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Response by GP to PMB

Maebelle2014

Hi

On Friday I had some light brown discharge on the toilet paper after wiping following a wee and there was also some slightly brighter red when I inserted my finger into my vagina (not visible on the actual finger but when wiped on toilet paper).  I’m 55 years old and it’s been over 3 years since my last period.  I have never had sex (virgin).  I spoke to the 111 service and the nurse advised I contact the GP on Monday so that I can be seen and referred to the hospital for further investigation.  She said it could be caused by a number of things, including cancer.  She also recommended I get a BV test kit, which indicated trichomoniasis which as I’ve not been sexually active suggests it’s not the most accurate result.

I contacted my GP yesterday (Monday) via their online system and received a call back asking me to go into the surgery that morning, get a vaginal swab kit, do the swab in their toilets so that it can be collected and taken for testing by midday.  I should get the results on Wednesday.  I queried why I wasn’t being offered a F:F appointment and an examination.  He said their first response would be the swab and it was quicker if I did that myself rather than wait for an appointment.  I queried the discharge and he said you don’t get discharge with cancer.  I queried BV and bleeding and he confirmed this could happen.  If the BV is negative they will offer me an appointment then.

I have been in touch two further times to request an appointment, highlighting that the NHS website says a patient with PMB should be referred by the GP to the hospital or clinic and that discharge can be a sign of cancer but have not heard back from them.

Please can you advise whether you think the above pathway and the triaging clinician’s rationale is correct.  

If the BV swab comes back positive should I still request a F:F appointment and examination or will treatment for BV be enough.

If the cause of the PMB is more sinister will this delay in being seen make the prognosis worse.

I have severe health anxiety already so would really appreciate your perspective to keep my concerns in check.  I’m also very socially isolated so have no one to talk to re this.  I’m not sleeping or eating due to fear/stress.

Thank you.

 

  • UPDATE: I’ve just phoned the GP surgery as I noticed on the NHS app my symptoms were coded as vaginal discharge, which I disagree with.  The GP receptionist advised that my further queries yesterday had been reviewed by a GP and they were in the process of arranging an appointment for me this week.  I have since been sent an appointment for Friday.

    Please do advocate for yourself - I’m sure the original triaging clinician found me annoying but go with your gut if something feels off.

  • Hi there Maebelle2014 and thanks for the post

    I am sorry to hear about the recent discharge and bleeding you noticed and can appreciate your worry about this.

    You have done the right thing by contacting your GP about this and hopefully you will know more soon.

    Whilst any sign of post menopausal bleeding should be investigated most people won't go on to be diagnosed with cancer with this symptom. Other reasons for pm bleeding include vaginal atrophy (thinning tissues) and dryness, polyps and something called endometrial hyperplasia where the womb lining is thickened.

    Usually a GP will examine someone who has pm bleeding and then refer for further tests according to the findings. It isn't unusual to check for infection and to take swabs to check this out.

    Sit tight as best you can until tomorrow and then I would call the surgery to find out if the swab results are back. If there is infection detected then treatment will be prescribed and there would be a good indicator of that being the cause of the bleeding. If after a course of treatment the discharge and bleeding continues then the doctor I am sure will want to examine you and refer you on accordingly.

    If as you say the swab comes back negative hopefully a GP will see you face to face, examine you and refer you on for more tests, just to be on the safe side.

    Don't let your mind run away with itself if you can. You have done everything you can for now and it is important to look after yourself by trying to eat a good healthy, balanced diet, get some fresh air and have a good bedtime routine to ensure a good nights sleep.

    keep yourself busy with other things as this can really help. The NHS web page Every mind matters has some helpful tips and advice to help manage any stress and anxiety people may be going through so take a look.

    I hope you hear something soon and that everything turns out okay for you.

    Remember we are here and if you prefer give one of the nurses a call on the helpline. Our number is 0808 800 4040 and the line is open weekdays 9-5.

    Take care of yourself

    Naomi

  • in reply to CRUK Nurse Naomi

    Thank you so much Naomi for this response.  As well as clarifying my queries, it has given me a reference point for when my health anxiety kicks in.

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