that your hormone levels are starting to change in preparation for menopause) and that can have an effect on the cervix.
Third, stress is also a powerful influence in women’s menstrual cycles.
So, there are many factors that can cause a bit of spotting, especially after intercourse. I’d agree that it’s important to see the results of the Pap smear before making any recommendations. The pap smear can tell us if there are changes in the cells, if there is inflammation from bacteria, viruses, yeasts or changes in the acid/base balance in your vagina. If the spotting continues for more than a week, it would be very important for you to have it evaluated by your provider. Thanks for your question - it’s a really good one.
First, a pap smear can irritate the cervix and cause a minimal amount of spotting for a day or so after the exam.
Second, the thyroid gland is one of the important glands in the reproductive cycle, so if you aren’t taking your thyroid medication regularly, there could be changes in your cycle because of fluctuating hormone levels. You also may be peri-menopausal (meaning that your hormone levels are starting to change in preparation for menopause) and that can have an effect on the cervix.
Third, stress is also a powerful influence in women’s menstrual cycles.
So, there are many factors that can cause a bit of spotting, especially after intercourse. I’d agree that it’s important to see the results of the Pap smear before making any recommendations. The pap smear can tell us if there are changes in the cells, if there is inflammation from bacteria, viruses, yeasts or changes in the acid/base balance in your vagina. If the spotting continues for more than a week, it would be very important for you to have it evaluated by your provider.
Hope this helps!

For more information:

Go to the Women's Health health topic, where you can:

Read articles on this topic
Browse the previously asked questions
Ask your own question.

Response by:

Elizabeth R Barker, APRN, BC, FNP, FAANP, CHE, PhD
Associate Professor
Director, MS Program
College of Nursing
The Ohio State University