Abnormal Bleeding, Pregnancy Concerns, and Hormonal Issues

Abnormal bleeding, pregnancy, endocrine issues?

Hello Doctor: In the past, I experienced irregular periods and severe menstrual pain that required painkillers.
My menstrual cycle lasted 7 to 9 days.
Later, after taking herbal medicine to improve my health, I noticed some changes.
I’m not sure if it’s related to using tampons, but recently my period has shortened to 4 to 7 days, and the flow seems lighter.
However, a couple of days after my period ends, I notice some brown discharge (which I also had before using tampons, but it wasn’t as much).
Is this normal?
Additionally, my period started on December 4, 2016, and after it ended on December 10, I had sexual intercourse.
My boyfriend accidentally left some semen in the vagina, so on December 12, I took a less harmful emergency contraceptive pill.
On December 14, I suddenly experienced a quick flow of bright red blood that lasted for a day or two.
Could this be related to taking the emergency contraceptive?
Following that, I had sexual intercourse again on December 15 and January 4, 2017.
My menstrual cycle is usually regular, and I expected my period to start around January 4, but it’s now been over a week since then.
I took a pregnancy test on January 10, and it showed one line, indicating no pregnancy.
However, I’m worried that the test might be faulty and not detecting a pregnancy.
Should I wait another week to test again or go directly to a doctor to confirm if I’m pregnant?
Additionally, I’ve been experiencing frequent urination, and although I don’t feel excessively tired, I’ve been sleeping around 10 hours a night.
My appetite has increased, and I often feel hungry.
I usually have a lot of hormonal fluctuations and frequently experience inflammation, sometimes with white, yellow, or yellow-green discharge.
I also notice white, thick, and clumpy discharge (similar to mucus) when I have a bowel movement.
Given that I experience inflammation so often, should I undergo a detailed examination? Thank you, Doctor.

Niming, 20~29 year old female. Ask Date: 2017/01/12

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the factors that can affect the menstrual cycle or cause bleeding outside of menstruation are numerous, including age, environment, lifestyle, stress, emotional instability, weight changes, medications, emergency contraceptive pills, diet, uterine or cervical lesions, infections, pregnancy, and breastfeeding, among others.
The impact of emergency contraceptive pills on menstruation can vary; it may cause the period to come earlier or later, and its contraceptive effectiveness is not 100%.
It is advisable to consult a gynecologist if symptoms persist or worsen to check for hormonal imbalances or other causes.

Under normal circumstances, the amount of vaginal discharge varies by individual and changes throughout the menstrual cycle.
For instance, immediately after menstruation, the discharge is minimal and gradually increases.
During ovulation, the discharge becomes more abundant, characterized by a clear, stretchy, and elastic consistency with no odor.
After ovulation, the discharge decreases again but becomes thicker.
Leading up to menstruation, the discharge increases once more, often appearing slightly yellow or blood-tinged and may have a faint odor.
However, you should seek medical attention if you experience any of the following concerning symptoms:
1.
An abnormal increase in discharge that is uncomfortable or requires the use of panty liners.
2.
Changes in the color and consistency of the discharge that seem unusual.
3.
An unpleasant odor, as normal vaginal discharge is typically odorless; a foul smell may indicate a disruption in the vaginal environment and the presence of pathogens.
4.
Accompanying symptoms such as itching or burning in the vulva or vagina, lower abdominal pain, which may suggest vaginitis or pelvic inflammatory disease.
Wishing you peace and health,
Dr.
Zhang

Reply Date: 2017/01/12

More Info

Understanding abnormal bleeding, pregnancy concerns, and hormonal issues can be quite complex, especially when considering the various factors that can influence menstrual cycles and overall reproductive health. Based on your description, it seems you are experiencing a range of symptoms that may be related to hormonal fluctuations, potential pregnancy, and possibly underlying health issues.

Firstly, regarding your menstrual cycle changes, it is not uncommon for women to experience variations in their cycle length and flow. Factors such as stress, diet, exercise, and hormonal changes can all contribute to these variations. The fact that your periods have shortened to 4-7 days and the flow seems lighter could be a sign of hormonal adjustments, possibly influenced by your previous use of herbal remedies and tampons. The presence of brown discharge a few days after your period could indicate old blood that is taking longer to exit the body, which is generally considered normal.

Your concern about the bright red bleeding after taking emergency contraception (the "morning-after pill") is valid. Emergency contraceptive pills can cause changes in your menstrual cycle, including breakthrough bleeding or spotting. This bleeding can occur as a side effect of the hormonal changes induced by the medication and is typically not a cause for alarm unless it is excessively heavy or accompanied by severe pain.

Given that you have had unprotected intercourse and are experiencing symptoms that could suggest pregnancy (such as increased frequency of urination, changes in appetite, and fatigue), it would be prudent to conduct a follow-up pregnancy test. Home pregnancy tests are generally reliable, but testing too early can yield false negatives. If your period is significantly delayed beyond your expected date, or if you continue to have symptoms suggestive of pregnancy, it would be advisable to consult with a healthcare provider for a more definitive test, such as a blood test, which can detect pregnancy earlier and with greater accuracy.

Regarding your concerns about frequent infections and unusual discharge, it is important to pay attention to these symptoms. Frequent infections and changes in vaginal discharge can indicate an underlying issue, such as a bacterial or yeast infection, or even sexually transmitted infections (STIs). The presence of thick, colored discharge, especially if accompanied by itching or a strong odor, warrants a visit to a healthcare provider for evaluation and possible testing. A thorough examination can help identify any infections or hormonal imbalances that may be contributing to your symptoms.

In summary, here are some key points to consider:
1. Menstrual Changes: Variations in cycle length and flow can be normal but should be monitored, especially if accompanied by other symptoms.

2. Emergency Contraception Effects: Spotting or bleeding after taking emergency contraception is common and usually not a cause for concern unless it is heavy or painful.

3. Pregnancy Testing: If you suspect pregnancy, wait a few days after your missed period for the most accurate test results, or consult a healthcare provider for further evaluation.

4. Vaginal Health: Frequent infections and unusual discharge should be assessed by a healthcare provider to rule out infections or other health issues.

It is always best to consult with a healthcare professional who can provide personalized advice based on your medical history and current symptoms. They can guide you through the necessary tests and treatments to ensure your reproductive health is managed effectively.

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