Prolonged Menstrual Bleeding: Causes and Concerns - Obstetrics and Gynecology

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Prolonged menstrual bleeding, also known as menorrhagia, can be concerning, especially when it deviates from your regular cycle. In your case, you mentioned that your menstrual cycle has been consistently 28-30 days, lasting about five to six days. However, your recent cycle started on June 18 and has lasted for seven days, which is unusual for you. Additionally, you noted that you had a sexual encounter on June 6 and subsequently experienced a yeast infection, for which you sought medical treatment.

There are several potential causes for prolonged menstrual bleeding, and it’s important to consider various factors that could contribute to this change in your cycle. Here are some common causes:
1. Hormonal Imbalances: The menstrual cycle is regulated by hormones, and any imbalance can lead to changes in bleeding patterns. Conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders can affect hormone levels and result in prolonged bleeding.

2. Infections: You mentioned having a yeast infection. While yeast infections typically do not cause prolonged menstrual bleeding, any infection in the reproductive tract can lead to inflammation and changes in menstrual patterns. It’s essential to ensure that the infection is fully resolved.

3. Uterine Fibroids or Polyps: These benign growths in the uterus can cause heavier and prolonged menstrual bleeding. They are often asymptomatic but can lead to changes in your menstrual cycle.

4. Endometrial Issues: Conditions such as endometriosis or endometrial hyperplasia can also lead to prolonged bleeding. Endometriosis occurs when tissue similar to the lining of the uterus grows outside of it, causing pain and irregular bleeding.

5. Medications: If you are taking any medications, including hormonal contraceptives, they can affect your menstrual cycle. Some medications can lead to breakthrough bleeding or prolonged periods.

6. Stress and Lifestyle Factors: Stress, significant weight changes, or changes in physical activity can also impact your menstrual cycle. Emotional or physical stress can lead to hormonal fluctuations that may result in prolonged bleeding.

Regarding your concern about whether the internal examination could have caused the prolonged bleeding, it is generally unlikely. While some women may experience light spotting after a pelvic exam, it typically does not lead to prolonged bleeding. However, if the examination was particularly uncomfortable or if there was any trauma, it could potentially cause some temporary changes.

Given your situation, it is advisable to monitor your symptoms closely. If the prolonged bleeding continues beyond a week or if you experience additional symptoms such as severe pain, dizziness, or passing large clots, you should seek medical attention promptly. A healthcare provider may perform a pelvic exam, ultrasound, or blood tests to determine the underlying cause of your prolonged bleeding.

In summary, while there are several potential causes for prolonged menstrual bleeding, it is essential to consider your overall health, any recent infections, and changes in your lifestyle. If you have concerns about your menstrual cycle or if symptoms persist, consulting with a healthcare professional is the best course of action to ensure proper diagnosis and treatment.