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 are experiencing prolonged bleeding that started on July 16 and has continued until now, with the presence of dark red blood and blood clots. This situation warrants careful consideration and potentially further evaluation.


Causes of Abnormal Bleeding
1. Hormonal Imbalances: One of the most common causes of abnormal bleeding is hormonal imbalances. Conditions such as polycystic ovary syndrome (PCOS), thyroid disorders, or fluctuations in estrogen and progesterone levels can lead to irregular bleeding patterns. Stress, significant weight changes, and lifestyle factors can also contribute to these imbalances.

2. Ovulation Bleeding: Some women experience spotting during ovulation, which typically occurs around the midpoint of the menstrual cycle. This is usually light and short-lived, but it can sometimes be mistaken for abnormal bleeding.

3. Uterine Fibroids or Polyps: These benign growths in the uterus can cause heavy or prolonged bleeding. They may also lead to the passage of blood clots. While they are not cancerous, they can cause discomfort and other symptoms.

4. Infections: Pelvic inflammatory disease (PID) or other infections of the reproductive tract can lead to abnormal bleeding. Symptoms may include pain, fever, and unusual discharge.

5. Pregnancy-Related Issues: Although you mentioned that there was no internal ejaculation, it is still important to consider the possibility of pregnancy. Early pregnancy complications, such as ectopic pregnancy or miscarriage, can present with abnormal bleeding. A pregnancy test can help rule this out.

6. Medications: Certain medications, particularly hormonal contraceptives, can cause irregular bleeding. If you have recently started or changed any medications, this could be a contributing factor.

7. Other Medical Conditions: Conditions such as endometriosis, adenomyosis, or even more serious issues like endometrial hyperplasia or cancer can lead to abnormal bleeding. These conditions often require medical evaluation and treatment.


When to Seek Help
Given that your bleeding has persisted for an extended period and includes blood clots, it is advisable to seek medical attention if you experience any of the following:
- Prolonged Bleeding: If the bleeding lasts more than a week or is significantly heavier than your normal menstrual flow.

- Severe Pain: If you experience severe abdominal or pelvic pain accompanying the bleeding.

- Signs of Infection: Fever, chills, or unusual discharge may indicate an infection that requires treatment.

- Fatigue or Weakness: If you feel unusually tired or weak, this could be a sign of anemia due to blood loss.

- Changes in Symptoms: If the nature of the bleeding changes significantly, such as becoming heavier or more painful.


Conclusion
In your case, it is essential to consult with a healthcare provider to determine the underlying cause of your abnormal bleeding. They may recommend tests such as a pelvic ultrasound, blood tests, or a Pap smear to assess your reproductive health. Early intervention can help address any potential issues and provide peace of mind. Remember, it is always better to err on the side of caution when it comes to your health.