Abnormal Bleeding: Causes and When to Seek Help - Obstetrics and Gynecology

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Abnormal bleeding can be a concerning issue for many women, and understanding its causes and when to seek medical help is crucial for maintaining reproductive health. Based on your description, it seems you have experienced a variety of bleeding patterns, including post-coital bleeding (bleeding after sexual intercourse) and intermenstrual bleeding (bleeding between periods).
First, let's explore some common causes of abnormal bleeding:
1. Hormonal Imbalances: Fluctuations in hormone levels can lead to irregular bleeding. Conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders can disrupt the normal menstrual cycle.

2. Ovulation Bleeding: Some women experience light spotting during ovulation, which can occur around the midpoint of their cycle. This is generally harmless but can be confusing if one is not aware of this phenomenon.

3. Infections: Pelvic inflammatory disease (PID), sexually transmitted infections (STIs), or other infections can cause inflammation and lead to abnormal bleeding. Your previous diagnosis of inflammation suggests this could be a relevant factor.

4. Uterine Fibroids or Polyps: These benign growths in the uterus can cause heavy or irregular bleeding. They are often discovered during pelvic examinations or ultrasounds.

5. Endometriosis: This condition occurs when tissue similar to the lining of the uterus grows outside of it, leading to pain and abnormal bleeding.

6. Cervical or Uterine Issues: Conditions affecting the cervix or uterus, such as cervical ectropion or endometrial hyperplasia, can also lead to abnormal bleeding.

7. Medications: Certain medications, especially hormonal contraceptives, can cause irregular bleeding as a side effect.

Given that you have already consulted with a gynecologist who diagnosed inflammation, it is essential to follow up if the bleeding persists or worsens. Here are some recommendations on when to seek further medical attention:
- Persistent Bleeding: If the abnormal bleeding continues for more than a few days or becomes heavier, it is important to return to your healthcare provider.

- Severe Pain: If you experience significant pain accompanying the bleeding, this could indicate a more serious issue that requires immediate evaluation.

- Changes in Menstrual Patterns: If you notice significant changes in your menstrual cycle, such as increased frequency, duration, or volume of bleeding, it is advisable to seek further evaluation.

- Other Symptoms: If you experience additional symptoms such as fever, chills, or unusual discharge, these could indicate an infection or other complications that need to be addressed.

In your case, since you mentioned that the bleeding has persisted for several days and has been associated with previous inflammation, it may be beneficial to undergo further testing. This could include a pelvic ultrasound to assess for any structural abnormalities or additional laboratory tests to rule out infections or hormonal imbalances.

Additionally, maintaining a healthy lifestyle, including a balanced diet, regular exercise, and managing stress, can help regulate menstrual cycles and improve overall reproductive health. If you are concerned about your symptoms or if they do not resolve, do not hesitate to seek a second opinion or further evaluation from a healthcare professional. Your health and peace of mind are paramount, and addressing these issues early can lead to better outcomes.