Vaginal bleeding

By Tedler D. Depaynos, MD

“ Before she left, she mentioned that her boyfriend works in another country and they planned to get married early next year. She then asked if the specialist could be invited to be one of their “ninangs””

The 33 year old female patient is an OFW who unfortunately had difficulty of returning to her place of work abroad because of the Covid problem. When she started having vaginal bleeding and began to worry because anytime she would be going back to work abroad, she consulted their old family MD whom she trusted. Besides, her late mother was under his care when diagnosed with a late stage cervical cancer and the only manifestation was vaginal bleeding. Initially, she was inhibited to express herself when asked if she had any sexual contact. She said her last sexual contact was during her college days and she never had one when she went abroad. She also never consulted an OB-GYNE MD.
A pelvic ultrasound was then done which revealed no significant findings. She was then referred to a lady OB-GYNE MD with the assurance that she would be comfortable with her.
During the pelvic examination, the specialist felt no mass which was confirmed by the ultrasound (UTZ). Likewise, no tenderness was elicited which may imply inflammation if present. There was no blood appreciated when the vagina was visualized but the cervix which is the opening of the uterus appeared to be a little swollen. A pap smear was done to rule out any malignancy.
While waiting for the pap smear result, the OB-GYN MD mentioned to her the swollen cervix and asked her again with a serious tone if she had any recent sexual contact. If none, the probability that the swelling is due to malignancy would be very much higher. She then confessed that while following her papers, she met her former college boyfriend who incidentally was also following up his papers. They have not met for many years so that their meeting was a reunion. She admitted that they renewed their relationships and they had several contacts. It was then that her vaginal bleeding started. What worried her is that even when her boyfriend left already, she still experienced occasional bleeding.
The MD then lectured that cervical cancer is usually diagnosed when already at a late stage because most of the time the symptoms noticed and emanating from it are from a late stage. She then mentioned that the possible earliest manifestations are either a vaginal bleeding or foul smelling vaginal discharges. It again reminded her of her mother and silently murmured her hope that her bleeding was due to her excessive excitement. The patient denied any history of unpleasant vaginal discharges.
It was a few days after when the MD called and gave the good news that her pap smear was negative for malignancy. Her prayers were answered and she was so joyous that she will not undergo any pelvic surgery or any chemotheraphy or radiotheraphy. When she visited the OB-GYN MD for follow-up and to express her gratitude, she was advised with emphasis that only early detection could one survive this type of malignancy. She was instructed to visit an OB-GYNE MD regularly even when abroad because the possibility of cervical cancer is still there. She should only have one sexual partner and best to have her partner use a condom.
Before she left, she mentioned that her boyfriend works in another country and they planned to get married early next year. She then asked if the specialist could be invited to be one of their “ninangs”.**

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