Abnormal Bleeding: Possible Causes and When to Test for Pregnancy

Abnormal bleeding

I previously consulted a doctor, and this time I would like to ask in more detail.
From April 28 to 30, my boyfriend had unprotected intercourse, and he did not ejaculate.
My menstrual periods were from April 10 to April 15 and May 14 to May 18.
The flow during my periods in April and May was slightly lighter than usual.
On June 3, my boyfriend had unprotected penetration for about a minute.
It was somewhat painful, so we stopped.
After taking a break and going to the bathroom, I noticed a drop of bright red blood when I wiped.
The second wipe showed a darker brown color, but my underwear did not have any blood on it.
After that, there was no further bleeding when I wiped.
Could this be implantation bleeding or ovulation bleeding? On June 4, I felt some discomfort in my lower abdomen.
I saw a doctor on June 6, who performed a transvaginal ultrasound and said my endometrial lining was 14mm.
I was prescribed Provera tablets (5mg) to induce menstruation, but my period has not started yet.
Is there a possibility of pregnancy? Should I take a pregnancy test? When is the best time to test? When do you recommend taking the medication to induce menstruation?

Xiao Ru, 20~29 year old female. Ask Date: 2017/06/14

Dr. Huang Jianzhong reply Obstetrics and Gynecology

From April 28 to 30, my boyfriend had unprotected intercourse, and he did not ejaculate.
My menstrual period was from April 10 to April 15, and again from May 14 to May 18.
The menstrual flow in April and May was slightly lighter than usual.
On June 3, my boyfriend had unprotected penetration for about a minute, but it was painful, so he stopped.
After resting, I went to the bathroom and noticed a drop of bright red blood when I wiped.
The second time I wiped, it was a darker brown color, and my underwear did not have any blood on it.
After that, there was no more bleeding when I wiped.
Could this be implantation bleeding or ovulation bleeding? On June 4, I felt a dull ache in my lower abdomen.
I saw a doctor on June 6, who performed a vaginal ultrasound and said my endometrium was 14mm.
I was prescribed Provera tablets (5mg).

1.
My period has not come yet.

Answer: After finishing the 14 Provera tablets, wait 3-7 days for your period to arrive.

2.
Is there a possibility of pregnancy? Should I take a pregnancy test, and when?
Answer: If your period has not arrived after 14 days, then you should take a pregnancy test.

3.
When should I take the medication to induce my period?
Answer: Wait 14 days; if your period has not arrived and the pregnancy test is negative, you can take the medication.

You may need to seek knowledge about sexual health rather than medical advice.
For such questions, it is recommended to refer to the National Health Administration's "Sexual Happiness e-Learning" or the Society of Obstetrics and Gynecology's "Consultation Guide for Adolescents on Contraception" at http://goo.gl/dc6PfW.

Reply Date: 2017/06/14

More Info

Understanding abnormal bleeding during early pregnancy can be quite concerning, especially when combined with the uncertainty of potential pregnancy. Based on your timeline and symptoms, let's break down the possible causes of your bleeding and when you should consider testing for pregnancy.

Possible Causes of Abnormal Bleeding
1. Implantation Bleeding: This is light spotting that can occur when a fertilized egg attaches to the lining of the uterus, typically around 6 to 12 days after conception. Given your timeline, if you are indeed pregnant, the bleeding you experienced on June 3rd could potentially be implantation bleeding. However, this is usually very light and short-lived.

2. Ovulation Bleeding: Some women experience light spotting during ovulation, which occurs about midway through their menstrual cycle. This can happen around the time you had unprotected intercourse. The timing of your bleeding could suggest this as a possibility, especially if it was light and did not last long.

3. Menstrual Cycle Variations: It is also possible that the bleeding you experienced is related to your menstrual cycle. If your periods have been lighter than usual, this could be a normal variation.
4. Hormonal Changes: If you are experiencing hormonal fluctuations, this can also lead to abnormal bleeding. Stress, changes in weight, or other factors can influence your menstrual cycle.

5. Potential Pregnancy: If you have missed your period and have had unprotected intercourse, there is a possibility of pregnancy. The absence of your period, combined with any bleeding, warrants further investigation.

When to Test for Pregnancy
Given that you had unprotected intercourse on June 3rd and are experiencing symptoms that could indicate pregnancy, it would be advisable to take a home pregnancy test. The best time to test is after your expected period date, as this allows for the hormone hCG (human chorionic gonadotropin) to build up in your urine, providing a more accurate result. If your period does not arrive by the time you expect it, testing a few days after the missed period would be ideal.

Recommendations
1. Home Pregnancy Test: If your period does not arrive by the expected date, take a home pregnancy test. If the result is positive, schedule an appointment with your healthcare provider for further evaluation.

2. Monitoring Symptoms: Keep track of any additional symptoms you may experience, such as cramping, changes in bleeding patterns, or any other unusual signs. This information will be helpful for your healthcare provider.

3. Consult Your Doctor: Since you have already seen a doctor and were prescribed Provera, it is important to follow their guidance. If you suspect you might be pregnant, inform your doctor about your symptoms and any concerns regarding the use of Provera.

4. Avoid Self-Medication: Do not take any medications or supplements without consulting your healthcare provider, especially if you suspect you might be pregnant.

5. Follow-Up: If you experience heavy bleeding, severe pain, or any other concerning symptoms, seek medical attention immediately. These could be signs of complications that require prompt evaluation.

In conclusion, while the bleeding you experienced could be related to several factors, including potential pregnancy, it is essential to monitor your symptoms and consult with your healthcare provider for personalized advice and care.

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