Abnormal Bleeding: Causes and Concerns in Women's Health

Abnormal bleeding

My menstrual cycle has been regular for the past few months, usually starting between the 4th and 13th.
However, last month it started on March 13th, and I typically have my period for about 4.5 days, but this time it lasted for 7 days.
After that, it stopped on March 19th, but then it returned on March 26th.
I consulted a doctor who said it was ovulation bleeding and prescribed a medication called Yisde.
It stopped by March 31st, but I still experienced some intermittent bleeding.
Then, on April 4th, my period returned, but the flow was light.
By April 8th, the flow increased, and I experienced significant menstrual cramps.
My mother made me a traditional herbal remedy, Si Wu Tang, which caused my abdomen to suddenly bloat, along with the cramps.
I also drank brown sugar water at home.
The next day, I woke up to a very heavy flow.
I would like to know if this irregularity is due to an abnormal lifestyle or if there might be an underlying issue with my uterus.
I also had sexual intercourse on March 17th, March 26th, April 2nd, and April 6th, with ejaculation occurring most of the time.

Yu, 10~19 year old female. Ask Date: 2017/04/11

Dr. Huang Jianzhong reply Obstetrics and Gynecology

A few months ago, my menstrual cycle was very regular, usually occurring between the 4th and 13th of each month.
However, last month, my period started on March 13th, and I typically finish within 4 to 5 days, but this time it lasted for 7 days.
It finally ended on March 19th, but then I got my period again on March 26th.
I consulted a doctor who said it was ovulation bleeding and prescribed a medication called Estradiol Valerate.
My period ended on the 31st, but I still experienced intermittent bleeding.
Then, on April 4th, my period returned, but the flow was light.
By April 8th, the flow increased, and I experienced significant menstrual cramps.
My mother made me a traditional herbal remedy, but my abdomen suddenly became very bloated along with the cramps.
I drank brown sugar water at home, and the next day I woke up to a very heavy flow.
I am wondering if this irregularity is due to an abnormal lifestyle or if there is an underlying condition affecting my uterus.
I had sexual intercourse on March 17th, March 26th, April 2nd, and April 6th, with most being unprotected ejaculation.
Regarding the medication, Estradiol Valerate is a natural estrogen ester secreted by the ovaries, specifically 17β-estradiol.
When used for physiological purposes, long-term use does not carry the risk of thrombosis associated with synthetic estrogens.
Estradiol Valerate can induce secondary sexual characteristics in women and maintain female reproductive functions, such as thickening and increasing the development of blood vessels and endometrial glands.
It is used for hormone replacement therapy in women with infertility, promoting the growth of vaginal mucosal tissue, treating vaginal atrophy, dryness, itching, vaginitis, and estrogen deficiency due to ovarian removal or dysfunction.
In terms of physiological metabolism, it promotes bone deposition and reduces bone loss, treating postmenopausal osteoporosis.
Additionally, Estradiol Valerate promotes lipoprotein and cholesterol metabolism in the liver, preventing atherosclerosis and coronary artery disease.
Therefore, it is recommended to first take a pregnancy test, followed by blood tests for hormone levels and an ultrasound examination.
If everything is normal, a menstrual regulation medication may be prescribed.

Reply Date: 2017/04/11

More Info

Abnormal bleeding can be a significant concern for many women, as it can indicate underlying health issues or hormonal imbalances. Based on your description, it seems you have been experiencing irregular menstrual cycles, including prolonged bleeding and intermittent spotting. Let's break down the potential causes and concerns associated with your symptoms.

Understanding Your Symptoms
1. Irregular Menstrual Cycles: You mentioned that your periods were typically regular but have recently become erratic, with variations in duration and flow. This can be attributed to several factors, including stress, hormonal fluctuations, lifestyle changes, and even dietary habits.

2. Ovulation Bleeding: Your doctor suggested that the bleeding you experienced could be ovulation bleeding, which is a common occurrence for some women. This type of bleeding happens when the ovary releases an egg, and it can cause a slight drop in estrogen levels, leading to light spotting. While this is generally harmless, it can be confusing, especially if it occurs frequently.

3. Hormonal Imbalances: Fluctuations in hormones, particularly estrogen and progesterone, can lead to irregular bleeding. Factors such as stress, significant weight changes, and lifestyle habits (like irregular sleep patterns) can disrupt hormonal balance. Given that you mentioned changes in your sleep schedule and stress levels, these could be contributing factors.

4. Potential Infections or Conditions: Although your doctor has ruled out significant issues through examinations, it's essential to consider that conditions like polycystic ovary syndrome (PCOS), fibroids, or endometriosis can also cause abnormal bleeding. These conditions can lead to heavier periods, prolonged bleeding, and pain.

5. Impact of Medications: You mentioned taking a medication called "益斯得" (likely a hormonal treatment). Hormonal medications can sometimes lead to irregular bleeding as your body adjusts to the new hormone levels. It's crucial to monitor how your body responds to any medication and communicate any ongoing issues with your healthcare provider.

Recommendations
1. Keep a Detailed Record: Document your menstrual cycle, including the start and end dates, flow intensity, any spotting, and associated symptoms (like pain or mood changes). This information can help your healthcare provider identify patterns and potential issues.

2. Consult a Specialist: If your symptoms persist or worsen, consider seeking a second opinion from a gynecologist or a reproductive endocrinologist. They may recommend further testing, such as blood tests to check hormone levels, ultrasounds to examine the ovaries and uterus, or even a hysteroscopy if necessary.

3. Lifestyle Adjustments: Focus on maintaining a balanced lifestyle. Regular exercise, a healthy diet, and adequate sleep can help regulate your menstrual cycle. Stress management techniques, such as yoga or meditation, may also be beneficial.

4. Discuss Sexual Health: Since you mentioned having multiple sexual encounters, it's essential to discuss your sexual health openly with your doctor. They may recommend STI testing or other evaluations to rule out infections that could contribute to abnormal bleeding.

5. Follow-Up: Regular follow-ups with your healthcare provider are crucial, especially if you continue to experience irregular bleeding. They can adjust your treatment plan based on your evolving symptoms and health status.

Conclusion
Abnormal bleeding can be distressing, but understanding the potential causes and seeking appropriate medical advice can help you manage your symptoms effectively. It's essential to communicate openly with your healthcare provider about your concerns and any changes in your health. By taking proactive steps, you can work towards achieving a more regular menstrual cycle and overall reproductive health.

Similar Q&A

Understanding Abnormal Vaginal Bleeding: Causes and Solutions

I would like to ask about recent abnormal bleeding, which is not related to stress, and I am unsure of the cause. I previously had a Pap smear that showed no issues. Recently, I have been trying to lose weight and have developed a habit of jogging. Could this be the reason for my...

Dr. Yang Wangjun reply Obstetrics and Gynecology
Hello: When experiencing abnormal vaginal bleeding, the first step is to rule out bleeding caused by pregnancy. Next, a pelvic examination and ultrasound should be performed to check for any organic causes of bleeding, such as cervical polyps or lacerations. Most cases of abnorma...

Understanding Abnormal Post-Coital Bleeding: Causes and Solutions

Hello doctor, for the past six months, I have been experiencing slight spotting the day after intercourse, which lasts for about ten days, and then it stops until my next period. I have consulted a physician and undergone two Pap smears, pelvic examinations, and a colposcopy, all...

Dr. Wu Zongcheng reply Obstetrics and Gynecology
The causes of abnormal bleeding can be divided into two main categories: 1. Tumors: such as uterine fibroids, uterine polyps, and malignant uterine tumors. 2. Functional bleeding: such as endocrine disorders and poor uterine contractions caused by contraceptive devices. First, ...

Understanding Abnormal Bleeding: Causes and Concerns for Women

I am #145291. I later visited a doctor who suggested that it might be due to excessive stress. On April 13th or 14th, I noticed a slight increase in blood flow, but it was manageable with a panty liner; the bleeding was not heavy enough to require a sanitary pad, and there was al...

Dr. Lin Manying reply Obstetrics and Gynecology
Hello, Miss: Irregular lifestyle is a common cause of menstrual disorders, but if it persists for a period of time, it is recommended to visit a gynecologist for further examination. Hualien Hospital, Ministry of Health and Welfare, cares about your health.

Understanding Abnormal Vaginal Bleeding: Causes and Concerns

Hello Doctor, I am 155 cm tall and weigh 50 kg. I was previously diagnosed with polycystic ovary syndrome (PCOS), and I have excessive body hair and frequently experience acne, which appears on my chest and back. Although my menstrual cycle has been irregular over the past two ye...

Dr. Cao Guotao reply Obstetrics and Gynecology
You may consider taking birth control pills to regulate your menstrual cycle; you can consult your obstetrician-gynecologist about this. Wishing you good health.