instruction: hi doctor I have been bleeding heavily from my vagina for past five days it only happens when I either open my bowel or while urinating I put in a tampon to confirm that the bleeding is coming from my vagina and not from rectum when I am not using the bathroom there is no bleeding and no blood on underwear but as soon as I urinate and have a bowel movement I start to bleed it is not just spotting it is a heavy bright blood to sometimes dark heavy blood it reminds me of my heavy days on my periods I am nowhere close to my periods now I am taking birth control and have been getting my periods correctly each month this bleeding is not a consistent flow it only happens when I use the bathroom it is like I have blood pool above my vagina and the minute I push a little to pee or have a bowel movement it spills out I do not have period cramping but the pain will be like a dull achy to sometimes sharp pain especially when the blood comes out it radiates all over my pelvis ovaries stomach and back sometimes to my kidneys I did consult a gynaecologist earlier today he pressed on my stomach in which I had some discomfort he also did a vaginal exam and said there was a lot of mucus with blood when pressed inside I felt little discomfort he did a swab and sent it out to be checked for infection and prescribed me some antibiotics just in case it was an infection he also scheduled me an ultrasound for next week and wants me back in two weeks he told me to come back sooner if it gets worse he seemed quite concerned this evening I have started to become more dizzy and lightheaded could this be just an infection or something else I do not have itchy or burning vaginal symptoms that you get when you have an infection I am really worried about this I am scared of cancer now as I knew that the abnormal bleeding and pain are signs of reproductive cancer so I need a second opinion from another doctor while I am waiting for the results
output: hi I believe this is the first episode of heavy intermenstrual bleeding or polymenorrhagia for you and during the mid cycle if the bleeding is not controlled and remains heavy causing anemia and dizziness as manifestation then to stop the bleed the best way would be to undertake a dilatation and curettage procedure through which can remove the endometrium and subject sample for histopathological exam to rule out any endometrial hyperplasia and accompanied atypia which may indicate towards an endometrial cancer depending on the reports at present wait and watch for excessive bleeding for few more days and if it does not reduce then review with er and get the ultrasound done sooner and further evaluation keep yourself well hydrated to maintain the blood volume and avoid dizziness episodes for further information consult an obstetrician and gynaecologist online