Post-Menstrual Bleeding: Causes and When to Seek Further Evaluation

Postmenstrual bleeding

I would like to ask the doctor, after my menstrual period ends, I experience some brown or red spotting.
I went to the hospital for an ultrasound and a pelvic exam, and everything seemed fine.
The transvaginal ultrasound showed no major issues, but they mentioned that my endometrium is a bit thicker and suggested a hysteroscopy for further examination.
I'm unsure whether this is necessary or what might be going on with my body.
Why do I experience some bleeding after my period?

Joi, 20~29 year old female. Ask Date: 2016/04/15

Dr. Lin Wenbin reply Obstetrics and Gynecology

Please go to the hospital for an examination.

Reply Date: 2016/04/15

More Info

Post-menstrual bleeding, or bleeding that occurs after the menstrual period has ended, can be concerning for many women. It is essential to understand the potential causes of this phenomenon and when to seek further evaluation.

There are several reasons why you might experience bleeding after your menstrual cycle. One common cause is hormonal fluctuations. The menstrual cycle is regulated by a complex interplay of hormones, and sometimes, the balance can be disrupted, leading to irregular bleeding. This can occur due to stress, changes in weight, excessive exercise, or hormonal contraceptives.

Another potential cause is the presence of uterine fibroids or polyps. These are non-cancerous growths in the uterus that can lead to abnormal bleeding patterns. While your ultrasound did not indicate any significant issues, it is still possible for smaller fibroids or polyps to be present that may not have been detected.

Endometrial hyperplasia, which is a thickening of the uterine lining, can also lead to post-menstrual bleeding. This condition can occur due to prolonged exposure to estrogen without sufficient progesterone, often seen in women who are perimenopausal or those with certain hormonal imbalances.

In some cases, post-menstrual bleeding can be a sign of more serious conditions, such as endometrial cancer, especially in women who are postmenopausal. Therefore, it is crucial to monitor the bleeding closely. If the bleeding is persistent, heavy, or accompanied by other symptoms such as severe pain, it is essential to seek further evaluation.

Regarding your situation, since your ultrasound and pelvic examination did not reveal any significant abnormalities, the recommendation for a hysteroscopy (a procedure to look inside the uterus) may be a prudent next step. This procedure can help identify any issues within the uterine cavity, such as polyps or abnormal tissue, that may not be visible on an ultrasound. It is a minimally invasive procedure and can often be done on an outpatient basis.

In summary, while post-menstrual bleeding can be caused by various factors, it is essential to pay attention to your body and any changes you experience. If the bleeding continues or worsens, or if you develop additional symptoms, it is advisable to follow up with your healthcare provider. They can help determine the best course of action, which may include further testing or treatment options. Always trust your instincts about your health, and do not hesitate to seek a second opinion if you feel it is necessary. Your health and peace of mind are paramount.

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