Irregular Menstrual Cycles: Causes and Concerns

Menstruation has stopped and then reappeared?

Hello Doctor, I am the owner of this article: My menstrual period usually lasts 5 to 6 days (the first day starts with light flow, then increases, peaks on the third day, and gradually decreases, with the last one or two days being dark blood).
However, this time it lasted only about three days.
At first, when I wiped with toilet paper, it was brown, then it slowly turned pink, then dark red, and finally back to pink or a mixture of blood and discharge.
After that, there was not much blood.
Is this a normal menstrual period, or could it possibly be due to pregnancy (I have not taken a pregnancy test)? This menstrual period started about a day before the expected date (14 days after the peak of egg white discharge).

Answer: It should be a normal menstrual period, but it would be better to take a pregnancy test.

I originally thought my period had ended last night, and there was nothing in the morning when I went to the bathroom.
However, just now around 11 o'clock, I suddenly felt something coming out, and when I went to the bathroom, I found it was blood.
When I wiped with toilet paper, it was a pinkish-red color, and I used about two pieces of toilet paper.
Recently, I have been taking gastrointestinal medication, but I have finished it, and I have also been under a lot of stress and not sleeping well.
I am unsure if this has any effect, but is it normal for me to have no menstrual blood and then suddenly experience this? What could be the possible causes?

xuan, 10~19 year old female. Ask Date: 2017/03/31

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Typically, menstruation lasts for 5 to 6 days (starting with light flow that increases, peaking around the third day, then gradually decreasing, with the last one or two days featuring dark blood).
However, this time it lasted only about three days, starting with brown discharge when wiping with tissue, then gradually changing to pink, then deep red, and finally back to pink or a mixture of blood and discharge, after which there was little bleeding.
Is this a normal period, or could it be due to pregnancy (I have not taken a pregnancy test)? This period started about a day before the expected date (14 days after the peak of egg white cervical mucus).
Answer: It should be a normal period, but it would be better to take a pregnancy test just to be sure.
I initially thought my period had ended last night, and there was nothing when I went to the bathroom this morning.
However, around 11 AM, I suddenly felt something coming out, and when I went to the bathroom, I found blood.
Wiping with tissue revealed a pinkish-red color, and I used about two tissues.
Recently, I have been taking gastrointestinal medication, but I have finished it, and I’ve been under a lot of stress and not sleeping well.
I’m unsure if this has any effect.
Is it normal for bleeding to stop and then reappear like this? What could be the possible causes?
Answer: There are many factors that can influence menstruation.
As long as the changes are temporary and manageable, they are usually not a concern.
It’s best to observe and adjust as needed.
The main concern would be the possibility of pregnancy or an abnormal pregnancy, so taking a pregnancy test would be advisable.

Reply Date: 2017/03/31

More Info

Understanding irregular menstrual cycles can be complex, as they can be influenced by a variety of factors, including hormonal changes, stress, lifestyle, and underlying health conditions. Based on your description, it seems that your menstrual cycle has deviated from your usual pattern, which can understandably cause concern.

Typically, a normal menstrual cycle lasts between 21 to 35 days, with bleeding lasting anywhere from 2 to 7 days. The flow can vary in color and consistency, often starting with a lighter flow that becomes heavier and then tapers off. The changes you’ve described—starting with brown spotting, transitioning to pink and then red—can be part of a normal menstrual cycle. However, the fact that your period was shorter than usual and that you experienced some unexpected bleeding after it seemed to have stopped warrants further consideration.

There are several potential causes for irregular menstrual cycles and the symptoms you are experiencing:
1. Hormonal Fluctuations: Hormones such as estrogen and progesterone regulate your menstrual cycle. Any imbalance—due to stress, changes in weight, or other factors—can lead to irregularities. Stress, in particular, can significantly impact your cycle by affecting the hypothalamus, which regulates hormonal signals.

2. Pregnancy: While you mentioned that you have not taken a pregnancy test, it’s worth noting that some women experience light bleeding or spotting in early pregnancy, often referred to as implantation bleeding. If there’s any chance of pregnancy, it would be prudent to take a test for confirmation.

3. Medications: You mentioned taking gastrointestinal medications. Some medications can influence menstrual cycles, either by affecting hormone levels or through other mechanisms. If you have recently started or stopped any medications, this could be a contributing factor.

4. Lifestyle Factors: Changes in sleep patterns, diet, and exercise can all impact your menstrual cycle. Stress and lack of sleep, as you noted, can lead to irregularities.
5. Underlying Health Conditions: Conditions such as polycystic ovary syndrome (PCOS), thyroid disorders, or uterine fibroids can also cause irregular bleeding. If your irregular cycles persist, it may be worth discussing these possibilities with a healthcare provider.

Given your symptoms, it is advisable to monitor your cycle closely over the next few months. If you continue to experience irregularities, or if you have other concerning symptoms (such as severe pain, heavy bleeding, or significant changes in your cycle), it would be wise to consult with a healthcare professional. They may recommend tests such as blood work to check hormone levels or imaging studies to assess the reproductive organs.

In summary, while some irregularities can be normal, especially in the context of stress and lifestyle changes, persistent or concerning symptoms should not be ignored. Taking a pregnancy test could provide clarity, and consulting with a healthcare provider can help rule out any underlying issues and provide peace of mind.

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