Menstrual Irregularities and Vaginal Discharge Concerns

Menstrual issues, vaginal discharge issues?

Hello Dr.
Huang,
1.
I became aware about a year and a half ago that my menstrual cycle has been irregular.
Previously, I thought as long as my periods were somewhat regular, everything was fine, so I didn't pay much attention.
Typically, my period lasts about three days, then stops for one to one and a half days, and resumes for another two days.
There was one instance where it stopped for about three days.
I suspect that some of these interruptions were due to emotional distress; when I recall unpleasant memories, I experience chest tightness and sharp pain in my vagina (or possibly urethra?).
A year ago, I had an examination, and the doctor mentioned I had vaginal spasms, but he said that I would become less sensitive as I grew older (I have not engaged in sexual intercourse).
The more severe pain occurred after my period had been ongoing for two days, then it stopped for nearly three days.
After accidentally consuming angelica, my period returned.
Recently, I visited a metabolic specialist because I felt I had excessive facial hair and acne.
The doctor suggested it might be related to polycystic ovary syndrome (PCOS) and inquired about my menstrual history.
However, my testosterone levels were within the normal range, and while my blood sugar and insulin levels were normal, they were on the higher side.
I have not undergone an ultrasound.
After starting medication to lower my blood sugar, my acne has decreased, but my period has not yet arrived, so I am uncertain about my current situation.
2.
I am unclear about what constitutes a normal vaginal discharge.
During my freshman health check-up in college, there was a note about my discharge, but I did not follow up for a re-examination at that time.
During periods of increased discharge, it tends to be thick and somewhat resembles dried white glue (it can form shapes and can be picked up with my fingers).
I often notice yellow, moist spots on my underwear, especially before my period starts, leading me to believe my period has begun, only to realize it was just discharge.
I think I have been wiping myself clean after urination, but I am not entirely sure if the odor is related to urine.
Almost every day, there is an indescribable scent that has a slightly sweet note.
I would like to ask the doctor if these conditions warrant a medical consultation.
When should I seek medical advice? Should I schedule an appointment during my menstrual period, or is it acceptable to do so at any time? Thank you!

Niming, 20~29 year old female. Ask Date: 2016/07/12

Dr. Huang Yiwen reply Obstetrics and Gynecology

1.
Menstrual symptoms vary from person to person, but commonly include lower abdominal pain, bloating, diarrhea, lower back pain, or headaches.
As long as these symptoms are cyclical and improve after menstruation ends, they are generally considered physiological and not a major concern.
Symptoms like having a day or two of cessation during menstruation or experiencing vaginal spasms are not uncommon.
Sometimes, diet, emotions, or stress can lead to changes in menstrual patterns, so there is usually no need for excessive worry.
The doctor mentioned that you might have multiple ovarian cysts and suggested continuing to take blood sugar-lowering medication for a while.
2.
Generally, normal females will have some vaginal discharge.
As long as it is not increasing in amount, does not have an unpleasant odor, and does not cause itching, there is no need to be anxious.

Reply Date: 2016/07/12

More Info

Understanding menstrual irregularities and concerns about vaginal discharge can be quite complex, especially when various symptoms are involved. Based on your description, it seems you are experiencing a combination of menstrual irregularities, potential hormonal imbalances, and concerns about your vaginal discharge. Let's break down these issues and provide some guidance.

Menstrual Irregularities
From what you've described, your menstrual cycle has become irregular over the past year and a half. This can be influenced by several factors, including stress, hormonal changes, and underlying medical conditions. You mentioned experiencing interruptions in your menstrual flow, which could be attributed to various factors, including emotional stress, as you noted that certain memories trigger discomfort. Stress can significantly impact the hypothalamus, which regulates the menstrual cycle, leading to irregularities.

Additionally, you mentioned a previous diagnosis of vaginal spasms, which can also contribute to discomfort during your menstrual cycle. It's important to note that while some irregularities can be normal, persistent changes in your cycle warrant further investigation, especially if they are accompanied by pain or other symptoms.

Polycystic Ovary Syndrome (PCOS)
You mentioned that a healthcare provider suggested the possibility of Polycystic Ovary Syndrome (PCOS) due to symptoms like increased facial hair and acne. PCOS is a common endocrine disorder that can cause irregular menstrual cycles, hormonal imbalances, and other symptoms. The fact that your testosterone levels were within normal ranges is reassuring, but it’s essential to monitor your symptoms closely. The use of medications to manage blood sugar levels can help with symptoms like acne and may also have a positive effect on your menstrual cycle.

Vaginal Discharge
Regarding your concerns about vaginal discharge, it’s normal for women to experience variations in discharge throughout their menstrual cycle. The consistency and color of discharge can change due to hormonal fluctuations. Clear, stretchy discharge is typically associated with ovulation, while thicker, white discharge can occur at other times. However, if you notice an unusual odor, color changes, or if the discharge is accompanied by itching or irritation, it may indicate an infection or other medical issue.

You mentioned a sweet smell to your discharge, which can sometimes be associated with certain infections, such as bacterial vaginosis or yeast infections. It’s crucial to differentiate between normal physiological changes and signs of a potential infection.

When to Seek Medical Attention
Given your symptoms, it would be advisable to consult a healthcare provider. You do not necessarily need to wait until your menstrual period to seek care. If you experience significant discomfort, changes in your discharge, or if your menstrual irregularities worsen, it’s best to schedule an appointment sooner rather than later. A healthcare provider can perform a thorough evaluation, including a pelvic exam, and possibly order tests such as blood work or an ultrasound to assess your hormonal levels and reproductive health.

Conclusion
In summary, your symptoms of menstrual irregularities and concerns about vaginal discharge are valid and should be addressed with a healthcare provider. It’s essential to monitor your symptoms and seek medical advice, especially if you experience significant changes or discomfort. Early intervention can help manage any underlying conditions and improve your overall reproductive health. Remember, you are not alone in this, and many women experience similar concerns. Seeking help is a proactive step towards understanding and managing your health.

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